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The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand

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Authors:
Summary:

This intervention study recruited 10 general practices with low immunisation coverage rates and a high percentage of the enrolled population being of Māori ethnicity. The study aim was to translate best practices from high performing general practices into strategies to improve childhood immunisation coverage in these low performing practices. The 6 intervention groups received customised action plans and support for a 12-month period; 4 control groups received ‘business as usual’ support. Key informants from all participating practices took part in structured interviews that explored current aspects related to childhood immunisation delivery. Surveys were conducted to understand how the intervention worked. Thematic analysis of the interview data revealed two positive aspects of childhood immunisation delivery: high prioritisation at the practice and staff who were pro-immunisation and knowledgeable. Key challenges cited by participants included inaccurate family contact information and discrepancies with referral processes to other providers. Other challenges included building rapport with families and vaccine hesitancy. The action plans included various strategies aimed to improve processes at the practice, contact and engagement with parents, and partnership development with local service providers. Comment: I wish more people took notice of the hard work that

Comment:
I wish more people took notice of the hard work that goes in to achieving 95% immunisation rates. The clinical champions (i.e. NURSES) that engage and have the critical conversations with whānau in my experience, and as described here, achieve results. The nurses in my quintile 5 practice achieved all targets this last quarter. However, media, and some of my colleagues, won’t talk with us but instead seek the views of individual grand-standers. In my opinion, attending anti-vax events and calling for benefits to be cut not only requires less effort but appears to be counterproductive.
Reference: BMC Nurs. 2017;16:31
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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