PT  - JOURNAL ARTICLE
AU  - Shuldiner, Jennifer
AU  - Shah, Huda
AU  - Bar-Ziv, Stacey
AU  - Mauti, Joe
AU  - Kaplan, David
AU  - Tradrous, Mina
AU  - Green, Michael E.
AU  - Bogoch, Isaac
AU  - Nowak, Dominik Alex
AU  - Mehta, Kavita
AU  - Desveaux, Laura
AU  - Marshall, Lydia-Joi
AU  - Ikura, Sophia
AU  - Taljaard, Monica
AU  - Hu, Jia
AU  - Vohra-Miller, Sabina
AU  - Presseau, Justin
AU  - Witteman, Holly
AU  - Lofters, Aisha
AU  - Kiran, Tara
AU  - Ivers, Noah
TI  - Practice Facilitation to Support Family Physicians in Encouraging COVID-19 Vaccine Uptake: A Multimethod Process Evaluation
AID  - 10.1370/afm.3041
DP  - 2023 Nov 01
TA  - The Annals of Family Medicine
PG  - 526--533
VI  - 21
IP  - 6
4099  - http://www.annfammed.org/content/21/6/526.short
4100  - http://www.annfammed.org/content/21/6/526.full
SO  - Ann Fam Med2023 Nov 01; 21
AB  - PURPOSE We offered a practice facilitation intervention to family physicians in Ontario, Canada, known to have large numbers of patients not yet vaccinated against coronavirus disease 2019 (COVID-19).METHODS We conducted a multimethod process evaluation embedded within a randomized controlled trial (clinical trial #NCT05099497). We collected descriptive statistics regarding engagement and qualitative interview data from family physicians and practice facilitators, as well as data from facilitator field notes. We analyzed and triangulated the data using thematic analysis and mapped barriers to and enablers for implementation to structural, organizational, physician, and patient factors.RESULTS Of the 300 approached, 90 family physicians (30%) accepted facilitation. Of these, 57% received technical support to identify unvaccinated patients, 29% used trained medical student volunteers to contact patients on their behalf, and 30% used automated calling to reach patients. Key factors affecting engagement with the intervention were staff shortages owing to COVID-19 (structural), clinic characteristics such as technical issues and gatekeeping by staff, which prevented facilitators from talking with physicians (organizational), burnout (physician), and specialized populations that required targeted resources (patient). The facilitator’s ability to address technical issues and connect family physicians with medical students helped with engagement.CONCLUSIONS Strategies to help underresourced family physicians serving high-needs populations for issues of public health importance, such as vaccine promotion, must acknowledge the scarcity of physicians’ time and provide new resources. To successfully engage family physicians, practice facilitators should seek to build trust and relationships over time, including with front-office staff.