RT Journal Article
SR Electronic
T1 Practice Facilitation to Support Family Physicians in Encouraging COVID-19 Vaccine Uptake: A Multimethod Process Evaluation
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 526
OP 533
DO 10.1370/afm.3041
VO 21
IS 6
A1 Shuldiner, Jennifer
A1 Shah, Huda
A1 Bar-Ziv, Stacey
A1 Mauti, Joe
A1 Kaplan, David
A1 Tradrous, Mina
A1 Green, Michael E.
A1 Bogoch, Isaac
A1 Nowak, Dominik Alex
A1 Mehta, Kavita
A1 Desveaux, Laura
A1 Marshall, Lydia-Joi
A1 Ikura, Sophia
A1 Taljaard, Monica
A1 Hu, Jia
A1 Vohra-Miller, Sabina
A1 Presseau, Justin
A1 Witteman, Holly
A1 Lofters, Aisha
A1 Kiran, Tara
A1 Ivers, Noah
YR 2023
UL http://www.annfammed.org/content/21/6/526.abstract
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.