| Popis: |
Background: When the COVID-19 vaccination program started in Saskatchewan, Canada, there was a need to understand what worked or did not work during the vaccination pilot phase that took place in Regina, Saskatoon, and Prince Albert to plan for improved vaccine uptake. This evaluation study had three objectives: a) to document the vaccination implementation plan in the three pilot sites; b) to understand how, for whom, in which circumstances, and why the plan led to vaccine uptake from the perspectives of eligible vaccine recipients; and c) to establish program theories that could be adapted to multiple settings. Methods: We conducted a patient-oriented realist evaluation of the Saskatchewan’s vaccination pilot phase that happened from December 2020 to March 2021. The study comprised of three iterative phases, including developing initial program theories (IPTs) by reviewing literature as well as Saskatchewan’s COVID-19 vaccination delivery plan (phase one), testing the IPTs by conducting interviews with vaccine recipients (phase two), and developing final program theories (PTs) by refining the IPTs (phase three). Three patient and family partners were fully engaged at each phase. A retroductive approach was used to analyze qualitative data. Results: Virtual interviews were performed with six participants representing each group of eligible vaccine recipients (ICU/ED physicians, nurses, and healthcare workers; long-term care [LTC] managers and healthcare workers; and family members and care givers of LTC residents on behalf of LTC residents). In the three final PTs, 12 contextual factors and 14 casual mechanisms resulted in an intermediate outcome of vaccine willingness or hesitancy which then led to vaccine uptake as an outcome of interest. Communication (e.g., social media, internal and external sources of communication) and trust (e.g., in leadership and medical professionals), were the most prominent contextual factor and causal mechanism, respectively. Conclusions: Our final program theories displayed the complexity and interconnectedness of contexts and mechanisms. Some mechanisms were activated for some participants, and not for others, depending on their circumstances which consequently affected vaccine uptake. These findings suggest the need for more tailored strategies to address vaccine recipients’ specific needs and conditions. |
