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Prokopovich K, Braunack-Mayer A, Street J, Stanoevska B, Pitts L, Phillipson L. Applying a Participatory Action Research Approach to Engage an Australian Culturally and Linguistically Diverse Community around Human Papillomavirus Vaccination: Lessons Learned. Vaccines (Basel) 2024; 12:978. [PMID: 39340010 PMCID: PMC11436009 DOI: 10.3390/vaccines12090978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/30/2024] Open
Abstract
Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR to engage priority migrant and CALD communities around school and HPV vaccination. To address this gap, we partnered with our local Multicultural Health Service to understand how the largest CALD group in our region of New South Wales, Australia, engages with their local school and HPV vaccination program. Through a long-standing PAR relationship, we used a participatory research method (World Café) approach to explore the level of awareness and engagement a multi-generational community member had concerning HPV vaccination. We acted by sharing a co-designed information website to answer the community's questions about HPV vaccination. We then evaluated these engagements with surveys, focus groups and online analytic platforms. Last, we reflected with project partners and health service stakeholders on the overall project outcomes and shared our learnings. In our discussion, we shared our lessons learned and contributed to a wider conversation about the benefits, challenges, and practicalities of using PAR to engage a priority CALD community around HPV vaccination.
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Affiliation(s)
- Kathleen Prokopovich
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
| | - Annette Braunack-Mayer
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
| | - Jackie Street
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Level 4, Rundle Mall Plaza, 50 Rundle Mall, Adelaide, SA 5000, Australia
| | - Biljana Stanoevska
- Multicultural and Refugee Health Service-Illawarra Shoalhaven Local Health District, 67 King St., Warrawong, NSW 2502, Australia
| | - Leissa Pitts
- Multicultural and Refugee Health Service-Illawarra Shoalhaven Local Health District, 67 King St., Warrawong, NSW 2502, Australia
| | - Lyn Phillipson
- Australian Centre for Health Engagement, Evidence and Values, Faculty of the Arts, Social Science and Humanities, University of Wollongong, Northfields Ave., Wollongong, NSW 2522, Australia
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Aya Pastrana N, Agudelo-Londoño S, Franco-Suarez O, Otero Machuca J, Guzman-Tordecilla DN, López Sánchez MC, Rodriguez-Patarroyo M, Rivera-Sánchez CA, Castro-Barbudo D, Trujillo AJ, Maniar V, Vecino-Ortiz AI. Improving COVID-19 vaccine uptake: a message co-design process for a national mHealth intervention in Colombia. Glob Health Action 2023; 16:2242670. [PMID: 37643136 PMCID: PMC10467523 DOI: 10.1080/16549716.2023.2242670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/23/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND COVID-19 vaccination is a global priority. Latin American countries have some of the highest COVID-19 death rates worldwide with vaccination hampered by a variety of reasons, including mis- and disinformation, vaccine hesitancy, and vaccine supply constraints. Addressing vaccine hesitancy through effective messages has been found to help increase vaccine uptake. Participatory processes could be used to co-design health messages for this purpose. OBJECTIVE This article describes the methodology used to co-design evidence-based audio messages to be deployed in a cohort of individuals through an interactive voice response (IVR) mobile phone survey intervention, aimed towards increasing vaccination uptake in an adult population in Colombia. METHODS Participants of the COVID-19 vaccination message co-design process included a sample of the general population of the country, representatives of the funder organisation, and research team members. The co-design process consisted of four phases: (1) formative quantitative and qualitative research, (2) message drafting based on the results of the formative research, (3) message content evaluation, and (4) evaluation of the voices to deliver the audio messages; and was informed by reflexive meetings. RESULTS Three categories of evidence-based audio messages were co-designed, each corresponding to an arm of the mHealth intervention: (1) factual messages, (2) narrative messages, and (3) mixed messages. An additional fourth arm with no message was proposed for control. The iterative co-design process ended with a total of 14 audio messages recorded to be deployed via the intervention. CONCLUSIONS Co-developing health messages in response to health emergencies is possible. Adopting more context-relevant, participatory, people-centred, and reflexive multidisciplinary approaches could help develop solutions that are more responsive to the needs of populations and public health priorities. Investing resources in message co-design is deemed to have a greater potential for influencing behaviours and improving health outcomes.
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Affiliation(s)
- Nathaly Aya Pastrana
- IMEK Centro de Investigación en Mercadeo & Desarrollo, Santiago de Cali, Colombia
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Oscar Franco-Suarez
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jessica Otero Machuca
- Instituto de Salud Pública, Pontificia Universidad Javeriana, Bogotá, Colombia
- Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | | | | | - Antonio J. Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Vidhi Maniar
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andres I. Vecino-Ortiz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Akwataghibe NN, Ogunsola EA, Popoola OA, Agbo AI, Dieleman MA. Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria. Health Res Policy Syst 2021; 19:88. [PMID: 34380510 PMCID: PMC8356382 DOI: 10.1186/s12961-021-00719-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2005, Nigeria adopted the Reaching Every Ward strategy to improve vaccination coverage for children 0-23 months of age. By 2015, Ogun state had full coverage (100%) in 12 of its 20 local government areas, but eight had pockets of unimmunized children, with the highest burden (37%) in Remo North. A participatory action research (PAR) approach was used to facilitate implementation of local solutions to contextual barriers to immunization in Remo North. This article assesses and seeks to explain the outcomes of the PAR implemented in Remo North to understand whether and possibly how it improved immunization utilization. METHODS The PAR intervention took place from 2016 to 2017. It involved two (4-month) cycles of dialogue and action between community members, frontline health workers and local government officials in two wards of Remo North, facilitated by the research team. The PAR was assessed using a pre/post-intervention-only design with mixed methods. These included household surveys of caregivers of 215 and 213 children, respectively, 25 semi-structured interviews with stakeholders involved in immunization service delivery and 16 focus group discussions with community members. Data were analysed using the Strategic Advisory Group of Experts (SAGE) vaccine hesitancy framework. RESULTS Collaboration among the three stakeholder groups enabled the development and implementation of solutions to identified problems related to access to and use of immunization services. At endline, assessment by card for children older than 9 months revealed a significant increase in those fully immunized, from 60.7% at baseline to 90.9% (p < .05). A significantly greater number of caregivers visited fixed government health facilities for routine immunization at endline (83.2%) than at baseline (54.2%) (p < .05). The reasons reported by caregivers for improved utilization of routine immunization services were increased community mobilization activities and improved responsiveness of the health workers. Spillover effects into maternal health services enhanced the use of immunization services by caregivers. Spontaneous scale-up of actions occurred across Remo North due to the involvement of local government officials. CONCLUSION The PAR approach achieved contextual solutions to problems identified by communities. Collection and integration of evidence into discussions/dialogues with stakeholders can lead to change. Leveraging existing structures and resources enhanced effectiveness.
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Affiliation(s)
- Ngozi N Akwataghibe
- Royal Tropical Institute, Amsterdam, The Netherlands. .,Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | | | | | | | - Marjolein A Dieleman
- Royal Tropical Institute, Amsterdam, The Netherlands.,Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Dadari I, Ssenyonjo J, Anga J. Effective vaccine management through social behavior change communication: Exploring solutions using a participatory action research approach in the Solomon Islands. Vaccine 2020; 38:6941-6953. [PMID: 32943266 DOI: 10.1016/j.vaccine.2020.08.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
Addressing vaccine management bottlenecks, including high vaccine wastage rates, has traditionally been addressed through health worker training and other didactic methods of technical assistance or support as required. It has been shown, though, that the high level of technical skills, expertise, and responsibility required in vaccine handling and management cannot be achieved by mere didactic learning. While gains have been made in vaccine management and handling with these approaches, there remain challenges of high vaccine wastage rates and poor vaccine management practices across the board. Interestingly, approaching vaccine management through social behavior change has not been documented. Through Participatory Action Research (PAR), which is increasingly being used in health sciences, we explore an attempt at strengthening vaccine management and thus reducing high vaccine wastage rates by working together with health workers to identify plausible, realistic solutions to vaccine management through social behavior change. Select health workers directly involved with the immunization program in the four major provinces of the Solomon Islands were identified purposively to use action media and come up with concepts and materials for social behavior change communication that will have an impact on effective vaccine management and reducing wastages. This is the first documented use of such methodology in addressing vaccine management issues.
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Affiliation(s)
- Ibrahim Dadari
- United Nations Children's Fund (UNICEF) Pacific, UN Joint Presence, ANZ Haus, P.O. Box 1786, Honiara, Solomon Islands; College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, Tampa, FL 33612, USA.
| | - Jude Ssenyonjo
- United Nations Children's Fund (UNICEF) Pacific, UN Joint Presence, ANZ Haus, P.O. Box 1786, Honiara, Solomon Islands; Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
| | - Jenniffer Anga
- Ministry of Health and Medical Services, Honiara, Chinatown, Solomon Islands.
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