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Rahmadhan MAWP, Handayani PW. Integrated Immunization Information System in Indonesia: Prototype Design Using Quantitative and Qualitative Data. JMIR Form Res 2023; 7:e53132. [PMID: 38096005 PMCID: PMC10755663 DOI: 10.2196/53132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/03/2023] [Accepted: 11/24/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND As the volume of immunization records increases, problems with fragmented records arise, especially since the majority of records in developing countries, including Indonesia, remain paper based. Implementing an immunization information system (IIS) offers a solution to this problem. OBJECTIVE In this study, we designed an integrated IIS prototype in Indonesia using the design science research (DSR) methodology. METHODS The stages of the DSR methodology followed in this study included identifying problems and motivating and defining objectives for a solution, design and development, demonstration, evaluation, communication, and drawing conclusions and suggestions. Specifically, this study began with problem formulation and a literature review. We then applied quantitative (questionnaire with 305 members of the public) and qualitative (interviews with 15 health workers including nurses, midwives, and doctors) data collection approaches. RESULTS The resulting high-fidelity prototype follows the 8 golden rules. There are 2 IIS designs, one for the public as immunization recipients and another for health workers. The functionalities include immunization history, schedule, recommendations, verification, certificates, reminders and recalls, coverage, monitoring, news, and reports of adverse events. Evaluation of the prototype was carried out through interviews and a questionnaire designed according to the System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ). The SUS value was 72.5 or "Good (Acceptable)," while the system usefulness, information quality, interface quality, and overall value on the PSSUQ were 2.65, 2.94, 2.48, and 2.71, respectively, which indicate it has an effective design. CONCLUSIONS This provides a guide for health facilities, health regulators, and health application developers on how to implement an integrated IIS in Indonesia.
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Rahmadhan MAWP, Handayani PW. Challenges of vaccination information system implementation: A systematic literature review. Hum Vaccin Immunother 2023; 19:2257054. [PMID: 37747287 PMCID: PMC10619519 DOI: 10.1080/21645515.2023.2257054] [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: 07/24/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023] Open
Abstract
Globally, healthcare services have begun to show interest in switching from paper-based to electronic-based vaccination records through Vaccination Information Systems (VIS). VIS have been implemented in various countries, but the study on the challenges of implementing VIS in these countries is still limited. The challenges of implementing VIS need to be understood to become a subject of discussion and anticipation by other countries that are just starting to implement VIS. We analyzed 32 selected publications from 634 initially retrieved. Fourteen challenges were successfully identified when implementing VIS, including interoperability, data quality, security and privacy, standardization, usability, internet connectivity, infrastructure, workflow, funding, government regulations, awareness, skeptical response, computer literacy, and staff-related challenges. The challenges of interoperability and data quality were found to be the most widely discussed by previous studies. In addition to identifying the challenges, this study includes a series of solutions that can be applied to overcome each challenge.
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Fishman J, Mandell DS, Salmon MK, Candon M. Large and small financial incentives may motivate COVID-19 vaccination: A randomized, controlled survey experiment. PLoS One 2023; 18:e0282518. [PMID: 36930588 PMCID: PMC10022800 DOI: 10.1371/journal.pone.0282518] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Experts continue to debate how to increase COVID-19 vaccination rates. Some experts advocate for financial incentives. Others argue that financial incentives, especially large ones, will have counterproductive psychological effects, reducing the percent of people who want to vaccinate. Among a racially and ethnically diverse U.S. sample of lower income adults, for whom vaccine uptake has lagged compared with higher income adults, we empirically examine such claims about relatively large and small guaranteed cash payments. METHODS In 2021, we conducted a randomized, controlled experiment among U.S. residents with incomes below $80,000 who reported being unvaccinated against COVID-19. Study participants were randomized to one of four study arms. In two arms, respondents first learned about a policy proposal to pay $1,000 or $200 to those who received COVID-19 vaccination and were then asked if, given that policy, they would want to vaccinate. In the two other arms, respondents received either an educational message about this vaccine or received no vaccine information and were then asked if they wanted to vaccinate for COVID-19. The primary analyses estimated and compared the overall percentage in each study arm that reported wanting to vaccinate for COVID-19. In other analyses, we estimated and compared these percentages for subgroups of interest, including gender, race/ethnicity, and education. MAIN RESULTS Among 2,290 unvaccinated adults, 79.7% (95%CI, 76.4-83.0%) of those who learned about the proposed $1,000 payment wanted to get vaccinated, compared with 58.9% (95%CI, 54.8-63.0%) in the control condition without vaccine information, a difference of 20 percentage points. Among those who learned of the proposed $200 payment, 74.8% (95% CI, 71.3-78.4%) wanted to vaccinate. Among those who learned only about the safety and efficacy of COVID-19 vaccines, 68.9% (95% CI, 65.1-72.7%) wanted to vaccinate. Findings were consistent across various subgroups. DISCUSSION Despite several study limitations, the results do not support concerns that the financial incentive policies aimed to increase COVID-19 vaccination would have counterproductive effects. Instead, those who learned about a policy with a large or small financial incentive were more likely than those in the control condition to report that they would want to vaccinate. The positive effects extended to subgroups that have been less likely to vaccinate, including younger adults, those with less education, and racial and ethnic minorities. Financial incentives of $1,000 performed similarly to those offering only $200.
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Affiliation(s)
- Jessica Fishman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Message Effects Lab, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - David S. Mandell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Mandy K. Salmon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Molly Candon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Fishman J, Salmon MK, Scheitrum D, Aleks Schaefer K, Robertson CT. Comparative effectiveness of mandates and financial policies targeting COVID-19 vaccine hesitancy: A randomized, controlled survey experiment. Vaccine 2022; 40:7451-7459. [PMID: 35914961 PMCID: PMC9148933 DOI: 10.1016/j.vaccine.2022.05.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 01/28/2023]
Abstract
Experts debate whether COVID-19 vaccine mandates or financial incentives will reduce, rather than increase, interest in vaccination. Among 3,698 unvaccinated U.S. residents, we conducted a randomized, controlled survey-embedded experiment to estimate the absolute and relative psychological effects of vaccine policies specifying: mandates by employers or airlines, bars, and restaurants; lotteries for $1 million, $200,000, or $100,000; guaranteed cash for $1000, $200, or $100; and $1,000 as either a tax credit or penalty. Vaccine intention -the study outcome- predicts uptake and provides insight into the psychological mechanism that is most proximal to behavior (i.e., vaccination). Compared to controls, those who learned about the $1,000 cash reward policy were 17.1 (±5.3)% more likely to want vaccination. Employer mandates are more promising than other mandate policies (8.6 [+/- 7.4]% vs. 1.4 [+/- 6.0]%). The full results suggest that neither mandates nor financial incentives are likely to have counterproductive psychological effects. These policies are not mutually exclusive and, if implemented well, they may increase vaccine uptake.
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Affiliation(s)
- Jessica Fishman
- Message Effects Lab, Perelman School of Medicine & Annenberg School, University of Pennsylvania, Philadelphia, PA, United States,Corresponding author at: Director, Message Effects Lab, University of Pennsylvania, United States
| | - Mandy K. Salmon
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Scheitrum
- Department of Agricultural and Resource Economics, University of Arizona, Tucson, AZ, United States
| | - K. Aleks Schaefer
- Department of Agricultural Economics, Oklahoma State University, Stillwater, OK, United States
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Sardar T, Nadim SS, Rana S. Detection of multiple waves for COVID-19 and its optimal control through media awareness and vaccination: study based on some Indian states. NONLINEAR DYNAMICS 2022; 111:1903-1920. [PMID: 36246667 PMCID: PMC9540085 DOI: 10.1007/s11071-022-07887-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/11/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED COVID-19 is a highly infectious disease, and in very recent times, it has shown a massive impact throughout the globe. Several countries faced the COVID-19 infection waves multiple times. These later waves are more aggressive than the first wave and drastically impact social and economic factors. We developed a mechanistic model with imperfect lockdown effect, reinfection, transmission variability between symptomatic & asymptomatic, and media awareness to focus on the early detection of multiple waves and their control measures. Using daily COVID-19 cases data from six states of India, we estimated several important model parameters. Moreover, we estimated the home quarantine, community, and basic reproduction numbers. We developed an algorithm to carry out global sensitivity analysis (Sobol) of the parameters that influence the number of COVID-19 waves ( W C ) and the average number of COVID-19 cases in a wave ( A W ). We have identified some critical controlling parameters that mainly influenced W C and A W . Our study also revealed the best COVID-19 control strategy/strategies among vaccination, media awareness, and their combination using an optimal cost-effective study. The detailed analysis suggests that the severity of asymptomatic transmission is around 10% to 29% of that of symptomatic transmission in all six locations. About 1% to 4% of the total population under lockdown may contribute to new COVID-19 infection in all six locations. Optimal cost-effective analysis based on interventions, namely only vaccination (VA), only media awareness (ME), and a combination of vaccination & media (VA+ME), are projected for the period March 14, 2020, to August 31, 2021, for all the six locations. We have found that a large percentage of the population (26% to 45%) must be vaccinated from February 13 to August 31, 2021, to avert an optimal number of COVID-19 cases in these six locations. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11071-022-07887-5.
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Affiliation(s)
- Tridip Sardar
- Department of Mathematics, Dinabandhu Andrews College, Kolkata, India
| | - Sk Shahid Nadim
- Odum School of Ecology, University of Georgia, Athens, USA
- Department of Mathematics, Indian Institute of Technology, Roorkee, India
| | - Sourav Rana
- Department of Statistics, Visva-Bharati University, Santiniketan, West Bengal India
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Yawn BP, Loskutova NY, Merrill DD, Martinez S, Callen E, Cotton J, Carroll JK, Williams D. Health Care Professionals' Herpes Zoster Awareness and Vaccine Recommendations for Patients with COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2022; 9:562-575. [PMID: 36199223 PMCID: PMC9718579 DOI: 10.15326/jcopdf.2022.0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives The objective of this study was to assess health care professionals' (HCPs) knowledge of an increased herpes zoster (HZ) risk and burden for patients with chronic obstructive pulmonary disease (COPD), HCPs' familiarity with the Advisory Committee on Immunization Practices' (ACIP) HZ vaccine recommendations, and the HCPs' current adult vaccine practices. Another objective was to evaluate the impact of a short educational video on knowledge and future vaccine intent. Participants and Methods An online survey of family physicians (FPs), pulmonologists, nurse practitioners (NPs), and physician assistants (PAs) querying demographics, awareness of ACIP HZ vaccine recommendations, and HZ burdens and risks in patients with COPD and their current recommendations for HZ, influenza, and pneumococcal vaccines was conducted. For those not strongly recommending HZ vaccines concordant with ACIP recommendations, a 5-minute educational video was presented, and post video questions assessed future intended HZ vaccine recommendations. Results Among 1020 HCP responders, awareness and ACIP concordant HZ vaccine recommendations ranged from 59.0% to 95.2% across HCPs. Lowest recommendation rates were consistently reported by pulmonologists for the 2-dose HZ vaccine beginning at age 50; for the 2-dose vaccine use in those with prior 1-dose HZ vaccinations, and for those with prior HZ. Among all HCPs, HZ vaccine recommendations were lower than for pneumococcal and influenza vaccines. After viewing the educational video, reported vaccine recommendation intent increased significantly in all groups of HCPs, as did awareness of increased HZ risk among patients with COPD. Conclusions Significant educational opportunities exist for HCPs related to HZ and its vaccine prevention among patients with COPD which may be responsive to brief, targeted interventions.
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Affiliation(s)
- Barbara P. Yawn
- Department of Family and Community Health, University of Minnesota, Minneapolis, Minnesota, United States,COPD Foundation, Miami, Florida, United States,*Affiliation at the time the study was conducted
| | - Natalia Y. Loskutova
- American Academy of Family Physicians National Research Network, Leawood, Kansas, United States,*Affiliation at the time the study was conducted
| | | | | | - Elisabeth Callen
- American Academy of Family Physicians National Research Network, Leawood, Kansas, United States
| | | | - Jennifer K. Carroll
- American Academy of Family Physicians National Research Network, Leawood, Kansas, United States,Department of Family Medicine, University of Colorado, Aurora, Colorado, United States
| | - Dennis Williams
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, United States
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Mukandavire Z, Nyabadza F, Malunguza NJ, Cuadros DF, Shiri T, Musuka G. Quantifying early COVID-19 outbreak transmission in South Africa and exploring vaccine efficacy scenarios. PLoS One 2020; 15:e0236003. [PMID: 32706790 PMCID: PMC7380646 DOI: 10.1371/journal.pone.0236003] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/27/2020] [Indexed: 01/24/2023] Open
Abstract
The emergence and fast global spread of COVID-19 has presented one of the greatest public health challenges in modern times with no proven cure or vaccine. Africa is still early in this epidemic, therefore the extent of disease severity is not yet clear. We used a mathematical model to fit to the observed cases of COVID-19 in South Africa to estimate the basic reproductive number and critical vaccination coverage to control the disease for different hypothetical vaccine efficacy scenarios. We also estimated the percentage reduction in effective contacts due to the social distancing measures implemented. Early model estimates show that COVID-19 outbreak in South Africa had a basic reproductive number of 2.95 (95% credible interval [CrI] 2.83-3.33). A vaccine with 70% efficacy had the capacity to contain COVID-19 outbreak but at very higher vaccination coverage 94.44% (95% Crl 92.44-99.92%) with a vaccine of 100% efficacy requiring 66.10% (95% Crl 64.72-69.95%) coverage. Social distancing measures put in place have so far reduced the number of social contacts by 80.31% (95% Crl 79.76-80.85%). These findings suggest that a highly efficacious vaccine would have been required to contain COVID-19 in South Africa. Therefore, the current social distancing measures to reduce contacts will remain key in controlling the infection in the absence of vaccines and other therapeutics.
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Affiliation(s)
- Zindoga Mukandavire
- Centre for Data Science, Coventry University, Coventry, United Kingdom
- School of Computing, Electronics and Mathematics, Coventry University, Coventry, United Kingdom
| | - Farai Nyabadza
- Department of Mathematics and Applied Mathematics, University of Johannesburg, Johannesburg, South Africa
| | - Noble J. Malunguza
- Department of Insurance and Actuarial Science, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH, United States of America
- Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, OH, United States of America
| | - Tinevimbo Shiri
- Liverpool School of Tropical Medicine, Liverpool, England, United Kingdom
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