Identifying and supporting vaccine champions in pediatric primary care: a qualitative interview study

Transl Behav Med. 2024 Oct 14:ibae054. doi: 10.1093/tbm/ibae054. Online ahead of print.

Abstract

Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were "part of the DNA" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being "insatiable in their quest for knowledge," champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them "go above and beyond" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates.

Keywords: champions; human papillomavirus; immunization; implementation science; primary health care; vaccine promotion.

Plain language summary

Clinical champions are healthcare professionals who seek to help their colleagues improve the quality of health services, including vaccinations. However, efforts to engage clinical champions are challenged by our limited understanding of these individuals. Thus, we interviewed 24 healthcare professionals from 8 healthcare systems in Wisconsin to explore who vaccine champions are, how they promote vaccination, and how healthcare systems can support them. Our interviewees described vaccine champions as healthcare professionals with direct patient care experience, whether as physicians or nurses, who demonstrated a strong dedication to vaccine promotion primarily through learning and sharing complex vaccine information and data. Having dedicated time was an important support for champions in their efforts to promote vaccination, with champions relying on their colleagues to participate in or assist with those efforts. Interviewees recommended identifying champions through nominations from their colleagues, rather than relying on vaccination rates alone. Healthcare systems may need to provide additional time and staff support to meaningfully engage champions and expand their involvement in other vaccine promotion strategies.