背景:移动综合健康社区辅助医疗(MIH-CP)是一种新方法,可以减少美国城乡疫苗接种的差距。MIH-CP提供商,作为医生延伸者,在家庭和社区提供临床随访和环绕服务,将它们独特地定位为值得信赖的信使和疫苗提供者。本研究探讨了利益相关者对社区辅助医疗疫苗接种计划的可行性和可接受性的看法。
方法:我们与MIH-CP的辅助医疗机构领导人进行了半结构化定性访谈,没有MIH-CP,和印第安纳州的州/地区领导人。采访是录音,逐字转录,并使用内容分析进行分析。
结果:我们采访了24位代表EMS组织参加MIH-CP计划(MIH-CP;n=10)的个人,没有MIH-CP计划的EMS组织(非MIH-CP;n=9),和州/地区管理员(SRA;n=5)。总的来说,样本包括该领域平均19.6年的专业人员(范围:1-42年)。大约75%(n=14)是男性,全部被认定为非西班牙裔白人。MIH-CP报告说,他们启动了一项疫苗计划,以覆盖服务不足的地区,作为卫生部门的延伸。一些MIH-CP集成了现有服务,比如食物银行,疫苗诊所,而其他MIH-CP则专注于将疫苗接种作为独立计划提供。疫苗接种计划启动的主要障碍包括资金和疫苗接种是MIH-CP计划的低优先级。然而,参与者报告了对疫苗计划的支持,特别是它们为缓解健康差距和改善社区健康提供了机会。MIH-CPs报告说,当社区护理人员接种疫苗时,社区对疫苗的犹豫很低。如果有明确的指导,非CP机构表示有兴趣启动疫苗计划,可持续资金,和足够的人员。
结论:我们的研究提供了实施MIH-CP计划的可行性和可接受性的重要背景。研究结果提供了宝贵的见解,以减少通过社区护理人员接种疫苗时出现的健康差异,一种新颖和创新的方法来减少农村社区的健康差距。
BACKGROUND: Mobile Integrated Health-Community Paramedicine (MIH-CP) is a novel approach that may reduce the rural-urban disparity in vaccination uptake in the United States. MIH-CP providers, as physician extenders, offer clinical follow-up and wrap-around services in homes and communities, uniquely positioning them as trusted messengers and vaccine providers. This study explores stakeholder perspectives on feasibility and acceptability of community paramedicine vaccination programs.
METHODS: We conducted semi-structured qualitative interviews with leaders of paramedicine agencies with MIH-CP, without MIH-CP, and state/regional leaders in
Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis.
RESULTS: We interviewed 24 individuals who represented EMS organizations with MIH-CP programs (MIH-CP; n = 10), EMS organizations without MIH-CP programs (non-MIH-CP; n = 9), and state/regional administrators (SRA; n = 5). Overall, the sample included professionals with an average of 19.6 years in the field (range: 1-42 years). Approximately 75% (n = 14) were male, and all identified as non-Hispanic white. MIH-CPs reported they initiated a vaccine program to reach underserved areas, operating as a health department extension. Some MIH-CPs integrated existing services, such as food banks, with vaccine clinics, while other MIH-CPs focused on providing vaccinations as standalone initiatives. Key barriers to vaccination program initiation included funding and vaccinations being a low priority for MIH-CP programs. However, participants reported support for vaccine programs, particularly as they provided an opportunity to alleviate health disparities and improve community health. MIH-CPs reported low vaccine hesitancy in the community when community paramedics administered vaccines. Non-CP agencies expressed interest in launching vaccine programs if there is clear guidance, sustainable funding, and adequate personnel.
CONCLUSIONS: Our study provides important context on the feasibility and acceptability of implementing an MIH-CP program. Findings offer valuable insights into reducing health disparities seen in vaccine uptake through community paramedics, a novel and innovative approach to reduce health disparities in rural communities.