Health Services Research
HSR 4: National or Novel
Sarah E. Brewer, PhD MPA (she/her/hers)
University of Colorado School of Medicine
Aurora, Colorado, United States
Adolescents in rural communities have substantially lower vaccination rates than their urban and suburban counterparts. Engaging community stakeholders in translating medical evidence can help improve vaccine uptake. Successful implementation of interventions created with community stakeholders is key to their effectiveness in improving vaccine uptake.
To assess rural participants’ experiences of the community co-creation process and evaluate implementation of community co-created adolescent vaccination campaigns in 4 Colorado regions using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.
We used a qualitative approach to assess co-creation experiences as well as Reach, Adoption, Implementation and (anticipated) Maintenance for 4 community co-created adolescent vaccination campaigns. Effectiveness was not assessed in this evaluation but will be assessed in parent randomized trial. Data collection included semi-structured exit interviews with community members who partnered in campaign creation and interviews of community stakeholders who supported campaign distributions (“implementers”).
18 exit interviews and 15 (of 22 invited) semi-structured interviews with “implementers” were conducted in 2021. Table 1 shows community co-creator perceptions of the process in four themes: (1) Co-creation process was a positive overall experience; (2) Co-creation was a learning opportunity; (3) Pride in final products; (4) Hope and anxiety about community impact. Table 2 shows findings by RE-AIM domain. Reach was perceived as high, and many implementers were able to report metrics on their efforts. Most implementers agreed to adopt the campaigns. Reasons for adoption included the local relevance of the creation and materials. COVID and lack of infrastructure hindered some adoption and implementation efforts. Implementation: Implementers reported using the materials both according to community plans and adapting them to their current perceived needs. Intended Maintenance: Most implementers reported intention to continue using the co-created materials in the short term and some requested materials for future use.
Co-creating materials was a positive experience for rural community members. Overall implementation of the co-created materials was successful; and could be further improved. Future work should assess effectiveness of such materials to improve rural adolescent vaccination rates in a randomized-controlled trial using vaccination registry data.