Acceptance and use of the Information System of the National Immunization Program.
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ABSTRACT:
SUBMITTER: Oliveira VC
PROVIDER: S-EPMC7304980 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Publications
Acceptance and use of the Information System of the National Immunization Program.
Oliveira Valéria Conceição de VC Guimarães Eliete Albano de Azevedo EAA Amaral Gabriela Gonçalves GG Silva Talita Ingrid Magalhães TIM Fabriz Luciana Aparecida LA Pinto Ione Carvalho IC
Revista latino-americana de enfermagem 20200619
<h4>Objective</h4>to analyze the acceptance and use of the Information System of the National Immunization Program in primary health care vaccination rooms.<h4>Method</h4>a unique case study of a qualitative approach in the light of the Unified Theory of Acceptance and Use of Technology. Data collection included an interview with 18 professionals responsible for the implementation of the information system, observation of vaccination rooms in 12 municipalities of the West Macro-region of Minas G ...[more]
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Project description:BackgroundThe National Immunization Program Information System (SIPNI - Sistema de Informação do Programa Nacional de Imunização) in Brazil is a technological innovation management tool that enhances the performance of managers and health professionals in the evaluation and monitoring of immunization activities. In the country, the decentralization of the System is at an advanced stage, but it still faces challenges regarding its operation and use, impacting on its results. This study aims to evaluate the deployment of SIPNI in the state of Minas Gerais, in 2017.MethodCross-section study performed in Primary Healthcare vaccination rooms in 54 municipalities in the Brazilian state of Minas Gerais, in 2017. A multidimensional questionnaire was used with nursing professionals who work in vaccination rooms, containing questions about the structure (presence of an internet-connected computer, instruction manual, software version, IT professional for technical support, trained healthcare professional, use of communication channels to obtain system information) and the process (activities performed by the staff to operate the immunization information system) of their work. Those questions refer to the components of the information system: system management, immunized-patient records, and Movement of Immunobiological. Implementation Degree (ID) was defined by a score system with different weights for each criterion, according to the importance level observed in it, with a rating of: adequate, partially adequate, inadequate and critically inadequate. For data analysis, median was used as the summary measure, and Pearson's Chi-Squared Test was used for proportion comparison.ResultsMunicipal SIPNI is not adequately implemented and that results mainly from the actions performed in health service units, indicating problems in the use of technology by professionals working in vaccination rooms. The structure was better evaluated than the process, presenting IDs of 70.9 and 59.5%, respectively. Insufficient internet access, inadequate use of communication channels, and lack of professional qualification were some of the identified structural issues. "Movement of Immunobiological" was the best-ranked component (ID = 68.5%), followed by "immunized patient records" (ID = 59.3%) and "SIPNI management" (ID = 50.7%). Partial performance of SIPNI is independent of population size in the municipality and of FSH coverage.ConclusionsSIPNI is still an underutilized technological innovation. There are challenges that must be overcome, such as implementation of the final web version, internet connectivity, and capabilities aimed at the use of information generated by technology. Nevertheless, perspectives regarding SIPNI are positive, with functionalities to optimize activities in vaccination rooms.
| S-EPMC7171780 | biostudies-literature
Project description:BACKGROUND:One way to optimize the adoption and use of technological innovations is to understand how those involved perceive, assess and decide to use them. This study aims to analyze the attributes that influence the adoption and use of the Brazilian National Immunization Program Information System (NIPIS) from the perspective of vaccination room workers. METHODS:This is a mixed method research, and a quantitative cross-sectional analytical study, with concomitant triangulation of data, carried out in a region of Brazil by using the Diffusion of Innovation Theory. We used a questionnaire with 183 nursing professionals who work at vaccination rooms in 12 municipalities. To test the research model, partial least squares structural equation modeling (PLS-SEM) and SmartPLS 2.3.0 have been applied to estimate the model. The qualitative research had a descriptive-exploratory character, using interviews (n?=?18) analyzed through thematic analysis. RESULTS:The model proposed showed a mean correlation between the perceived attributes in the adoption and use of NIPIS. The results of the multiple regression indicated that the attributes "relative advantage" and "image" have a significant effect at 5% level (T?>?1.97), positively influence the adoption and use of NIPIS; the attribute "voluntary use" negatively influences the adoption and use of the system; the attributes "experimentation", "compatibility", "profitability", and "ease of use" did not influence the adoption and use of NIPIS. Emphasis has been placed on aspects that weaken the adoption and use of NIPIS such as lack of good quality internet and resistance to use the technology by some professionals. Workers perceive the importance of NIPIS for the municipality and point out that technological innovation provides data at an individual level, inserted in real time, which makes it possible to assess vaccination coverage. Lack of an unstable internet compromises data release due to system slowness. CONCLUSIONS:The mixed method allowed an in-depth analysis of the adoption and use of NIPIS in the Western Health Macroregion of Minas Gerais State, and similarities were observed in the results. The attribute "relative advantage" is the one that most influences the adoption and use of NIPIS, which is the strongest predictor of innovation adoption rate.
| S-EPMC7433062 | biostudies-literature
Project description:IntroductionVaccine acceptance is a critical component of sustainable immunization programs, yet rates of vaccine hesitancy are rising. Increased access to misinformation through media and anti-vaccine advocacy is an important contributor to hesitancy in the United States and other high-income nations with robust immunization programs. Little is known about the content and effect of information sources on attitudes toward vaccination in settings with rapidly changing or unstable immunization programs.ObjectiveThe objective of this study was to explore knowledge and attitudes regarding vaccines and vaccine-preventable diseases among caregivers and immunization providers in Botswana, the Dominican Republic, and Greece and examine how access to information impacts reported vaccine acceptance.MethodsWe conducted 37 focus groups and 14 semi-structured interviews with 96 providers and 153 caregivers in Botswana, the Dominican Republic, and Greece. Focus groups were conducted in Setswana, English, Spanish, or Greek; digitally recorded; and transcribed. Transcripts were translated into English, coded in qualitative data analysis software (NVivo 10, QSR International, Melbourne, Australia), and analyzed for common themes.ResultsDominant themes in all three countries included identification of health care providers or medical literature as the primary source of vaccine information, yet participants reported insufficient communication about vaccines was available. Comments about level of trust in the health care system and government contrasted between sites, with the highest level of trust reported in Botswana but lower levels of trust in Greece.ConclusionsIn Botswana, the Dominican Republic, and Greece, participants expressed reliance on health care providers for information and demonstrated a need for more communication about vaccines. Trust in the government and health care system influenced vaccine acceptance differently in each country, demonstrating the need for country-specific data that focus on vaccine acceptance to fully understand which drivers can be leveraged to improve implementation of immunization programs.
| S-EPMC5542683 | biostudies-literature
Project description:Broad benefits of vaccination programs are well acknowledged but difficult to measure, especially when considering all vaccines included in a National Immunization Program (NIP). The aim was to conduct a cost-benefit analysis of the entire NIP in Spain, and an expanded NIP including four potential additional programs. A cost-benefit analysis was performed in Excel to assess the economic and health benefits (€) of vaccinating a single cohort of newborns over a lifetime horizon compared to no vaccination, from a societal perspective: firstly, according to the 2020 NIP in Spain (including 2021 recommendation for herpes zoster in 65-year-olds); and secondly, with an expanded NIP (adding rotavirus and meningococcal B in infants, and pertussis booster in adults aged >65 years and herpes zoster in all adults >50 years). The main inputs were taken from published literature and Spanish databases. Results were presented as a benefit-cost ratio (economic benefit per €1 invested). A cohort of 343,126 newborns were included in the analysis. The total investment needed to vaccinate the cohort throughout their lifetime, according to the 2020 NIP and the expanded NIP, was estimated at €168.5 million and €275.5 million, respectively. Potential economic benefits were €772.2 million and €803.0 million, respectively. The societal benefit-cost ratio was €4.58 and €2.91 per €1 invested, respectively. Even with the addition of new vaccination programs, the Spanish NIP yielded positive benefit-cost ratios from the societal perspective, demonstrating that NIPs spanning the full life course are an efficient public health measure.
| S-EPMC11340736 | biostudies-literature
Project description:today's standard quality control methods used to control the protein composition of inactivated influenza vaccines only take into account a few key reference components. They do not allow for thorough characterization of protein compositions. As a result, observation of unpredictable variations in major viral constituents and admixtures of cellular proteins within manufactured vaccines that may seriously influence the immunogenicity and safety of such vaccines has become a pressing issue in vaccinology. This study aims at testing a more sophisticated approach for analysis of inactivated split influenza vaccines licensed in the Russian Federation. The formulations under study are the most available on the market and are included in the Russian National Immunization Program. liquid chromatography with tandem mass spectrometry (LC-MS/MS) analysis, in combination with label-free protein quantitation via the intensity-based absolute-quantitation (iBAQ) algorithm, as well as a number of standard molecular analysis methods, such as sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), dynamic light scattering (DLS), and negative-stain transmission electron microscopy (TEM) were applied. the methods implemented were able to identify dozens of viral and host proteins and quantify their relative amounts within the final formulations of different commercially available inactivated split influenza vaccines. Investigation of molecular morphology of the vaccine preparations using TEM revealed typical rosettes of major surface proteins (hemagglutinin and neuraminidase). DLS was used to demonstrate a size distribution of the rosettes and to test the stability of vaccine preparations at increased temperatures. a holistic approach based on modern, highly productive analytical procedures was for the first time applied for a series of different commercially available inactivated split influenza vaccines licensed in Russia. The protocols probed may be suggested for the post-marketing quality control of vaccines. Comparison of different preparations revealed that the Ultrix® and Ultrix® Quadri vaccines produced by pharmaceutical plant FORT LLC and trivalent vaccine Vaxigrip® produced by pharmaceutical company Sanofi Pasteur have well-organized antigen rosettes, they contain fewer admixture quantities of host cell proteins, and demonstrate good correlation among mostly abundant viral proteins detected by different methods.
| S-EPMC7564049 | biostudies-literature
Project description:China's National Immunization Program has made remarkable achievements but does not include several important childhood vaccines that are readily available in the private market, such as pneumococcal conjugate vaccine (PCV), rotavirus vaccine, Haemophilus influenzae serotype b (Hib) vaccine, and varicella vaccine. We reviewed the literature to assess these four non-National Immunization Program vaccines in terms of their disease burdens, coverage, inequalities, and cost-effectiveness in China and aimed to recommend priorities for introducing them to the National Immunization Program. Based on our calculations using the available evidence, incorporating these vaccines into China's National Immunization Program in 2019 could have averted 11 761 deaths among children younger than 5 years, accounting for 10·29% of the total deaths in children younger than 5 years and reducing the mortality rate from 7·8 per 1000 to 7·0 per 1000. The review showed that 13-valent PCV (PCV13) had the lowest and most inequitable coverage but could prevent the highest number of deaths. In a budgetary analysis for the cohort of newborns in 2023, we estimated that the projected aggregate government costs were US$1954·92 million for PCV13, $1273·13 million for pentavalent rotavirus vaccine, $415·30 million for Hib vaccine, and $221·64 million for varicella vaccine. Our overall multicriteria decision analysis suggested the following priority order for introducing these four non-programme vaccines to the National Immunization Program to benefit the Chinese population: PCV13, rotavirus vaccine, Hib vaccine, and varicella vaccine.
| S-EPMC10695764 | biostudies-literature
Project description:Little is known about Immunization Information System (IIS) attitudes and experiences using Centralized IIS-based Reminder/Recall (CI-R/R), an effective approach to increasing immunization rates. To describe among IIS managers as it relates to CI-R/R: 1) past experiences and future plans conducting it; 2) attitudes and barriers, 3) IIS capabilities and polices that influence, and 4) factors that differentiate IIS who have and have not conducted CI-R/R. Electronic Surveys were sent to all IIS managers in July 2018 using a member listserve. Fifty-seven of 62 IIS programs contacted (92%) responded. The majority (61%) had ever conducted CI-R/R; 34% reported they were "very likely" to conduct CI-R/R within 6 months. The majority (64%) were in favor of CI-R/R. Barriers included lack of staff (78%), competing demands (76%), and cost (63%). Thirty percent reported receiving a ≥75% of immunization data via real-time electronic interfaces (HL7). Overall, 49% and 24% of jurisdictions had mandatory immunization reporting from private and public health entities for childhood and adult immunizations, respectively. Differences between IIS that ever and never performed CI-R/R, respectively, included: mandatory reporting from private and public entities for children (65% v 27%, p = 0.006), having a legal mandate for CI-R/R (50% v 19%, p = 0.02), less likely to prefer practice-based R/R to CI-R/R (68% v. 91%, p = 0.04), and not reporting having too many competing demands (29% v 67%, p = 0.007). Most IIS have conducted CI-R/R and have positive attitudes towards it. Given it effectiveness and low cost, efforts to sustain it should be considered.
| S-EPMC7808944 | biostudies-literature
Project description:Adequate and quality immunization coverage plays a key role in controlling the outbreaks of vaccine preventable diseases. Places where immunization coverage is low, vaccine preventable diseases contribute to worse health outcomes. This is especially true in Indian slum dwellings where 33.0% of the urban population live. The aim of the study was to explore the coverage, quality, and correlates of primary immunization under national immunization program among children aged 12-23 months, living in slums of Mumbai. A community based cross-sectional survey was conducted. Parents or caretakers of 550 eligible children aged 12-23 months were interviewed using a structured interview schedule. Regression analysis was used to detect correlates of full immunization coverage (children who received one dose each of BCG, measles, and three doses each of DPT, OPV, and HBV by his/her first birthday) and of quality immunization coverage (children who received primary vaccines at appropriate age and intervals as mentioned above and had filled immunization card). Out of total 550 children, 402 (73.1%), 131 (23.8%), and 17 (3.1%) were fully, partially, and unimmunized, respectively. Almost 86.0% children received quality immunization coverage. In the regression analysis, reminder for immunization services was found to be the single most significant correlate of full and quality immunization coverage. In this study, full immunization coverage was found to be below the expected level. This study also revealed that the awareness regarding the importance of adequate immunization was still lacking in the slum population. Emphasizing on reminders for immunization services, encouraging institutional deliveries, and scaling up use of postnatal care services may act as keys to improving the immunization coverage in Indian slums.
| S-EPMC6734516 | biostudies-literature
Project description:BackgroundVaccination coverage is widely used to assess immunization performance but, on its own, provides insufficient information to drive improvements. Assessing the performance of underlying components of immunization systems is less clear, with several monitoring and evaluation (M&E) resources available for use in different operational settings and for different purposes. We studied these resources to understand how immunization system performance is measured.MethodsWe reviewed peer-reviewed and gray literature published since 2000 to identify M&E resources that include national-level indicators measuring the performance of immunization systems or their components (governance, financing, regulation, information systems, vaccine logistics, workforce, service delivery, and demand generation). We summarize indicators by the system components or outcomes measured and describe findings narratively.ResultsWe identified 20 resources to monitor immunization program objectives and guide national strategic decision-making, encompassing 631 distinct indicators. Indicators for immunization program outcomes comprised the majority (124/631 [19.7%]), largely vaccination coverage (110/124 [88.7%]). Almost all resources (19/20 [95%]) included indicators for vaccine logistics (83/631 [13.2%]), and those for regulation (19/631 [3.0%]) and demand generation (28/631 [4.4%]) were least common. There was heterogeneity in how information systems (92/563 [14.6%]) and workforce (47/631 [7.4%]) were assessed across resources. Indicators for vaccination coverage in adults, data use in decision-making, equity and diversity, effectiveness of safety surveillance, and availability of a public health workforce were notably lacking.ConclusionsBetween the resources identified in this review, we identified considerable variability and gaps in indicators assessing the performance of some immunization system components. Given the multitude of indicators, policymakers may be better served by tailoring evaluation resources to their specific context to gain useful insight into health system performance and improve data use in decision-making for immunization programs.
| S-EPMC10285727 | biostudies-literature
Project description:Xenograft models remain a cornerstone technology in the development of anti-cancer agents. The ability of immunocompromised rodents to support the growth of human tumors provides an invaluable transition between in vitro testing and clinical trials. Therefore, approaches to improve model selection are required. In this study, cDNA microarray data was generated for a collection of xenograft models at in vivo passages 1, 4 and 10 (P1, P4 and P10) along with originating cell lines (P0). These data can be mined to determine transcript expression 1) relative to other models 2) with successive in vivo passage and 3) during the in vitro (P0) to in vivo (P1) transition. For originating cell lines (P0) and xenograft fragments at P1, P4 and P10, RNA was isolated, cDNA transcribed and hybridized to Affymetrix HG-U133 Plus 2.0 arrays. P0 samples have 2-3 replicates, whereas P1, P4 and P10 samples have 5 replicates. This dataset comprises a total of 823 array files.
2013-07-01 | E-GEOD-48433 | biostudies-arrayexpress