week 5 .0

Implementation of Literature Research and Design Sampling to Vaccines

Running head: VACCINATIONS

Running head: VACCINATIONS

Implementation of Literature Research and Design Sampling to Vaccines

In this section of the paper, the author will continue to delve into the evidence-based proposal project. The author will discuss ten single study research articles related to the topic of vaccines. The author will then identify the quantitative approach and discuss the selected design further. The author will then discuss the target population and how the research will be gathered. The PDSA Change Model will be described in great detail along with how it is applicable to the research.

Research Literature Support

In this section, the author will disseminate research studies consistent with the childhood vaccination topic. For healthy children 2 months and older (P), how does parental education about vaccines (I) compared to no supplemental education about vaccines (C) increase the number of vaccinated children (O) in a six-week time period (T)? We will explore this PICOT question and find support from previous studies.

Jin et al. (2018) published a study that aimed to review the immunization status of cochlear implant recipients, assess if adding a vaccine specialist made a change in vaccine compliance, and elucidate any barriers to vaccine compliance. This study implemented the quantitative approach. Chart review and a telephone survey were used to obtain vaccination status and collect data. The results were that ninety-eight percent of children were vaccinated before surgery as opposed to sixty-seven percent prior to the vaccine specialist consultation. A strength of this study was the inclusion of one hundred and sixteen children. One limitation of this study was the fact that data was collected via a telephone survey. The parents could have been dishonest about whether their child was vaccinated or not.

Kaufman et al. (2017) conducted a study that aimed to define different ways to communicate interventions for routine vaccinations and integrate them into a hierarchy of vaccination communication. The quantitative approach was used. Through a targeted literature search, primary fieldwork observation, and consultations with stakeholders data was collected including inclusion and exclusion criteria. The results of the study were the creation of a hierarchy that is categorized by purpose and outlines communication interventions to address gaps in vaccination education. A strength of the study was that data was collected globally during the literature search. The interventions suggested have not been reviewed for accuracy, therefore, the hierarchy could show gaps in evidence.

Weidemann et al. (2017) set out to create a mathematical transmission model to examine differences in childhood vaccination efficacy. Transmission modeling was developed in order to estimate the influenza epidemic using population counts, contact patterns, and influenza history. They found that the influenza vaccine had the potential to reduce influenza rates in Germany, but not at the rate they had hoped. The quantitative approach was applied. One limitation is that in their study they modeled vaccines being given before influenza season began when in reality people often get vaccines later in the season. This could have altered the replication of the data. The model’s stratification approach did allow for seasonal heterogeneity during influenza season transmission.

Lasseter, Al-Janabi, Trotter, Carroll, & Christensen (2018) surveyed people in the United Kingdom to help inform policy-making decisions regarding vaccines. They implemented a qualitative design utilizing face-to-face interviews and analyzed using a thematic framework approach. They concluded through surveying that some of the population has separate views than the health-maximization approach for assessing benefits. The sampling method was flawed because although 504 people were invited to participate in the interview, there were only 21 surveyed. This is a relatively small sample size, which is a weakness. Strength was that although the sample size was small, they all had varying opinions on vaccines, which can help generalize results.

Bao et al. (2018) set out to review how Rwanda has achieved a ninety-eight percent vaccination rate, nearly exclusively vaccinated. Two avenues of research were studied both primary and secondary sources. They interviewed residents of Rwanda and conducted interviews with government officials and those responsible for the vaccine programs. The secondary sources consisted of databases and peer-reviewed literature. The results of the study concluded that Rwanda used several components to achieve their vaccination success. Some of these include political will, multilevel accountability and effective use of funding. A strength of the study was that they used primary and secondary sources in order to gather data. One limitation is that with qualitative studies there is no result verification. The answers to the survey are taken at face value and could have been altered.

Mayer, Frontino, Melissen, Yu & PatelShori (2018) set out to determine what factors influence a parent to bring a child in the community to receive influenza vaccination using the qualitative approach. This was a cross-sectional exploratory survey. Data was collected from 349 participants in three separate grocery store chains. They found that a swift vaccination without an appointment were important factors in their decision to vaccinate. One strength of the study was the large sample size considering shoppers were chosen at random. One limitation was the random selection of shoppers. These shoppers could have been regulars at the store and knew the staff, which led them to feel more comfortable which could have swayed the results of the study for or against the researchers.

SarveshKumar & Brundha (2018) wanted to create awareness about vaccination for parents with children under fifteen. The quantitative approach was implemented. Parents were given a questionnaire that contained fourteen closed-ended questions to answer. SPSS software analyzed the answers and organized them into tables. They found that there was a lack of awareness between parents about childhood vaccination, which calls for further research. One limitation is that self-reported vaccination status is a sensitive measure of vaccination. Strength in the study is that the sample size was representative of the population.

Oku et al. (2017) explored factors affecting vaccination communication in Nigeria. A qualitative approach was used to identify factors implementing communication interventions. Data was collected implementing the SURE framework to organize the identified factors. The study found that it is pertinent for policymakers to identify barriers and facilitators that influence the delivery of vaccination education. The researcher’s qualitative approach was positive in that it was flexible and they were able to go back to questions that needed clarification. One potential limitation is that polio was still active when everyone was surveyed and the focus was mainly on eliminating polio as opposed to the prevention of already eradicated disease.

After discovering that the vaccination rates in Tamil Nadu were fifty-six percent, Murkehar et al. (2017) set out to identify why these numbers were lower than previous rates. Cross-sectional surveys were conducted on over three thousand participants. The approach the researchers took was qualitative. Data were collected from the children’s mother or caretaker. The study found that eighty percent of children received their primary vaccinations. This was higher than the researchers were anticipating. They did identify a need to continue to increase vaccine compliance through education and supervision of the schedule. One limitation was that twenty percent of children did not have their vaccine record, so the data was extrapolated from the mother’s memory of which vaccines had been given. However, the study did determine that the mother’s sensitivity for recall was high.

Zamir & Israeli (2017) set out to learn about attitudes and knowledge about vaccinations among mothers in low immunization areas. The qualitative approach included focus groups and semi-structured interviews. This is a qualitative study as well that using focus groups and approached via telephone in private homes in the community. The results were that the parent’s vaccine knowledge was inefficient. There was no haste in when vaccines should be given, if at all. One limitation is that this study was conducted in an area that has relatively high fertility rates, which could be seen as a possible limitation. One positive is the inclusion of five different communities within the population.

Research Approach

Quantitative research is a form of research that implements rigorous control of the environment to definitively measure phenomena (Rutberg & Bouikidis, 2018). This is the most appropriate approach for this design because the author is attempting to compare two concrete measurements in a controlled environment. The qualitative method would be more appropriate if the author wanted to determine people’s feelings about vaccinations. For this PICOT question, the quasi-experimental approach is most appropriate. The quasi-experimental approach involves an intervention, but no control group. The author is comparing whether or not the intervention made a difference, and there will be no randomization (Rutberg & Bouikidis, 2018). One advantage to this design is a reduction in the amount of time and energy spent. For randomization, extensive pre-screening is required and since this approach does not implement that it saves time and resources. One disadvantage to this approach is that without randomization, non-equivalent test groups can limit the ability to generalize results and apply to the general population.

Sampling

For a confidence level of 95%, a sample size of 300 and a population of 500 at 50 percent, the confidence interval would be 3.58. The sample size should be about 300 people, which should be achievable. Inclusion criteria for this study are parents of children 2 months to sixteen years of age. Exclusion criteria are adults that are not parents or refuse to participate in the supplemental education. Having a child is essential to this research because the topic is childhood vaccinations.

In order to participate in a research study, participants want to know that their rights will be upheld. It is important to protect their confidentiality, anonymity, protection from harm and obtaining informed consent. It is pertinent that the data collected for the study is not shared with anyone that is not apart of the study. Participants will be anonymous because their information will not be recorded such as address and identifiable information. Their initials and age can identify the research participants. Informed consent requires that the participants are given facts about the study and if they agree they should sign a form. If the subject has any questions about the study they should be allowed to air their concerns. Protection from harm alludes to the fact that all participants in the study will act ethically and make sure no intentional harm is inflicted on the patients.

Proposed Implementation with Change Model

The PDSA model is known as the plan, do, study, act model. This cycle is an improvement process typically used in healthcare to influence change. The PDSA model tests small changes in the cycle to optimize the process (Coury et al, 2017). The PDSA model is helpful for any research study because by following the steps you can tweak the process as needed based on observations.

In the planning step of the cycle, this is where the author’s solidified research approach will be applied. Inclusion criteria, exclusion criteria, sample size, and the target population are all identified. In this step, we will also plan which supplemental education will be implemented in our intervention. In the do step, we would implement the vaccine education on a small scale, to begin with. In the study set, the author will analyze the data from the do step and collect information about the small-scale education. In the act phase, the intervention will be refined and make changes based on the observations from the do phase.

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VACCINATIONS

References