Evaluation report
Improving child immunisation rates in a disadvantaged community in New South Wales, Australia: a process evaluation for research translation
Susan L Thomas, Helen Higgins, Julie Leask, Lisa Menning, Katrine Bach Habersaat et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated why a new immunisation strategy to increase vaccination coverage in a disadvantaged community in New South Wales was slow to implement after 18 months. Researchers interviewed 24 health workers, nurses, managers and doctors to understand the barriers and facilitators using a behaviour change model. The evaluation found strong motivation for change but identified gaps in service capability, clarity about roles, and the need for better cross-institutional engagement and resources.
Key points
- After 18 months, the new immunisation strategy had not been fully implemented in the target community
- Five key themes emerged: time-consuming design and adoption requiring new skills; importance of cross-institutional engagement; need for implementation clarity; importance of maintaining focus on disadvantaged families' needs; and the role of trust and perseverance
- Staff had strong motivation and opportunity for change but needed enhanced service capability
- Implementation required clarity on roles, responsibilities, timing and processes across organisations
- Support and resources were identified as critical areas requiring investment
Limitations
This is a process evaluation examining implementation barriers rather than measuring immunisation outcomes or the effectiveness of the intervention itself. The study does not report whether vaccination coverage actually improved or what specific resource investments were needed.
Abstract
The World Health Organization's Tailoring Immunization Programmes approach was used to develop a new strategy to increase child vaccination coverage in a disadvantaged community in New South Wales, Australia, including reminders, outreach and home visiting. After 18 months, the strategy hasn't been fully implemented. A process evaluation was conducted to identify barriers and facilitators for research translation. Participants included child health nurses, Population Health staff, managers and general practitioners. The Capability-Opportunity-Motivation model of behaviour change (COM-B) was used to develop questions. Twenty-four participants took part in three focus groups and four interviews. Five themes emerged: (i) designing and adopting new ways of working is time-consuming and requires new skills, new ways of thinking and changes in service delivery; (ii) genuine engagement and interaction across fields and institutions helps build capacity and strengthen motivation; (iii) implementation of a new strategy requires clarity; who's doing what, when and how?; (iv) it is important not to lose sight of research findings related to the needs of disadvantaged families; and (v) trust in the process and perseverance are fundamental. There was strong motivation and opportunity for change, but a need to enhance service capability. Areas requiring support and resources were identified.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Tailoring Immunization Programmes approach including reminders, outreach and home visiting
- Population
- Children in a disadvantaged community in New South Wales; implementation evaluated with 24 health workers, nurses, managers and general practitioners
Key finding
After 18 months, the strategy had not been fully implemented