Document text
Principal Investigator: GEOFFREY M CURRAN
Organization: UNIV OF NORTH CAROLINA CHAPEL HILL
Fiscal Year: 2024
Award: $569,232
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT SUMMARY
The COVID-19 pandemic has disproportionally impacted rural communities, which are often health
professional shortage areas that lack health care infrastructure, including hospitals1-3. When compared to
urban populations, individuals living in rural areas are more vaccine hesitant8,9, have a higher prevalence of
comorbid health conditions that increase their risk for severe COVID-19 complications12, and are at greater risk
from SARS-CoV-2 variants due to lower vaccination rates and fewer vaccination mandates33,40. Thus,
interventions to increase vaccine uptake in rural areas are greatly needed. As the most accessible healthcare
professional in rural areas4,5 and one of the most trusted sources of medication information16, community
pharmacists are well-positioned to address vaccine hesitancy with underserved, rural populations.
Because vaccination conversations are sensitive and often politically charged, pharmacists need
implementation support, including training and ongoing guidance to deliver evidence-based vaccine
hesitancy counseling interventions18. Implementation facilitation, in which trained facilitators coach and
troubleshoot problems with professionals as they implement new practices, increases adoption of practices
with fidelity23-26. However, implementation facilitation generally, and virtual facilitation (e.g., video coaching) in
particular, has not been systematically studied in community pharmacy settings. The need to examine the
effectiveness of virtual facilitation as a means to increase vaccine hesitancy counseling and COVID-19
vaccination is of great importance given the large travel distances to rural areas and social distancing.
Our goal is to test if virtual facilitation increases rural pharmacists’ ability to implement COVID-19 vaccine
hesitancy counseling when compared to a “standard” implementation approach (e.g., training and
dissemination of implementation support tools). Using a rural pharmacy practice-based research network
(PBRN) that spans 5 southeastern states, we propose two aims. Aim 1 involves a stepped-wedge trial with 30
rural pharmacies to test whether virtual facilitation outperforms the standard approach in increasing: (a) the
fidelity with which pharmacists implement the vaccine hesitancy counseling intervention and (b) the number of
vaccine hesitant patients who agree to receive the vaccine. Using a project-sponsored data collection system,
we will gather data on implementation outcomes, including fidelity and effectiveness. In Aim 2, we will conduct
a cost assessment to explore the sustainability of virtual facilitation. We are uniquely positioned to test these
competing implementation approaches and leverage rural community pharmacists to engage in vaccine
hesitancy counseling in rural communities that have low vaccination rates.
Terms: <2019-nCoV vaccine><2019-nCoV variant><2019-nCoV variant forms><2019-nCoV variant strains><Address><Adoption><Agreement><Ally><Automobile Driving><Budgets><COVID complications><COVID crisis><COVID epidemic><COVID pandemic><COVID related complications><COVID-19 affected><COVID-19 complications><COVID-19 consequence><COVID-19 crisis><COVID-19 effect><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 impact><COVID-19 impacted><COVID-19 pandemic><COVID-19 period><COVID-19 predisposition><COVID-19 public health crisis><COVID-19 related complications><COVID-19 susceptibility><COVID-19 vaccination><COVID-19 vaccine><COVID-19 variant><COVID-19 variant forms><COVID-19 variant strains><COVID-19 vulnerability><COVID-19 years><Cessation of life><Charge><Communities><Community Pharmacy><Complex><Coronavirus disease 2019 predisposition><Coronavirus disease 2019 susceptibility><Coronavirus disease 2019 vulnerability><Cost Analyses><Cost Analysis><Counseling><Country><Data><Data Collection><Death><Decrease disparity><Dissemination and Implementation><Drugs><Effectiveness><Effectiveness of Interventions><Evidence based practice><Feedback><Goals><HPV><HPV Vaccination><Health><Health Care Professional><Health Professional><Healthcare><Healthcare Provider Shortage Areas><Healthcare professional><High Prevalence><Hospitals><Hour><Human Papilloma Virus><Human Papilloma Virus Vaccination><Human Papillomavirus><Human Papillomavirus Vaccination><Individual><Infectious Human Wart Virus><Infrastructure><Intervention><Intervention Strategies><Lower disparity><Medication><Modeling><Monitor><Patients><Pharmaceutical Preparations><Pharmacies><Pharmacists><Pharmacy facility><Phone><Physical distancing><Politics><Position><Positioning Attribute><Predisposed to COVID-19><Predisposed to SARS-CoV-2><Predisposed to Severe acute respiratory syndrome coronavirus 2><Primary Care><Research><Research Resources><Resources><Risk><Rural><Rural Community><Rural Population><Rural group><Rural people><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-CoV-2 predisposition><SARS-CoV-2 susceptibility><SARS-CoV-2 vaccination><SARS-CoV-2 vaccine><SARS-CoV-2 variant><SARS-CoV-2 variant forms><SARS-CoV-2 variant strains><SARS-CoV-2 vulnerability><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SARS-coronavirus-2 vaccine><Safety><Sampling><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe Acute Respiratory Syndrome CoV 2 vaccine><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome coronavirus 2 predisposition><Severe acute respiratory syndrome coronavirus 2 susceptibility><Severe acute respiratory syndrome coronavirus 2 vaccination><Severe acute respiratory syndrome coronavirus 2 vaccine><Severe acute respiratory syndrome coronavirus 2 vulnerability><Social Distance><Source><System><Telephone><Testing><Time><Training><Travel><Trust><Update><Urban Population><Vaccination><Vaccines><Walking><accept vaccination><accept vaccine><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><assess cost><assess effectiveness><co-morbid><co-morbidity><comorbidity><complications due to COVID-19><coronavirus disease 2019 consequence><coronavirus disease 2019 crisis><coronavirus disease 2019 effect><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 impact><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease 2019 vaccination><coronavirus disease 2019 vaccine><coronavirus disease 2019 variant><coronavirus disease 2019 variant forms><coronavirus disease 2019 variant strains><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 impact><coronavirus disease-19 pandemic><coronavirus disease-19 vaccine><cost assessment><cost effective><cost evaluation><determine effectiveness><disparity reduction><driving><drug/agent><effectiveness assessment><effectiveness evaluation><evaluate cost><evaluate effectiveness><evidence base><examine cost><examine effectiveness><flu><health care><health care access><health care availability><health care professional shortage areas><health care service access><health care service availability><health professional shortage areas><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><hesitant to vaccination><implementation facilitation><implementation fidelity><implementation outcomes><implementation science><improved><interventional strategy><life-threatening COVID><life-threatening COVID-19><life-threatening SARS-CoV-2><life-threatening coronavirus disease><life-threatening coronavirus disease 2019><life-threatening severe acute respiratory syndrome coronavirus 2><mitigate disparity><nCoV vaccine><nCoV-19 vaccine><nCoV19 vaccine><pandemic><pandemic disease><practice-based research network><predisposed to Coronavirus disease 2019><primary care provider><primary outcome><providers from primary care><providers of primary care><reduce disparity><reduction in disparity><rural area><rural counties><rural individual><rural location><rural patients><rural region><rural under served><rural underserved><secondary outcome><serious COVID><serious COVID-19><serious SARS-CoV-2><serious coronavirus disease><serious coronavirus disease 2019><serious severe acute respiratory syndrome coronavirus 2><severe COVID><severe COVID-19><severe COVID19><severe SARS-CoV-2><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><severe acute respiratory syndrome coronavirus 2 variant><severe acute respiratory syndrome coronavirus 2 variant forms><severe acute respiratory syndrome coronavirus 2 variant strains><severe coronavirus disease><severe coronavirus disease 19><severe coronavirus disease 2019><severe severe acute respiratory syndrome coronavirus 2><support tools><susceptible to COVID-19><susceptible to Coronavirus disease 2019><susceptible to SARS-CoV-2><susceptible to Severe acute respiratory syndrome coronavirus 2><urban group><urban individual><urban people><vaccinate against COVID-19><vaccinate against SARS-CoV-2><vaccinate against coronavirus disease 2019><vaccinate against severe acute respiratory syndrome coronavirus 2><vaccination acceptability><vaccination acceptance><vaccination against COVID-19><vaccination against SARS-CoV-2><vaccination against Severe acute respiratory syndrome coronavirus 2><vaccination against coronavirus disease 2019><vaccination confidence><vaccination hesitancy><vaccination uptake><vaccination willingness><vaccine acceptability><vaccine acceptance><vaccine against 2019-nCov><vaccine against COVID-19><vaccine against SARS-CoV-2><vaccine against SARS-coronavirus-2><vaccine against Severe Acute Respiratory Syndrome CoV 2><vaccine against Severe acute respiratory syndrome coronavirus 2><vaccine candidates against SARS-CoV-2><vaccine confidence><vaccine for novel coronavirus><vaccine hesitancy><vaccine hesitant><vaccine uptake><vaccine willingness><vaccines preventing COVID><vaccines to prevent COVID><video coaching><video counseling><virtual><vulnerable to COVID-19><vulnerable to Coronavirus disease 2019><vulnerable to SARS-CoV-2><vulnerable to Severe acute respiratory syndrome coronavirus 2><wart virus>