Page 15 - Preventing pertussis in early infancy - Visser

out to be very difficult. Therefore, an implementation plan was needed to prepare for the future pertussis cocooning and selective HCW vaccination programmes.
Developing an effective implementation strategy
The uptake of a new vaccination recommendation sometimes takes place almost automatically. For example, the new introduction of meningococcal serogroup C vaccination into the NIP in 2002 led to an uptake of 94% in that year (Kaaijk et al. 2012). Such a result, however, is not always obtained. The uptake of HPV vaccination in 12 years old girls was only 52% in the first years after its introduction in 2009 (Gefenaite et al. 2012). Similarly, the uptake of (seasonal) influenza vaccination among HCWs still remains a meagre 20-30%. And despite the recommendation of pertussis cocooning vaccination, various countries reported a problematic 16-34 % uptake (Baratin et al. 2014, Bodeker et al. 2014, Suryadevara et al. 2014, Williams et al. 2014, Wong et al. 2015, Hayles et al. 2016). These findings are not unique for vaccination acceptance: clinical and health services research consistently show the failure to translate scientific evidence into practice (Grimshaw et al. 2012).
Fortunately, it is possible to bridge this gap between evidence and practice. With pertussis cocooning, some studies show that in regions where vaccination programmes had been put into place to address the low uptake, the reported acceptance increased from 16- 34% to 70–90% (Healy et al. 2011, Camenga et al. 2012, Leboucher et al. 2012, Hayles et al. 2015). Implementation research teaches us that well-planned behavioural change strategies are required to achieve changes in behaviour so that innovations – such as vaccinations –are accepted (Grol et al. 2003, Grimshaw et al. 2012).
First, to successfully influence behaviour, tailoring is an essential principle in models and theories derived from various disciplines and scientific areas (Grol et al. 2003, Grol et al. 2007, Grimshaw et al. 2012, Grol 2013). Tailoring entails that the choice of interventions for change should be closely and explicitly linked to the results of a problem analysis identifying the specific determinants of the behaviour (i.e. the barriers and enablers). These determinants not only lie on individual level, as individual people function in a complex environment, where different social and physical conditions are relevant. These social and physical conditions should also be taken into account during programme development. Furthermore, it includes the involvement of stakeholders in all aspects of decision making, which is essential to the success of a programme (Grol 2013, Kok et al. 2016).
Despite the consensus on the importance of tailoring in intervention development, it is not yet clear how to best tailor interventions. A recent Cochrane review by Baker et al. (Baker et al. 2015) only found modest extra effects of tailored interventions over any intervention. The main reason Baker et al. give for this, is that currently available studies used different methods to identify determinants, and used different approaches while selecting interventions to address these determinants. Other studies indicated a mismatch between the identified determinants in the problem analysis and the selected interventions in the final implementation programme (Bosch et al. 2007). This underlines the importance of systematically applying the tailoring principle.
General Introduction
General introduction
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