Page 98 - Preventing pertussis in early infancy - Visser

Chapter 6
Chapter 6
Discussion
This study provides a detailed example of the application of IM for the systematic development of a pertussis vaccination programme for HCWs. The application of IM enabled us to combine original empirical evidence with literature review, social cognitive theory and target group participation, and to meticulously weave together the identified influential factors in one intervention. This resulted in a vaccination programme consisting of an invitation letter, an information folder, a website, posters and an online deliberation tool, aiming to facilitate achievement of five specific POs, which contribute in reaching the main programme goal: to optimize pertussis vaccination acceptance among HCWs.
The IM protocol enabl ed us to develop an effective pertussis vaccination programme, well adapted to the needs of the target group while considering social cognitive theories of behavioural change. We aimed to adopt a realistic approach to the vaccination decision making process of HCWs by formulating POs that relate to the factors that seem prerequisites for individuals to be able to make an informed and sustainable choice: acquiring knowledge, reflecting on personal values and deliberating on possible actions (van den Berg et al. 2006, Lehmann et al. 2017). The POs shaped the vaccination programme, together with a range of determinants such as knowledge, attitude, social norm, perceived capacity, anticipated negative affect and decisional uncertainty, which in turn guide the selection of theory-based methods of behavioural change. As a result of the subdivision of POs, we developed an innovative decision tool aiming to enable people to make deliberate decisions.
In addition, we trust that we provided an innovative and applied example of the IM approach, which can be useful for future other (vaccination) intervention programmes. Furthermore, working step-by-step and having the outcome of the previous step being the input for the next step, the mapping process is effectively cut into concrete products (e.g. objectives, behaviour change methods, design plan). These products facilitate the operationalisation into measurement instruments for process and effect evaluation studies. They also serve as starting points for the adaptation of the behavioural change intervention, and the transfer to different target populations and intervention contexts, while protecting its essential elements (Bartholomew-Eldredge et al. 2016).
This method is also useful in its contribution to the recommendations of Baker et al., (2015) which state that research should aim to establish which methods of tailoring, and under what circumstances, are most likely to be appropriate. Further research should reveal how our method of determinant selection (through assessments of odds ratios from quantitative studies and planning group assessment of changeability) compares to other possible methods (Baker et al. 2015). Within the IM method, it turned out to be meaningful and feasible to explicitly use theory for the translation of determinants into change method (see appendix for an elaboration) (Davidoff et al. 2015). For this purpose, the participation of behavioural scientists in the planning groups was very valuable.
The above description of the systematic planning of the pertussis vaccination 100
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