COVID-19 VACCINATION IN THREE SITES IN SASKATCHEWAN: A PATIENT-ORIENTED REALIST EVALUATION
The purposes of this research were to evaluate the COVID-19 vaccination campaign in three pilot sites (Regina, Saskatoon, Prince Albert) in Saskatchewan and construct program theories for vaccine uptake among the recipients and vaccine delivery by the Saskatchewan Health Authority (SHA) stakeholders who were involved in the planning and delivery of the vaccines. The program theories contain contextual factors and causal mechanisms that influenced vaccine uptake and delivery. Traditional evaluations oversimplify characteristics of interventions and the environment surrounding them (1). Finding solutions to complex problems needs a through understanding of the nature of the problem, interventions, and the implementation contexts (2). Problems operate at various levels (individual, local, organizational, societal) which makes the relevant interventions complex (2). Literature has shown that targeted efforts are needed to increase vaccine uptake (3). In a theory-driven realist evaluation, evaluators raise the question of “for whom, under what circumstances, how and why do interventions work or not work?”, and build program theories to answer the question (2,4,5). Realist evaluation requires considerable researcher reflection, creativity, judgment, and inferences (6,7). By using a novel combination of patient-oriented research (POR) strategy and the realist evaluation, three and six initial program theories (IPTs) for the vaccine recipients and the SHA stakeholders, respectively, were developed collaboratively with three patient and family partners (PFPs). We refined and finalized the IPTs into seven program theories (PTs) by collecting insights from six vaccine recipients and six SHA stakeholders via realist evaluation interviews. We identified salient contextual factors that evoked mechanism chains resulting in intermediate outcome of vaccine hesitancy or willingness among the recipients. These contextual factors and causal mechanisms demonstrate the complex reality of Saskatchewan’s COVID-19 vaccination campaign, show causal pathways for vaccine strategies, and help policymakers to enhance vaccination programs for other jurisdictions.
COVID-19 Vaccination, Patient Oriented Research, Realist Evaluation
Master of Science (M.Sc.)
Community Health and Epidemiology
Community and Population Health Science