The goal of this clinical trial is to test if virtual facilitation (e.g., video coaching)increases rural pharmacists' ability to implement COVID-19 vaccine hesitancy counselingwhen compared to a "standard" implementation approach (e.g., training and disseminationof implementation support tools) in rural pharmacies. The main question it aims to answeris if virtual facilitation improves fidelity to a newly developed vaccine hesitancycounseling intervention when compared to standard implementation.All participants will begin in the standard implementation condition, where they willcomplete a webinar on COVID-19 vaccinations and a 30-minute online training on vaccinehesitancy communication. After standard implementation, they will switch to the virtualfacilitation condition where they will be assigned a virtual coach to help them withimplementing the intervention. There will be six fidelity observations per each 8-weekintervention period to determine whether pharmacists are implementing the intervention asintended. Researchers will compare fidelity between the standard and virtual facilitationconditions.
Because COVID-19 vaccination conversations are sensitive and often politically charged,
pharmacists need implementation support, including training and ongoing guidance to
deliver evidence-based vaccine hesitancy counseling interventions. Implementation
facilitation, in which trained facilitators coach and troubleshoot problems with
professionals as they implement new practices, increases adoption of practices with
fidelity. However, implementation facilitation generally, and virtual facilitation (e.g.,
video coaching) in particular, has not been systematically studied in community pharmacy
settings.
The goal of this study 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 7
southeastern states, the investigators will conduct a stepped-wedge trial with 30 rural
pharmacies to test whether virtual facilitation outperforms the standard approach in
increasing the fidelity with which pharmacists implement the vaccine hesitancy counseling
intervention. Using a project-sponsored data collection system, the investigators will
gather data on implementation outcomes, including fidelity and effectiveness.
All participants will begin in the standard implementation condition, where they will
complete a webinar on COVID-19 vaccinations and a 30-minute online training on vaccine
hesitancy communication. After the standard implementation period, they will crossover to
the virtual facilitation condition where they will be assigned a virtual coach to help
them with implementing the intervention. There will be six fidelity observations per each
8-week intervention period to determine whether pharmacists are implementing the
intervention as intended. Researchers will compare fidelity between the standard and
virtual facilitation conditions. Based on a proposed Fall 2024 vaccine administration
schedule by the Federal Drug Administration, the investigators anticipate implementing
the study over two vaccination seasons (Fall 2024 and Fall 2025).
Behavioral: Standard implementation webinar and online training
The one-hour webinar (either live or pre-recorded) will include updated information about
the COVID-19 virus, variant nomenclature, vaccine eligibility, mechanisms of action, and
outcomes. The 30-minute online training addresses how to communicate about COVID-19
vaccinations, presents a 5-step process for initiating conversations, includes example
verbiage about how to address specific concerns, and has example videos that show how to
implement the 5-step process with vaccine hesitant patients.
Behavioral: Virtual facilitation
This intervention involves a 30-minute virtual facilitation site visit and at least 8,
30-minute virtual facilitator coaching sessions. The virtual site visit over Zoom will
establish the personnel and workflows at each pharmacy and allow the facilitator to
establish rapport. Weekly Zoom calls will allow the virtual facilitator to work with a
participant to review overall implementation challenges associated with approaching
patients, delivering the intervention, and documenting results. Lastly, either the
facilitator or the participant can request and schedule a Zoom call to go over any
pressing implementation issue in need of rapid attention (e.g., technical difficulties
with the website).
Inclusion Criteria:
- The pharmacy must be a member of the Rural Research Alliance for Community
Pharmacies (RURAL-CP).
- The pharmacy must be located in a county that has an African American population of
at least 25% or had at least 51% of the population vote for a Republican president
in 2020.
Exclusion Criteria:
- The pharmacy will be excluded if it does not offer COVID-19 vaccines.
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States