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Vaccine Action Directory

Empower local efforts to increase vaccine demand with a searchable database of the most effective interventions, tailored for front-line use

Photo of Estela Kennen
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Let’s improve vaccine demand by giving caregivers the information and resources they need and care about by funneling the world’s best, most evidence-based, and locally relevant ideas to vaccination efforts everywhere.

Explain the idea (less than 2,000 characters)

Picture 3 adjacent communities with suboptimal vaccination uptakes. In A, people remember vaccines “going bad” because of problems with refrigeration and record-keeping. They don’t trust the process. In B, the clinic is open at inconvenient hours. In C, they’re not sure what’s going on. Three communities with needs that cannot be determined at the national or international level, requiring interventions that must be tailored to 3 different realities. Caregivers need and deserve tools that address their realities. Currently however, the choices ground-level CSOs and health care orgs face are to carry out ill-fitting one-size-fits-none interventions, spend valuable time and effort creating interventions, or do nothing. We must leverage existing global knowledge to allow ground-level personnel to meet caregiver needs. The lag time between evidence generation and ground-level practice is well documented in both health care and education. We propose fast-tracking the deployment of relevant vaccine demand tools/interventions by developing a user-friendly website that features a filterable database of solutions ready for implementation. A responsive database would allow local practitioners to find relevant solutions or Immunization Managers to provide tailored recommendation. These solutions would not be written from a policy-maker or academic perspective but translated into actionable information, with clear tips regarding assumptions and best practices. Products might include straight-forward planning guides, training materials targeted at different types of users, literacy-appropriate talking points, and ready-made evaluation criteria. When communities can effectively and cost-efficiently respond to local issues, caregivers are empowered to increase their vaccine demand. When we provide a mechanism to evaluate and share the lessons learned from carrying out those interventions, we can further fast-track knowledge and appropriate responsiveness to caregivers.

Which part(s) of the world does this idea target?

  • North Africa
  • Eastern Africa
  • Middle Africa
  • Southern Africa
  • Western Africa
  • Caribbean
  • Central America
  • South America
  • South-eastern Asia
  • Southern Asia

Geographic Focus (less than 250 Characters)

Eventually, the database could be populated in the six official UN languages with ideas for all countries and vaccination rates, but during refinement, we realized it would be best to focus initially on the needs of East Africa and other LICs.

Who are your end users and how well do you know them? (750 characters)

Caregivers are the project’s beneficiaries. They are a diverse group with a range of concerns and roadblocks but a universal desire to do what they think is right. However, the project’s direct users are program managers and other staff at health clinics and CSOs/NGOs. They are smart, resourceful, and passionate but also understaffed and underfunded -- sometimes critically so. For most, maintaining/increasing vaccination rates is a fraction of their duties. They understand local needs and assets, but lack the time, resources and/or expertise to create tools/interventions. They don’t want policy directives or research papers. They want something they can deploy, or at least customize, immediately -- so they can help caregivers act.

How is the idea unique? (750 Characters)

Extensive resources on vaccination exists for policymakers and practitioners on the national level, but to our knowledge there is no central repository of resources to increase vaccine demand at the community level, where vaccinations actually occur. A VAD empower local communities to advocate for themselves, allow best practices to disseminate more quickly, and serve as a feedback mechanism from the field, thus refining our knowledge. We are creating the VAD, from site architecture to content, with the local end-user in mind. Further, we have identified a gap between existing interventions and barriers to vaccine demand, which allows us to borrow from other sectors to provide evidence-based tools until tailored solutions can be tested.

Idea Proposal Stage (Select 1)

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

How many months are required for the project idea? (140 characters)

12 months (criterion, database, UX, front end, and content development) to beta plus ongoing content development & evaluation.

Organization Name (less than 140 characters)

The NTA Group

Type of Submitter

  • We are not yet a registered organization but plan to in future

Organizational Characteristics

  • Female-led organization
  • Women’s health/rights focused
  • International/global organization (implementing in multiple countries)

Organization Location (less than 140 Characters)

Pyeongtaek, South Korea and Hartford, CT, USA

What is the current scale of your organization’s work?

  • Global (within 2 or more global regions)

Tell us more about your organization/company (1-2 sentences)

NTA Group is an informal think tank/consultancy dedicated to tackling thorny global problems by catalyzing knowledge transfer, supporting capacity-building, and employing human-centered practices. We have identified the long lag-time between evidence generation and practical adoption as a theme ripe for intervention. Interventions to increase vaccination demand are both critical and makes a good testing ground for a methodology to improve translational public health research.

Who will work alongside your organization in the project idea? (750 characters)

For knowledge transfer projects to be successful requires integrating key stakeholders throughout the process, from planning through creation to testing and beyond. We used a review of grey and academic literature and the results of focus groups with community health workers and caregivers in East Africa as a starting point for understanding the regional barriers to vaccine demand, and available resources and constraints. Moving forward, the project would ideally coordinate with or be nested under or more key players in the global vaccination effort: Gavi, UNICEF, or WHO for instance. However, consistent communication with caregivers, ground-level health care organizations CSOs involved with vaccination is key.

How many people are on your team?

4

Tell us more about you and your team

Ella Kennen, MA is a researcher and project manager. She is a published researcher on health communication, including regarding newborn screening and immunizations. She is currently working on a data collection and dissemination project for an environmental NGO focused on Tanzania. Her CV: https://drive.google.com/open?id=1lLEppd7uz7FZZRia94A_dPkdxGR_AIIE Estela Lopez, PhD has over 40 years of experience in policy, strategy, and implementation in the K-16 arena. Her brief bio: https://docs.google.com/document/d/1-dWm1U5hVdkPgzXDNgmrrbiPma1nFBEg3xkoPHqbHf0/edit?usp=sharing Anna Istomina is our UX consultant and Yegor Jbanov our software engineering consultant. The project team would also include a data architect and front-end developer as contractors.

Overview of How Your Concept Has Evolved (5-6 sentences):

Our first decision was to focus on East Africa, which made us realize that part of our vision (mobile-based cheat sheets for the field), would be of minimal use during the initial roll out. Our literature review and focus group results indicated a gap between existing interventions -- which focus on information and reminders -- and certain barriers to vaccine demand, such as barriers to access and issues with the healthcare system. The UNICEF and Gates webinars corroborated our intuition. Finally, in designing the website user interface, we realized that we needed to include problem identification and planning along with intervention tools and, after hearing the Gates team, needed a way of funneling users in that direction.

Viability (3-4 sentences and activity upload):

https://canvanizer.com/canvas/w8uUkcdnUpcqD To our knowledge, this is the first systematic attempt to grant community groups access to a world’s worth of vaccine demand interventions. Some of the knowledge is there, in ready-to-integrate format, while some needs to be altered to take into account end-user needs and communication best practices. Other knowledge needs to be borrowed from other areas and integrated into existing gaps in the vaccine demand arena. Partnerships at the highest international levels and at the ground level will help move the project forward in a meaningful way.

Feasibility (3-4 sentences):

Knowledge is not a sufficient condition to bring about change, but it is a necessary one. With IDEO prototyping support we examined 13+ health-related databases for architecture, flow, design elements, and output and extracted the most desirable elements as a basis for our underlying design. The prototyper reiterated on layout and features, based on user feedback each time. Our users helped us determine everything had to be quick-loading, downloads should not be the default option, interactivity was important, and scaffolding on how to choose and apply an intervention was needed.

Desirability (3-4 sentences and activity upload):

This exercise lead to several insights: 1) We must pay special attention to the technological reality of East Africa. Quick-loading summaries can increase accessibility. 2) Content creators matter and their user experience needs to be considered as well. 2b) We can encourage content creators to notice gaps in intervention areas and knowledge transfer/implementation science. 3) Some users will be unsure of the problem or how to implement change and others will want to jump to solutions without fully understanding the problem or implementation practices, so a mechanism to funnel people to foundational resources matters.4) Interactivity (from being able to bookmark resources to being able to share feedback) will increase site desirability.

Community Focus (2-3 sentences):

Capacity-building is not “sexy,” yet it is a crucial component of public health. A powerful idea is only as effective as it is usable, and before it can be used, it must be accessed. An online database allows us to simultaneously leverage the collective knowledge and input of global vaccine researchers AND the power of the internet to provide information anywhere, anytime. The VAD gives providers anywhere a toolbox they can use in a way that makes most sense locally. It also fills gaps between needs and existing interventions while prioritizing actionable relevance over exhaustive listings.

Community Impact (2-3 sentences):

Global access is automatic; further scaling could be achieved with the addition of local language translations. Maintenance costs are nominal, making sustainability past the development stage feasible. Analytics will let us continuously monitor useful markers, such as growth in original and user-modified content, website use, number and type of page visits, downloads, and use within the target region. Much remains to be learned about knowledge transfer in LMICs. Follow-up could be done with users who provide their emails (a biased but useful sample.) With funding, a full RCT could be done.

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Photo of Ashley Tillman
Team

Hi Estela Kennen great to have you in the Challenge can you share with me a bit more about NTA? I know it's not a formal organization but how long have you been working together? Have you done a similar project before? Can you include in the comments section, links to the bios of the main team members and any public academic papers?

Which countries would you prioritize to start with?

Photo of Estela Kennen
Team

Ashley Tillman ,

Thank you so much for your interest. Dr. Lopez and I have collaborated informally for decades over a matter of topics related to education, communication, health, and technology. The idea for NTA formed out of a desire to address the underlying commonalities we saw in disparate fields and the ability to work more closely together once she retired from her previous position.

I have been part of projects that assessed the reasons for vaccine refusal, examined HCW vaccine communication practices, and created and tested interventions to improve vaccine communication practices and parent satisfaction. (I have also analyzed existing communication materials and developed and tested new ones with various other health care topics.) I also collated vast amounts of information and repackaged it in a more user-friendly way for the now-defunct website About.com. Similarly, Dr. Lopez has overseen the creation of data architecture projects for institutes of higher education. We saw this challenge as an opportunity to not just create another vaccine demand intervention, but to combine various aspects of our background in order to help projects around the world leverage their findings.

Because our directory would be available globally, our current plan is not to prioritize countries, but a topic: safety concerns. As one of the most common reasons for vaccine hesitancy, and one that is less heterogenous than religious or cultural reasons, it seems like the quickest approach to maximizing impact. That being said, should our proposal be shortlisted, we will use our network to request beneficiary feedback from communities in Tanzania and the Dominican Republic. As we move forward, we are happy to prioritize vaccine demand issues that are particularly relevant to East Africa.

Estela Lopez’s brief bio is here: https://docs.google.com/document/d/1-dWm1U5hVdkPgzXDNgmrrbiPma1nFBEg3xkoPHqbHf0/edit?usp=sharing

You can view my CV here, with published academic papers on the 2nd and 3rd page:
https://drive.google.com/open?id=1lLEppd7uz7FZZRia94A_dPkdxGR_AIIE I have also excerpted my co-authored papers most relevant to this project below.

Davis, Terry C, Doren D Fredrickson, Estela M Kennen, Sharon G Humiston, Connie Arnold, Mackey S Quinlin, and Joseph A Bocchini. 2006. Vaccine Risk/Benefit Communication: Effect of an Educational Package for Public Health Nurses. Health Education and Behavior. 33(6):787-801. https://www.ncbi.nlm.nih.gov/pubmed/16861585

Davis, Terry C, Doren D Fredrickson, Estela M Kennen, Connie L Arnold, Eileen Shoup, Mackey Sugar, Sharon G Humiston, and Joseph A Bocchini. 2004. Childhood Vaccine Risk/Benefit Communication Among Public Health Clinics: A Time-Motion Study. Public Health Nursing. 21(3):228-36. https://www.ncbi.nlm.nih.gov/pubmed/15144367

Fredrickson, Doren D, Terry C Davis, Connie L Arnold, Estela M Kennen, Sharon G Humiston, JT Cross, Joseph Bocchini. 2004. Childhood Immunization Refusal: Provider and Parent Perceptions. Family Medicine. 36(6)431-9. https://www.ncbi.nlm.nih.gov/pubmed/15181556

Should you or anyone else on your team have any other questions, comments, or concerns, do not hesitate to ask. We look forward to the opportunity to work with you.

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