Utility of the theory of planned behaviour in health services research when examining the intentions of immunization provider behaviour

Abstract

This paper will demonstrate the need for public health involvement with health services research in order to effectively meet its' mandate for achieving population health. The success of our public health programs requires working effectively with other health service providers to achieve desired outcomes. The goal of the vaccine preventable disease program in Ontario will be used to illustrate the importance of health services research in accomplishing the desired outcomes. In Ontario, immunizations are primarily administered outside of the public health domain with approximately 85% of immunizations being administered in primary healthcare settings such as family physician offices or community health care centers. How do public health professionals affect immunization provider behaviour that is performed by independent practitioners in other healthcare sectors? The answer lies with health services researchers who wish to predict and understand specific behaviour in health care professionals. Knowledge transfer or implementation research which focuses on investigating the uptake of evidence-based practice in health care professionals has been conducted through questionnaires based on the Theory of Planned Behaviour (Francis et ah, 2004). The importance of immunization and the goal of the vaccine preventable disease program in Ontario will be presented. The theoretical framework of the Theory of Planned Behaviour will be examined to higlilight the constructs of the theory and how they interact with one another. Next, the application of the Theory of Planned Behaviour as a theoretical model on which to base the design of a questionnaire to assess health care provider's immunization behaviour will be reviewed. A survey instrument (jointly developed by the Communicable Diseases Epidemiology Services of the British Columbia Centre for Disease Control and the Clinical Trials Research Centre from Dalhousie University) to measure the psychological determinants of immunization intentions of Canadian Immunization Providers will be examined to detennine its usefulness for public health. Finally recommendations for future research will be presented in order to identify priorities for health service research to effectively advance the goals and objectives of staff working in the vaccine preventable diseases program area in Ontario.