Adoption of immunization delivery services in pharmacie

Increasing immunization rates among high-risk populations is a goal of Healthy People 2010. One strategy to improve these rates is Increasing accessibility to immunization providers. Pharmacists are able to make tremendous contributions in immunization delivery services by: (a) contracting with outside providers to administer vaccines, referred to as "outsourced service" and (b) having staff pharmacists administer vaccines, referred to as "in-house service". Goals of this study are to (a) identify the level of and trends in immunization promotion programs and delivery services and (b) better understand reasons for community pharmacies to provide outsourced and in-house immunization services. A framework integrating between Rational Choice and Institutional Theories is developed for predicting the adoption of outsourced and in-house immunization services.;Data were gathered from key informants in community pharmacies in Washington State through a 2-stage process. In Stage I, a mail survey was sent to 1,143 pharmacies; 315 (27.6%) responded. Follow-up telephone calls were made with 262 randomly selected pharmacies; 211 (87.6%) completed the telephone interview. In order to extrapolate the results to the general population, results from the telephone interview were weighted to reflect mail survey non-respondents. In Stage II, mail surveys were sent to all 526 Stage 1 respondents; 244 (46.9%) provided complete response.;Stage I results show that, in 2002--03, nearly 2 in 5 pharmacies provided outsourced services while approximately 1 in 5 provided in-house services. Stage II results show that both Rational Choice and Institutional theories independently predicted immunization service adoption. Among the independent variables examined, perceived complexity and normative pressure were significant predictors of outsourced immunization service adoption while perceived compatibility, perceived complexity, and normative pressure were significant predictors of in-house service adoption. A reduced model for predicting adoption of each immunization delivery service was estimated.;Study results show that organizational and social factors are important predictors of innovation adoption. This study suggests potential strategies for facilitating the adoption of immunization delivery services. Further research is needed into how to increase the number of initial adopters and to sustain adoption decisions.