Josephine van Dongen

Chapter 7 164 Outcome definitions The primary feasibility outcome was the overall vaccination coverage and timeliness of vaccination among eligible infants. Vaccination coverage was calculated as the propor tion of eligible infants that received at least one of the two doses of HRV.Timeliness of vaccination was defined as administration of the first dose of HRV between six and four teen weeks of postnatal age, preferably between six and nine weeks of age.Timeliness for administration of the second dose was determined as an interval of at least four weeks post-dose one and no later than 24 weeks of postnatal age. We assessed differences in vaccination coverage and timeliness between infants with different types of MRC and between par ticipating hospitals (i.e. academic versus general hospital). In addition, vaccination coverage relative to time since implementation is repor ted. Because only five hospitals had a policy of vaccinating infants with GA < 27 weeks, we repor ted that group separately (see supplement). From the survey results, we defined several indicators of implementation success. These included: 1) the propor tion of HCP and parents that agreed with clear information provision, 2) the propor tion of HCP and parents that agreed with timely and effective execution of the program and 3) the vaccination strategy chosen by the highest propor tion of HCP and parents as best approach.Any differences between type of HCP (i.e. medical doctor versus non-medical doctor) and parents of vaccinated or unvaccinated infants was also presented. In this paper we focused on program specific themes as described above, study-specific outcomes are described in the supplementary material.Theme related quantitative survey results were integrated with qualitative interview outcomes. Analyses We used Pearsons Chi-square, Fisher Exact, Students’T or non-parametric tests for comparison of vaccinated and unvaccinated infants, depending on the measured variable and its distribution. Survey statements scored on the five-point Liker t-score were dichotomized in agree and neutral/disagree. Theoretical thematic analysis of semi-structured interviews was done by JvD and PB.The barriers, facilitators and themes were identified and discussed in group meetings 18.After consensus was achieved, within each theme the different barriers and facilitators were distinguished. SPSS version 25.0 and RStudio version 5.0 were used as statistical software. This paper used the StaRI recommendations for repor ting implementation studies, and the COREQ checklist for qualitative research 19,20 .