Universal influenza immunization. Were Ontario family physicians prepared?

OBJECTIVE To explore family physicians' experiences during the first year of Ontario's universal influenza immunization program.

DESIGN Qualitative study using in-depth interviews.

SETTING Thames Valley region of southwestern Ontario.

PARTICIPANTS A maximum variation sample of nine family physicians selected by snowball sampling after initial consultation with a local family physician advisory committee.

METHOD Interviews were audiotaped and transcribed verbatim. Analysis was sequential, using a combination of editing, immersion, and crystallization. Interview transcripts were read by individual members of the team who met to compare findings at several stages during data collection.

MAIN FINDINGS The program affected family physicians because immunization strategies designed for immunizing high-risk patients needed to be modified to deal with greater numbers of patients. While generally supportive of the program, physicians found it difficult to implement. Responses reflected ongoing conflict between individual and public health priorities, particularly regarding children and pregnant women.

CONCLUSION The program could have been more effective if the culture and climate of Ontario family practice had been considered during its development and implementation.