Public perceptions of the role of community pharmacy in public health
Authors: Rapado R , Prior A L , James D H 
Published: April 2022

Abstract

Introduction
Community pharmacies are well-placed to provide public health interventions, yet they are underutilised for services of this nature (1), which are needed to achieve public health policy goals. Previous qualitative studies have explored public perceptions of the role of community pharmacy in delivering public health services (2). However, to date, these views have not been captured quantitatively, which means it is not clear if the general public shares these views.

Aim
The aim was to design a questionnaire to obtain public perceptions of the role of community pharmacy in public health interventions and to establish any barriers and facilitators that exist regarding community pharmacy utilisation.

Methods
A questionnaire was developed based on published literature and semi-structured interviews. Following initial piloting of a paper-based then online format (by ten individuals) a 42-item questionnaire was completed digitally via Qualtrics by a self-selecting sample of the general public recruited through social media (i.e., Twitter, Instagram and Facebook) in May and June 2021. Principal component analysis with Varimax rotation was used to identify the underlying factors (scales) of the questionnaire. Cronbach’s alpha analysis was undertaken to ensure good internal consistency. Information on frequency of community pharmacy use and for what reason was collected. Content and thematic analysis were conducted on the free text qualitative comments. Content analysis was conducted first to observe which aspects of the questionnaire were mentioned the most. Further to this, thematic analysis was conducted as there were responses which did not fit into the content analysis.

Results
There were 306 valid questionnaire responses, where 235 (76.8%) were females. The mean age was 34.5 years (SD=15.09). Factor analysis identified four scales with a total of 18-items, all demonstrating good internal consistency. Scales were labelled as (n=number of items; ἀ =Cronbach’s alpha value): Expertise (n=3, ἀ =0.815); Role (n=4, ἀ =0.745); Privacy (n=3, ἀ =0.770) and Relationship (n=8, ἀ =0.862). Scale scores indicated that a lack of awareness of their role and expertise was a barrier and adequate privacy was an important facilitator in delivering public health services. In support of the quantitative findings, content analysis identified lack of privacy as a dominant theme, and further thematic analysis uncovered lack of knowledge of community pharmacy’s role in public health as an important barrier to uptake of services. Thematic analysis uncovered the themes ‘lack of knowledge of services’ and ‘accessibility’.

Conclusion
The outcome of this study was the development of a four scale, 18-item questionnaire to capture public perceptions of the community pharmacy’s role in public health. This can, therefore, be used in future studies aiming to explore public perceptions of community pharmacy. Strengths include being the first questionnaire to explore perceptions of community pharmacy. Weaknesses include the possibility of bias using social media in recruitment. This could be tackled using paper versions of the questionnaire in different settings. Further research is needed to continue testing the psychometric properties of the questionnaire with consideration given to the addition of a fifth scale to measure perceptions of Accessibility.

References
(1) Kember, J., Hodson, K., & James, D. H. (2018). The public’s perception of the role of community pharmacists in Wales. International Journal of Pharmacy Practice (26), 120-128.
(2) Gidman, W., & Cowley, J. (2013). A qualitative exploration of opinions on the community pharmacists’ role amongst the general public in Scotland, International Journal of Pharmacy Practice, (21), 288-296.