J I Takayama1, J P Iser, A Gandelman. 1. Department of Pediatrics, University of California, San Francisco 94143, USA. jtaka@itsa.ucsf.edu
Abstract
OBJECTIVE: The impact of a community intervention to establish hospital nursery policies for universal newborn immunization against hepatitis B was determined by comparing primary care physician immunization practices in two counties, one intervention and one control. METHODS: Surveys were mailed to 855 physicians in 1994; 322 of 533 respondents were eligible, with 155 from San Francisco (SF), the intervention county, and 167 from Sacramento (SAC), the control county. Adoption of universal hepatitis B immunization was defined as immunizing more than 90% of infants seen in 1993. RESULTS: Although similar proportions of physicians agreed, 79% in SF and 72% in SAC, 64% of SF physicians and 40% of SAC physicians adopted universal infant immunization (P < 0.0001). Universal immunization was greater for pediatricians than for family physicians (OR = 2.00, 95% CI 1.66-2.41) but less for physicians who perceived their patients population to be at low risk for hepatitis B compared to those who did not (OR = 0.60, 95% CI 0.45-0.79). While 94% of physicians in both counties indicated their willingness to provide the second and third doses of the hepatitis B vaccine if the first dose had been administered in the newborn nursery, 64% of SF in contrast to 30% of SAC physicians reported routine nursery administration of the vaccine (P < 0.0001). CONCLUSIONS: Primary care physician adoption of universal hepatitis B infant immunization and routine nursery administration of the first dose of the vaccine were both greater in San Francisco than in Sacramento, suggesting impact of a community intervention to increase hepatitis B immunization rates.
OBJECTIVE: The impact of a community intervention to establish hospital nursery policies for universal newborn immunization against hepatitis B was determined by comparing primary care physician immunization practices in two counties, one intervention and one control. METHODS: Surveys were mailed to 855 physicians in 1994; 322 of 533 respondents were eligible, with 155 from San Francisco (SF), the intervention county, and 167 from Sacramento (SAC), the control county. Adoption of universal hepatitis B immunization was defined as immunizing more than 90% of infants seen in 1993. RESULTS: Although similar proportions of physicians agreed, 79% in SF and 72% in SAC, 64% of SF physicians and 40% of SAC physicians adopted universal infant immunization (P < 0.0001). Universal immunization was greater for pediatricians than for family physicians (OR = 2.00, 95% CI 1.66-2.41) but less for physicians who perceived their patients population to be at low risk for hepatitis B compared to those who did not (OR = 0.60, 95% CI 0.45-0.79). While 94% of physicians in both counties indicated their willingness to provide the second and third doses of the hepatitis B vaccine if the first dose had been administered in the newborn nursery, 64% of SF in contrast to 30% of SAC physicians reported routine nursery administration of the vaccine (P < 0.0001). CONCLUSIONS: Primary care physician adoption of universal hepatitis Binfant immunization and routine nursery administration of the first dose of the vaccine were both greater in San Francisco than in Sacramento, suggesting impact of a community intervention to increase hepatitis B immunization rates.
Authors: Karen Pazol; Julie A Gazmararian; Mila M Prill; Emily M O'Malley; Deborah Jelks; Margaret S Coleman; Alan R Hinman; Walter A Orenstein Journal: Open Health Serv Policy J Date: 2008-01-01