An evaluation of school-level factors used in a successful school-based hepatitis B immunization initiative.

PURPOSE: To examine the effect of different school-level factors on the percent return of consent or refusal forms, the percent student participation/enrollment rate, and the percent completion rate of all 3 immunizations in the vaccination series in a school-based hepatitis B immunization initiative.
METHODS: The Houston Hepatitis B Immunization Initiative (HBII) was conducted from 1998 through 2001 to provide free hepatitis B immunizations to elementary school students in low socioeconomic areas. At the end of each academic school year, the nurse from each school participating in the initiative was asked to complete a survey evaluating the different strategies utilized in each school to aid in the program's success. The effect of different organizational methods on rate of return of consent/refusal forms, participation rates, and immunization completion rates from the program year 1999-2000 was determined using frequencies, Mann-Whitney analyses, Kruskal-Wallis analyses, and Spearman's correlations.
RESULTS: An increase in percent return of signed consent/refusal forms was more likely when teachers helped in publicity/promotion (p = .012) and educational packet distribution (p = .041). Additionally, when teachers assumed responsibility for collecting the forms, the percent return of signed consent/refusal forms (p = .018) and the percent of students receiving all 3 vaccines in the series through HBII (p = .030) were more likely to increase. An increase in signed consent/refusal forms returned was also associated with increased rates of student participation in the program for each school. In schools where students helped specifically with educational packet distribution (p = .039), the percent of students receiving at least 1 vaccine dose from the program was more likely to be higher.
CONCLUSIONS: The involvement of teachers in vaccination programs is very important for program success, especially in the enrollment and return of consent/refusal form phases of immunization initiatives. Student involvement may empower the students and encourage other students to participate in the program. Future school-based immunization initiatives can utilize these data to incorporate the most effective school-level factors into their programs to maximize the number of students immunized.