PURPOSE: Influenza immunization rates among children with high-risk medical conditions are disappointingly low, and relatively few data are available on raising rates, particularly over 2 years. We wanted to determine whether interventions tailored to individual practice sites improve influenza immunization rates among high-risk children in inner-city health centers over 2 years. METHOD: A before-after trial to improve influenza immunization of children was conducted at 5 inner-city health centers (residencies and faith-based). Sites selected interventions from a menu (eg, standing orders, patient and clinician reminders, education) proved to increase vaccination rates, which were directed at children aged 2 to 17 years with high-risk medical conditions. Intervention influenza vaccination rates and 1 and 2 years were compared with those of the preintervention year (2001-2002) and of a comparison site. RESULTS: Influenza vaccination rates improved modestly from baseline (10.4%) to 13.1% during intervention year 1 and to 18.7% during intervention year 2 (P <.001), with rates reaching 31% in faith-based practices. Rates increased in all racial and age-groups and in Medicaid-insured children. The increase in rates was significantly greater in intervention health centers (8.3%) than in the comparison health center (0.7%; P <.001). In regression analyses that controlled for demographic factors, vaccination status was associated with intervention year 1 (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.6-2.2) and with intervention year 2 (OR, 2.8; 95% CI, 2.3-3.4), as well as with practice type. Adolescents had lower vaccination rates than children 2 to 6 years old (OR, 0.6; 95% CI, 0.5-0.7). CONCLUSIONS: Tailored interventions selected from a menu of interventions modestly increased influenza vaccination rates over 2 years at health centers serving children from low-income families. We recommend this strategy for faith-based practices and residencies with 1 practice site, but further research is needed on multisite practices and to achieve higher influenza vaccination rates.
PURPOSE: Influenza immunization rates among children with high-risk medical conditions are disappointingly low, and relatively few data are available on raising rates, particularly over 2 years. We wanted to determine whether interventions tailored to individual practice sites improve influenza immunization rates among high-risk children in inner-city health centers over 2 years. METHOD: A before-after trial to improve influenza immunization of children was conducted at 5 inner-city health centers (residencies and faith-based). Sites selected interventions from a menu (eg, standing orders, patient and clinician reminders, education) proved to increase vaccination rates, which were directed at children aged 2 to 17 years with high-risk medical conditions. Intervention influenza vaccination rates and 1 and 2 years were compared with those of the preintervention year (2001-2002) and of a comparison site. RESULTS: Influenza vaccination rates improved modestly from baseline (10.4%) to 13.1% during intervention year 1 and to 18.7% during intervention year 2 (P <.001), with rates reaching 31% in faith-based practices. Rates increased in all racial and age-groups and in Medicaid-insured children. The increase in rates was significantly greater in intervention health centers (8.3%) than in the comparison health center (0.7%; P <.001). In regression analyses that controlled for demographic factors, vaccination status was associated with intervention year 1 (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.6-2.2) and with intervention year 2 (OR, 2.8; 95% CI, 2.3-3.4), as well as with practice type. Adolescents had lower vaccination rates than children 2 to 6 years old (OR, 0.6; 95% CI, 0.5-0.7). CONCLUSIONS: Tailored interventions selected from a menu of interventions modestly increased influenza vaccination rates over 2 years at health centers serving children from low-income families. We recommend this strategy for faith-based practices and residencies with 1 practice site, but further research is needed on multisite practices and to achieve higher influenza vaccination rates.
Authors: K C Stange; S J Zyzanski; C R Jaén; E J Callahan; R B Kelly; W R Gillanders; J C Shank; J Chao; J H Medalie; W L Miller; B F Crabtree; S A Flocke; V J Gilchrist; D M Langa; M A Goodwin Journal: J Fam Pract Date: 1998-05 Impact factor: 0.493
Authors: Richard K Zimmerman; Alejandro Hoberman; Mary Patricia Nowalk; Chyongchiou J Lin; David P Greenberg; Stuart T Weinberg; Charles W Bemm; Bruce Block Journal: Am J Prev Med Date: 2004-12 Impact factor: 5.043
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Authors: Mary Patricia Nowalk; Chyongchiou Jeng Lin; Kristin Hannibal; Evelyn C Reis; Gregory Gallik; Krissy K Moehling; Hsin-Hui Huang; Norma J Allred; David H Wolfson; Richard K Zimmerman Journal: Am J Prev Med Date: 2014-08-08 Impact factor: 5.043
Authors: Eric K Shaw; Jenna Howard; David R West; Benjamin F Crabtree; Donald E Nease; Brandon Tutt; Paul A Nutting Journal: J Am Board Fam Med Date: 2012 Sep-Oct Impact factor: 2.657
Authors: Elisabetta Pandolfi; Maria C Graziani; Roberto Ieraci; Giovanni Cavagni; Alberto E Tozzi Journal: BMC Public Health Date: 2008-08-06 Impact factor: 3.295