OBJECTIVE: To test a stepped intervention of reminder/recall/case management to increase infant well-child visits and immunization rates. METHODS: We conducted a randomized, controlled, practical, clinical trial with 811 infants born in an urban safety-net hospital and followed through 15 months of life. Step 1 (all infants) involved language-appropriate reminder postcards for every well-child visit. Step 2 (infants who missed an appointment or immunization) involved telephone reminders plus postcard and telephone recall. Step 3 (infants still behind on preventive care after steps 1 and 2) involved intensive case management and home visitation. RESULTS: Infants in the intervention arm, compared with control infants, had significantly fewer days without immunization coverage in the first 15 months of life (109 vs 192 days P < .01) and were more likely to have >or=5 well-child visits (65% vs 47% P < .01). In multivariate analyses, infants in the intervention arm were more likely than control infants to be up to date with 12-month immunizations and to have had >or=5 well-child visits. The cost per child was $23.30 per month. CONCLUSION: This stepped intervention of tracking and case management improved infant immunization status and receipt of preventive care in a population of high-risk urban infants of low socioeconomic status.
RCT Entities:
OBJECTIVE: To test a stepped intervention of reminder/recall/case management to increase infant well-child visits and immunization rates. METHODS: We conducted a randomized, controlled, practical, clinical trial with 811 infants born in an urban safety-net hospital and followed through 15 months of life. Step 1 (all infants) involved language-appropriate reminder postcards for every well-child visit. Step 2 (infants who missed an appointment or immunization) involved telephone reminders plus postcard and telephone recall. Step 3 (infants still behind on preventive care after steps 1 and 2) involved intensive case management and home visitation. RESULTS:Infants in the intervention arm, compared with control infants, had significantly fewer days without immunization coverage in the first 15 months of life (109 vs 192 days P < .01) and were more likely to have >or=5 well-child visits (65% vs 47% P < .01). In multivariate analyses, infants in the intervention arm were more likely than control infants to be up to date with 12-month immunizations and to have had >or=5 well-child visits. The cost per child was $23.30 per month. CONCLUSION: This stepped intervention of tracking and case management improved infant immunization status and receipt of preventive care in a population of high-risk urban infants of low socioeconomic status.
Authors: Lisa M Nicholson; Patricia M Schwirian; Elizabeth G Klein; Theresa Skybo; Lisa Murray-Johnson; Ihuoma Eneli; Bethany Boettner; Gina M French; Judith A Groner Journal: Contemp Clin Trials Date: 2011-01-27 Impact factor: 2.226
Authors: Peter G Szilagyi; Christina Albertin; Sharon G Humiston; Cynthia M Rand; Stanley Schaffer; Howard Brill; Joseph Stankaitis; Byung-Kwang Yoo; Aaron Blumkin; Shannon Stokley Journal: Acad Pediatr Date: 2013-01-09 Impact factor: 3.107
Authors: Joanne E Cox; Matthew P Buman; Elizabeth R Woods; Olatokunbo Famakinwa; Sion Kim Harris Journal: Am J Public Health Date: 2012-08-16 Impact factor: 9.308
Authors: Jo Ann D'Agostino; Molly Passarella; Philip Saynisch; Ashley E Martin; Michelle Macheras; Scott A Lorch Journal: Pediatrics Date: 2015-10 Impact factor: 7.124