OBJECTIVE: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents. DESIGN: Randomized clinical trial allocating adolescents (aged 11-15 years) tointervention vs standard of care control. SETTING: Eight primary care practices. PARTICIPANTS: Population-based sample of adolescents (N = 7546). INTERVENTION: Immunization navigators at each practice implemented a tiered protocol: immunization tracking, telephone or mail reminder/recall, and home visits if participants remained unimmunized or behind on preventive care visits. MAIN OUTCOME MEASURES: Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs. RESULTS: The intervention and control groups were similar at baseline for demographics (mean age, 13.5 years; 63% black, 14% white, and 23% Hispanic adolescents; and 74% receiving Medicaid), immunization rates, and preventive care visit rates. Immunization rates at the end of the study were 44.7% for the intervention group and 32.4% for the control group (adjusted risk ratio, 1.4; 95% confidence interval, 1.3-1.5); preventive care visit rates were 68.0% for the intervention group and 55.2% for the control group (1.2; 1.2-1.3). Findings were similar across practices, sexes, ages, and insurance providers. The number needed to treat for immunizations and preventive care visits was 9. The intervention cost was $3.81 per adolescent per month; the cost per additional adolescent fully vaccinated was $465, and the cost per additional adolescent receiving a preventive care visit was $417. CONCLUSION: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00581347.
RCT Entities:
OBJECTIVE: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents. DESIGN: Randomized clinical trial allocating adolescents (aged 11-15 years) to intervention vs standard of care control. SETTING: Eight primary care practices. PARTICIPANTS: Population-based sample of adolescents (N = 7546). INTERVENTION: Immunization navigators at each practice implemented a tiered protocol: immunization tracking, telephone or mail reminder/recall, and home visits if participants remained unimmunized or behind on preventive care visits. MAIN OUTCOME MEASURES: Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs. RESULTS: The intervention and control groups were similar at baseline for demographics (mean age, 13.5 years; 63% black, 14% white, and 23% Hispanic adolescents; and 74% receiving Medicaid), immunization rates, and preventive care visit rates. Immunization rates at the end of the study were 44.7% for the intervention group and 32.4% for the control group (adjusted risk ratio, 1.4; 95% confidence interval, 1.3-1.5); preventive care visit rates were 68.0% for the intervention group and 55.2% for the control group (1.2; 1.2-1.3). Findings were similar across practices, sexes, ages, and insurance providers. The number needed to treat for immunizations and preventive care visits was 9. The intervention cost was $3.81 per adolescent per month; the cost per additional adolescent fully vaccinated was $465, and the cost per additional adolescent receiving a preventive care visit was $417. CONCLUSION: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00581347.
Authors: Emily B Walling; Sherry Dodd; Neil Bobenhouse; Evelyn Cohen Reis; Randy Sterkel; Jane Garbutt Journal: Am J Prev Med Date: 2019-01 Impact factor: 5.043
Authors: Alexander G Fiks; Robert W Grundmeier; Stephanie Mayne; Lihai Song; Kristen Feemster; Dean Karavite; Cayce C Hughes; James Massey; Ron Keren; Louis M Bell; Richard Wasserman; A Russell Localio Journal: Pediatrics Date: 2013-05-06 Impact factor: 7.124
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: Melissa B Gilkey; Michael J Parks; Marjorie A Margolis; Annie-Laurie McRee; Jason V Terk Journal: Pediatrics Date: 2019-06-17 Impact factor: 7.124
Authors: Susmita Pati; James Guevara; Guangxiang Zhang; Suraj K Bhatt; Jane Kavanagh; Marsha Gerdes; Russell Localio; Christopher B Forrest Journal: Matern Child Health J Date: 2013-12