Allison Kempe1, Karen Albright2, S O'Leary3, Maureen Kolasa4, Juliana Barnard5, Deidre Kile5, Steven Lockhart5, L Miriam Dickinson6, Doron Shmueli5, Christine Babbel5, Jennifer Barrow5. 1. Children's Outcomes Research Program, The Children's Hospital, Aurora, CO, USA; Department of Pediatrics, University of Colorado, Aurora, CO, USA; The Colorado Health Outcomes Program, University of Colorado, Aurora, CO, USA. Electronic address: allison.kempe@childrenscolorado.org. 2. Children's Outcomes Research Program, The Children's Hospital, Aurora, CO, USA; The Colorado Health Outcomes Program, University of Colorado, Aurora, CO, USA; Colorado School of Public Health, University of Colorado, Aurora, CO, USA. 3. Children's Outcomes Research Program, The Children's Hospital, Aurora, CO, USA; Department of Pediatrics, University of Colorado, Aurora, CO, USA. 4. National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, USA. 5. Children's Outcomes Research Program, The Children's Hospital, Aurora, CO, USA. 6. Children's Outcomes Research Program, The Children's Hospital, Aurora, CO, USA; Department of Family Medicine, University of Colorado, Aurora, CO, USA.
Abstract
OBJECTIVE: To assess effectiveness and feasibility of public-private collaboration in delivering influenza immunization to children. METHODS:Four pediatric and four family medicine (FM) practices in Colorado with a common public health department (PHD) were randomized at the beginning of baseline year (10/2009) to Intervention (joint community clinics and PHD nurses aiding in delivery at practices); or control involving usual care without PHD. Generalized estimating equations compared changes in rates over baseline between intervention and control practices at end of 2nd intervention year (Y2=5/2011). Barriers to collaboration were examined using qualitative methods. RESULTS: Overall, rates increased from baseline to Y2 by 9.2% in intervention and 3.2% in control (p<.0001), with significant increases in both pediatric and FM practices. The largest increases were seen among school-aged and adolescent children (p<.0001 for both), with differences for 6-month-old to 5-year-old children and for children with high-risk conditions not reaching significance. Barriers to collaboration included uncertainty regarding the delivery of vaccine supplies, concerns about using up all purchased vaccine by practices, and concerns about documentation of vaccination if collaboration occurred. CONCLUSIONS: In spite of barriers, public-private collaboration resulted in significantly higher influenza immunization rates, particularly for older, healthy children who visit providers less frequently.
RCT Entities:
OBJECTIVE: To assess effectiveness and feasibility of public-private collaboration in delivering influenza immunization to children. METHODS: Four pediatric and four family medicine (FM) practices in Colorado with a common public health department (PHD) were randomized at the beginning of baseline year (10/2009) to Intervention (joint community clinics and PHD nurses aiding in delivery at practices); or control involving usual care without PHD. Generalized estimating equations compared changes in rates over baseline between intervention and control practices at end of 2nd intervention year (Y2=5/2011). Barriers to collaboration were examined using qualitative methods. RESULTS: Overall, rates increased from baseline to Y2 by 9.2% in intervention and 3.2% in control (p<.0001), with significant increases in both pediatric and FM practices. The largest increases were seen among school-aged and adolescent children (p<.0001 for both), with differences for 6-month-old to 5-year-old children and for children with high-risk conditions not reaching significance. Barriers to collaboration included uncertainty regarding the delivery of vaccine supplies, concerns about using up all purchased vaccine by practices, and concerns about documentation of vaccination if collaboration occurred. CONCLUSIONS: In spite of barriers, public-private collaboration resulted in significantly higher influenza immunization rates, particularly for older, healthy children who visit providers less frequently.
Authors: Ruta Valaitis; Donna Meagher-Stewart; Ruth Martin-Misener; Sabrina T Wong; Marjorie MacDonald; Linda O'Mara Journal: BMC Health Serv Res Date: 2018-06-07 Impact factor: 2.655
Authors: Mohammad Shahzad; Ross Upshur; Peter Donnelly; Aamir Bharmal; Xiaolin Wei; Patrick Feng; Adalsteinn D Brown Journal: BMC Public Health Date: 2019-06-07 Impact factor: 3.295