Partnering with parents to remove barriers and improve influenza immunization rates for young children.

BACKGROUND: Despite the ongoing public health initiatives to increase pediatric influenza immunization rates to 80%, only a few US health centers have been able to meet this goal. The suboptimal immunity to influenza poses individual and societal risks for vaccine-preventable cases of influenza and its complications. LOCAL PROBLEM: At a diverse, urban, family health center, its influenza immunization rate of 44% represented the lowest uptake rate compared with all other early childhood vaccines, increasing the risk of morbidity and mortality in young children, including hospitalization and death. METHODS: To identify key barriers to influenza immunization, the investigators interviewed parents of children aged 6 through 24 months at this urban family health center via randomized sampling using an open-ended telephone survey. INTERVENTIONS: Based on the concerns parents expressed through the survey, a program was designed and implemented that included reminder calls, parent education, proactive appointment scheduling, and social media reminders. RESULTS: After implementing a parent-driven quality-improvement program for 6 months during influenza season, the health center's pediatric influenza immunization rates rose to 57% compared with 44% during the year before. CONCLUSIONS: Childhood immunization is a critical priority to protect the health and wellness of children. Increasing parent engagement in discussions about increasing immunization rates not only promotes awareness surrounding vaccines but also allows primary care providers to learn from parents to create a patient-centered immunization program. Programs that specifically target immunization efforts toward parental concerns have the potential for increased vaccine acceptance and improved health outcomes.

Pacifiers: an update on use and misuse.

PURPOSE: The use of pacifiers is a controversial topic; this article looks at the subject from both a historical and cultural perspective, with a review of current research. CONCLUSIONS: The use of pacifiers in infants older than 1 month is currently recommended by multiple researchers to prevent sudden infant death syndrome, and is associated with other benefits for premature infants. However, pacifier use has also been associated with higher risk of otitis media. PRACTICE IMPLICATIONS: Knowledge of the most recent evidence will enable providers to communicate appropriate guidelines on pacifier use to families.