ABSTRACT
We sought to determine if a simple educational intervention initiated at the first well-child care visit, with reinforcement at subsequent visits, can improve inner-city infant immunization rates. We conducted a controlled trial involving 315 newborn infants and their primary caregivers in 3 inner-city primary care centers. Child health care providers gave caregivers in the intervention group an interactive graphic card with verbal reinforcement. At later visits, stickers were applied to the card when immunizations were given. Routine information was given to controls. After the trial, age-appropriate immunization rates at 7 months were 58% in each group. Intervention infants had 50% fewer missed opportunities to immunize (p=0.01) but cancelled 77% more appointments (p=0.04) than controls. We conclude that a brief educational intervention at the first well-child care visit did not boost 7-month immunization rates, although it was associated with fewer missed opportunities to immunize.
Subject(s)
Communicable Disease Control/methods , Health Education/organization & administration , Immunization Programs/statistics & numerical data , Vaccination/statistics & numerical data , Analysis of Variance , Case-Control Studies , Educational Status , Female , Humans , Infant , Infant, Newborn , Male , Poverty , Probability , Risk Assessment , Risk Factors , Socioeconomic Factors , United States , Urban PopulationABSTRACT
OBJECTIVE: This study evaluated the benefit of consulting a statewide immunization registry for inner-city infants whose immunizations appeared, after single-site chart review, to have been delayed. METHODS: We prospectively enrolled 315 newborns in 3 inner-city pediatric clinics. When the infants turned 7 months old, we obtained immunization data from clinic charts and the state registry. RESULTS: On the basis of chart review, 147 infants (47%) were assessed to be delayed in their immunizations; of these, registry data revealed that 28 (19%) had received additional immunizations and 15 (10%) were actually up to date. CONCLUSIONS: A statewide registry can capture immunizations from multiple sources, improving accurate determination of immunization rates in a mobile, inner-city population.
Subject(s)
Immunization/statistics & numerical data , Registries , Chi-Square Distribution , Cohort Studies , Connecticut , Evaluation Studies as Topic , Female , Humans , Infant , Male , Medical Records , Prospective Studies , Urban PopulationABSTRACT
Case studies are presented on three organizational models for immunization registries in local communities: agency-based, facility-based, and population-based systems. The strengths and limitations of the respective approaches are highlighted. Each model faces three similar challenges: generating "real-time" information on the status of children who fall behind on their immunizations, assuring confidentiality of registrants and medical information, and maintaining operations amidst adverse social conditions that are at the root of underimmunization of children. With sufficient resources and cooperation among many private and public interests, registries have considerable potential to increase vaccination coverage among our population.
