Impact of Measurement and Feedback on Vaccination Coverage in Public Clinics, 1988-1994

LeBaron, Charles W.; Chaney, Michael A.; Baughman, Andrew L.; Dini, Eugene F.; Maes, Edmond F.; Dietz, Vance; Bernier, Roger H.

doi:10.1001/jama.1997.03540320033031

Cited by 85 publications

(48 citation statements)

References 11 publications

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“…10 -13 On the basis of this evidence, the Task Force on Community Preventive Services in 1999 strongly recommended that all practices implement these approaches. 14 In addition, both the National Vaccine Advisory Committee 15, 16 and the Task Force on Community Preventive Services 17,18 have recommended routine immunization audits to determine immunization coverage levels for preschoolage children in both the public 19 and private 20 sectors.…”

Section: Espite Increases In Immunization Coveragementioning

confidence: 99%

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Tierney¹,

Yusuf

McMahon

et al. 2003

Pediatrics

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ABSTRACT. Objective. Strong scientific evidence and national recommendations support the use of reminder and recall messages to improve immunization coverage rates, yet reports have suggested that only a minority of pediatric practices use such messages. Our aims were to 1) determine the proportions of pediatric practices and public clinics that currently use practicebased reminder or recall messages and routinely undergo immunization assessment efforts, 2) evaluate barriers and supports to implementing these practices, and 3) identify predictors of either current use or plans for future adoption of these practices.Methods. This study combined qualitative and quantitative methods in sequential phases. In the qualitative phase, we conducted semistructured, open-ended interviews with a convenience sample of 18 clinician-administrators representing adopters and nonadopters of these messages in both private practices and public health clinics. In the subsequent quantitative phase, we mailed a structured, closed-ended survey to national samples of randomly selected pediatricians (n ‫؍‬ 600) and public clinics (n ‫؍‬ 600).Results. Response rates were 75% for pediatricians and 77% for public clinics. Among pediatricians, 38% were conducting regular assessments of immunization coverage but only 16% were currently using routine reminder or recall messages. Among public clinics, 85% were conducting regular assessments and 51% were using reminder or recall messages. Among pediatricians' practices, the most commonly reported barriers to the adoption of reminder or recall messages were lack of time and funding and the inability to identify children at specified ages. For pediatricians' practices, the strongest predictors of current use of reminder or recall messages were having a champion who led efforts to improve immunization delivery (odds ratio: 1.85; 95% confidence interval: 1.08 -3.18) and current use of regular immunization assessments (odds ratio: 2.30; 95% confidence interval: 1.33-3.84). Likewise, for public health clinics, having a champion to lead immunization improvement efforts and believing that their current system needed improvement was associated with current use of reminder or recall messages.Conclusions. Reminder and recall messages remain underused by both pediatricians and public health clinics. Promising strategies to promote adoption of these approaches in both the private and the public sectors include identifying and training champions to promote immunization delivery improvement efforts and helping practices develop methods to identify children at specific ages. Pediatrics 2003;112:1076 -1082; immunizations, interventions, quality of care, recall, reminder, assessment.ABBREVIATIONS. OR, odds ratio; CI, confidence interval.

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Section: Espite Increases In Immunization Coveragementioning

confidence: 99%

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Tierney¹,

Yusuf

McMahon

et al. 2003

Pediatrics

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“…A study in Georgia public clinics demonstrated an increase in vaccine coverage with feedback to practitioners. 21 We also suggest regular review of immunization schedules with updates from the American Academy of Pediatrics or Advisory Committee on Immunization Practices, reviewing true and false contraindications for immunization and developing clinic guidelines on appropriate reasons to withhold immunizations.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Do Missed Opportunities Stay Missed? A 6-Month Follow-up of Missed Vaccine Opportunities in Inner City Milwaukee Children

et al. 1998

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ABSTRACT. Objectives. To determine 1) the frequency of missed vaccine opportunities (VOs) in inner city children <3 years of age; 2) whether the recommended vaccine(s) were given within 6 months of the missed opportunity (MO); 3) whether these vaccinations were ageappropriate according to the guidelines of the Advisory Committee on Immunization Practices; and 4) variables associated with MOs.Design. Retrospective chart review with a nested retrospective cohort of children with MOs.Setting. Two inner city practice settings in Milwaukee: a community health center and an academic continuity care practice.Patients/Selection Procedure. A consecutive sample of 710 visits of inner city children <3 years of age with VOs, seen between January 1 and March 31, 1995. A VO was defined as any encounter when the child was vaccine-eligible according to Advisory Committee on Immunization Practices guidelines.Results. MOs occurred in 47% (330/710) of the VOs. Only 40% of the children with MOs received age-appropriate immunizations within 6 months; 30% received the vaccinations beyond the age-appropriate time. The remaining 30% either did not return or were not vaccinated on return. The variables significantly associated with MOs were 1) age: children with MOs were older than those without, with a mean age of 15.5 months vs 10.9 months; 2) minor febrile illness; 3) moderate/severe illness; 4) acute illness encounters; and 5) patient's being seen at the community health center. Only 15.5% of all MOs were justified by the presence of moderate/severe illness.Conclusions. VOs are frequently missed in inner city children. Most of the MOs were not justified by the valid contraindication of moderate/severe illness. Sixty percent of the children with MOs did not receive age-appropriate immunizations within 6 months. These children are vulnerable to vaccine-preventable diseases such as measles and pertussis. Pediatrics 1998;101(5). URL: http://www. pediatrics.org/cgi/content/full/101/5/e5; immunization, vaccination, missed opportunities, children, pre-school.ABBREVIATIONS. DTP/DTaP, diphtheria, tetanus and pertussis/acellular pertussis vaccines; OPV/IPV, oral polio vaccine/ inactivated polio vaccine; MMR, measles, mumps, and rubella vaccine; VO, vaccine opportunities; MO, missed opportunities; Hib, Haemophilus influenzae type B vaccine; CI, confidence interval; SBI, serious bacterial illness.

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“…Vollständige Erfassungen sind nur über populationsbezogene Impfregister möglich, die jedoch einen erheblichen organisatorischen und finanziellen Aufwand erfordern und Probleme der Datensicherheit undnutzung aufweisen können. Bei Implementation und sachgerechter Nutzung sind populationsgerechte Register aber eine geeignete Methode um Impfraten zu erhöhen [11,12,13]. In Deutschland bestehen derzeit in zwei Bundesländern gesetzliche Grundlagen und Bemühun-gen, eine bevölkerungsbezogene Impferfassung einzuführen.…”

Section: Erfassungssysteme Zu Durchimpfungsratenunclassified

Über die Bedeutung von Schutzimpfungen

Reiter

2009

Public Health Forum

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ZusammenfassungSchutzimpfungen haben in der Bekämpfung von Infektionskrankheiten neben der Verbesserung der sozialen und hygienischen Lebensbedingungen aufgrund ihrer Effektivität, der günstigen Risiko-Nutzen-Relation und ihrer gesellschaftlichen und gesund- Vaccination, along with the improvement of social and hygienic living conditions, has played a key role in the prevention and control of infectious diseases due to its effectiveness, its favourable risk-benefit ratio and strong acceptance on the part of society and health policy makers.The further development of vaccination programs depends on the continual collection of valid data on the incidence of vaccine preventable diseases, immunisation rates, seroprevalence, vaccine related complications as well as on the evaluation of existing programs.The Protection against Infection Act (IfSG) in effect since January 1, 2001 has closed important gaps in the surveillance of vaccine preventable diseases and the implementation of vaccination programs in Germany.The data presented here show the decrease in the incidence of vaccine preventable diseases following implementation of vaccination and increasing vaccine coverage in Germany, underlining the effectiveness of vaccines as well as vaccination programs.The acceptance of vaccination is influenced by various factors that should be taken into account in the organization of vaccination programs.Measures shown to improve vaccination rates in international studies include the establishment of vaccine registries, reminder and recall systems, education of the public as well as health care workers, reimbursement of providers, improvement of access to providers and quality control measures.The deficits in Germany described here reveal further requirements for the organization of vaccination programs, for the improvement of awareness for the importance of vaccine coverage and for the achievement of health related goals. Originalien und Übersichtsarbeiten

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Impact of Measurement and Feedback on Vaccination Coverage in Public Clinics, 1988-1994

Abstract: A marked increase in vaccination coverage occurred in Georgia public clinics associated with a program of annual measurement and feedback.

Cited by 85 publications

References 11 publications

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Do Missed Opportunities Stay Missed? A 6-Month Follow-up of Missed Vaccine Opportunities in Inner City Milwaukee Children

Über die Bedeutung von Schutzimpfungen

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