IMPROVING IMMUNIZATION RATE IN LOW INCOME CHILDREN

提高低收入儿童的免疫率

• 批准号: 6664604
• 负责人: ROBERT M MAYBERRY
• 金额: $ 22万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-12 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6664604
• 关键词: Medicare /Medicaid; behavioral /social science research tag; clinical research; clinical trials; health care personnel performance; health care policy; health care quality; health care service evaluation; health economics; health services research tag; human subject; immunization; low socioeconomic status; outcomes research; patient care management; pediatrics; preschool child (1-5); primary care physician

Vaccination is one of the safest, most effective and cost-effective preventive interventions. The likelihood of achieving desired coverage is significantly increased by a more intense immunization effort focusing on at-risk low-income urban communities at the point of primary health care. Objective: The primary objective of this demonstration project is to examine the effect of provider-based interventions in private clinic to improve immunization coverage among low-income preschool-aged children, particularly Medicaid beneficiaries. Study Design: A randomized, controlled intervention trial will be conducted among selected private clinic serving a substantial number of preschool children <5 years of age who are enrolled in Medicaid Program. This prospective, experimental study design will compare the effect of two interventions among similar provider practice types. A control group for each practice type will serve to measure background in immunization coverage in the absence of new immunization practices. To measure effectiveness, the change from baseline immunization coverage 6 and 12 months after the intervention began will be computed as the primary outcome measures. Interventions. Two interventions will use: AFIX and Bonus. AFIX consists of periodic assessment of immunization coverage of children < 5 years of age in the practice who are enrolled in Medicaid and discussions with providers about policies, procedures and practices (feedback) as they relate to under immunization and improving the immunization coverage of all children in the practice. Data Analysis: Coverage levels (percentage of children up-to-date for immunization at baseline and 6 and 12 months after interventions) and rates of missed opportunities for immunization by provider intervention and control groups before and after the intervention will be calculated and compared.

疫苗接种是最安全，最有效，最具成本效益的预防性干预措施之一。在初级卫生保健时期，重点侧重于高危低收入城市社区，实现预期覆盖的可能性大大增加了。目的：该演示项目的主要目的是检查私人诊所中基于提供者的干预措施的影响，以改善低收入学龄前儿童的免疫覆盖范围，尤其是医疗补助受益人。研究设计：将在选定的私人诊所中进行一项随机，对照干预试验，该诊所为大量的学龄前儿童<5岁的孩子参加了医疗补助计划。这项前瞻性实验研究设计将比较类似提供商实践类型中两种干预措施的影响。在没有新的免疫实践的情况下，每种实践类型的对照组将用于衡量免疫覆盖的背景。为了衡量有效性，将在干预开始后6和12个月对基线免疫覆盖率的变化将被计算为主要结果指标。干预措施。两种干预措施将使用：AFIX和奖金。 AFIX包括定期评估少于5岁的儿童的免疫承保范围，这些孩子正在接受医疗补助，并与提供者讨论有关政策，程序和实践（反馈）的讨论，因为他们与免疫接种并改善了所有儿童的免疫承保范围。数据分析：覆盖范围（在基线时的免疫接种以及干预后的6和12个月的最新儿童的百分比）以及提供者干预和对照组的免疫接种率将在干预前后进行计算和比较。