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、最有效和最具成本效益的预防干预措施之一。通过在初级卫生保健方面重点关注高危低收入城市社区的更密集的免疫接种工作，实现预期覆盖率的可能性显着增加。目标：该示范项目的主要目标是检查私人诊所中基于提供者的干预措施对提高低收入学龄前儿童（特别是医疗补助受益人）的免疫覆盖率的效果。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，这些诊所为大量参加医疗补助计划的 5 岁以下学龄前儿童提供服务。这项前瞻性的实验研究设计将比较类似提供者实践类型中两种干预措施的效果。每种实践类型的对照组将用于在没有新的免疫接种实践的情况下衡量免疫覆盖率的背景。为了衡量有效性，将计算干预开始后 6 个月和 12 个月相对于基线免疫覆盖率的变化作为主要结果指标。干预措施。将使用两种干预措施：AFIX 和 Bonus。 AFIX 包括定期评估参加 Medicaid 的 5 岁以下儿童的免疫覆盖率，并与提供者讨论与免疫不足相关的政策、程序和做法（反馈）以及提高所有儿童的免疫覆盖率在实践中。数据分析：将计算并比较干预前后提供者干预组和对照组的覆盖率水平（在基线以及干预后 6 个月和 12 个月时最新接种疫苗的儿童百分比）以及错失免疫机会的比率。