Improving Childhood Immunization Coverage Using a Statewide Immunization Registry

使用全州免疫登记处提高儿童免疫覆盖率

• 批准号: 7498051
• 负责人: Kevin J. Dombkowski
• 金额: $ 22万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7498051
• 关键词: Improving; Childhood; Immunization; Coverage; Using

DESCRIPTION (provided by applicant): Reminder/recall has been demonstrated to be an effective means of improving vaccination rates among children, yet its use has not been widely adopted. Immunization providers cite perceived staff time and cost as major factors impeding the adoption of reminder/recall. The proposed study will assess the effectiveness of a centralized reminder/recall intervention toward improving the immunization status of children in the urban area of Detroit, MI. Three reminder/recall strategies will be employed during the intervention: 7-month recall of children who are not up-to-date for vaccine recommended for receipt by six months of age; 12-month reminder for all children, to emphasize vaccination early in the second year of life; and 19-month recall of children who are not up-to-date for the primary immunization series. For each of the 3 strategies, an intervention arm will be paired with a control arm, to serve as the basis for assessment of reminder/recall effectiveness. The 3 strategies will be implemented and assessed independently, and compared to each other with regard to cost-effectiveness. The specific aims are to 1) develop a centralized reminder/recall intervention, that targets key age groups, incorporates the needs and preferences of both immunization providers and parents, and builds on existing capabilities of a high-functioning statewide immunization registry; 2) conduct a randomized controlled trial of the centralized reminder/recall intervention in a large urban area with historically low vaccination rates; and 3) evaluate the cost-effectiveness of each reminder/recall intervention strategy, to inform future efforts to implement centralized reminder/recall systems. The proposed project is unique in that it focuses on a large, racially and socioeconomically diverse, urban area with documented low vaccination rates; it features 3 different reminder/recall strategies targeted to key points in the children's vaccination schedule; it encompasses both personalized, patient-directed reminder/recall and vaccine-specific provider cues to action; and it incorporates a rigorous randomized controlled design. Results from the proposed study will provide reliable cost and effect-size estimates for the use of immunization information systems for centralized reminder/recall efforts.

描述（由申请人提供）： 提醒/召回已被证明是提高儿童疫苗接种率的有效手段，但尚未广泛采用其使用。免疫提供者认为，感知员工的时间和成本是阻碍提醒/召回的主要因素。拟议的研究将评估集中提醒/召回干预措施对改善密歇根州底特律市区儿童的免疫状况的有效性。干预期间将采用三种提醒/召回策略：7个月的召回儿童，这些儿童未最新的疫苗，建议在六个月之前收到疫苗；所有儿童的12个月提醒，强调生命的第二年初疫苗接种；以及19个月的召回儿童，这些儿童不是初级免疫系列的最新时间。对于这三种策略中的每一个，将与对照组配对，以作为评估提醒/召回效率的基础。这三种策略将独立实施和评估，并在成本效益方面相互比较。 具体目的是1）制定集中提醒/召回干预措施，该干预措施针对关键年龄段，结合了免疫提供者和父母的需求和偏好，并以高功能的全州免疫注册为基础； 2）在疫苗接种率较低的大型城市地区进行集中提醒/召回干预的随机对照试验； 3）评估每个提醒/召回干预策略的成本效益，以告知未来实施集中提醒/召回系统的努力。 拟议的项目的独特之处在于它的重点是大型，种族和社会经济多样化的城市地区，其疫苗接种率低。它具有针对儿童疫苗接种时间表的关键点的3种不同提醒/召回策略；它涵盖了个性化的，患者指导的提醒/召回和疫苗特定的提供商提示的行动；它结合了严格的随机控制设计。拟议的研究的结果将为使用免疫信息系统提供可靠的成本和效果大小的估计，用于集中式提醒/召回工作。