School Located Influenza Vaccinations for Children: Community-Wide Dissemination

学校为儿童接种流感疫苗：社区范围内的传播

• 批准号: 8551623
• 负责人: PETER G SZILAGYI
• 金额: $ 48.08万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8551623
• 关键词: Located; Influenza; Vaccinations; Children; Community

DESCRIPTION (provided by applicant): Annual influenza epidemics result in substantial mortality and morbidity among adults and children with more than $10 billion in direct medical costs. Although national guidelines recommend annual influenza vaccination of all school-aged children, less than half of these children are vaccinated. The major barrier is the short time window for vaccination: primary care practices are simply unable to vaccinate all of their pediatric patients within a few months. An alternative setting for child influenza vaccination is school-located influenza vaccinations (SLIV), yet <5% of children receive vaccine in schools. Three barriers impede SLIV: an ineffective paper-based parent consent system, ineffective parent reminders, and lack of experience with SLIV among adolescents. The goal of this project is to address these 3 barriers and to optimize influenza vaccination rates via SLIV. We will adapt two dissemination/implementation conceptual models (the Chronic Care Model and RE- AIM). We will work closely with schools, primary care practices, and local and state public health leaders, and with two national partners - CDC's National Center for Immunization and Respiratory Diseases (NCIRD) and the National Association of School Nurses (NASN). We propose a technical aim, a scientific aim, and a dissemination aim. The technical aim (Aim 1, Yr 1) is to develop, pilot, and evaluate a web-based consent and parent reminder system, using an innovative web-based informatics system. We will perform formative studies of parents, school staff, and providers, to create a useful system. The scientific aim (Aim 2, Yrs 2-4) is to perform effectiveness testing of SLIV, using web-based consent + reminders. We will randomize schools to SLIV vs. control in 3 successive annual RCTs, with increasing number of schools, and measure vaccination rates, school absences, and SLIV processes and costs. In Yr 2 we will include 5 schools districts (all elementary; 26 study, 28 control schools, n=25,078). In Yr 3 we will expand to 8 school districts and also middle/high schools (n=59,556 children); in Year 4 to 12 districts (n=79,713 children). The dissemination aim (Aim 3, Yrs 4-5) is to spread SLIV throughout Monroe County and diffuse SLIV best practices and technological innovations nationally. We will offer SLIV to all county schools (182 schools, n=112,034), and work with national partners to disseminate the consent/reminder system and a training program for SLIV across the US. This project addresses AHRQ priority area Prevention/Care Management, includes a focus on priority populations (adolescents, urban), and is a major redesign of primary care.

描述（由申请人提供）：年度流感流行病导致成人和儿童的死亡率和发病率超过100亿美元，直接医疗费用超过100亿美元。尽管国家准则建议对所有学龄儿童进行年度流感疫苗接种，但这些儿童中只有不到一半是接种疫苗的。主要的障碍是疫苗接种的短时间窗口：初级保健实践根本无法在几个月内接种其所有儿科患者。儿童流感疫苗接种的另一种环境是学校占流感疫苗接种（SLIV），但<5％的儿童在学校接受疫苗。三个障碍阻碍了SLIV：基于纸张的父母同意系统，无效的父母提醒以及青少年缺乏SLIV的经验。该项目的目的是解决这三个障碍，并通过SLIV优化流感疫苗接种率。我们将调整两个传播/实施概念模型（慢性护理模型和重新目标）。我们将与学校，初级保健实践以及地方和州的公共卫生领导人紧密合作，以及两个国家伴侣 - CDC国家免疫和呼吸道疾病中心（NCIRD）（NCIRD）和国家学校护士协会（NASN）。我们提出了一个技术目标，一个科学目标和传播目标。技术目标（AIM 1，YR 1）是使用基于创新的网络信息学系统来开发，试点和评估基于Web的同意和父母提醒系统。我们将对父母，学校工作人员和提供者进行形成性研究，以创建一个有用的系统。科学目的（AIM 2，YRS 2-4）是使用基于Web的同意 +提醒对SLIV进行有效性测试。我们将在3个连续的年度RCT中随机将学校与SLIV与控制，并随着学校的数量增加，并衡量疫苗接种率，学校缺勤以及SLIV过程和成本。在第一年，我们将包括5个学校区（所有基础； 26个研究，28个对照学校，n = 25,078）。在3年中，我们将扩展到8个学区和中/高中（n = 59,556名儿童）；在4至12年级的地区（n = 79,713名儿童）。传播目的（AIM 3，YRS 4-5）是在整个梦露县（Monroe County）以及全国范围内的最佳实践和技术创新。我们将为所有县级学校（182所学校，n = 112,034）提供SLIV，并与国家合作伙伴合作，为整个美国的SLIV提供了同意/提醒系统和培训计划。该项目解决了AHRQ优先领域的预防/护理管理，包括关注优先人群（青少年，Urban），并且是初级保健的主要重新设计。