Centralized IIS-Based Reminder-Recall to Increase Influenza Vaccination Rates

基于 IIS 的集中提醒召回可提高流感疫苗接种率

• 批准号: 8961827
• 负责人: ALLISON KEMPE
• 金额: $ 77.05万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-15 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8961827
• 关键词: Accident and Emergency department; Address; Adoption; Adult; Advisory Committees; Age; Age-Months; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Child; Childhood; Clinical Protocols; Clinical Trials; Collaborations; Communities; Community Practice; Costs and Benefits; County; Data; Disease; Effectiveness; Elderly; Electronic Health Record; Electronics; Emergency department visit; Epidemic; Failure; Family; Goals; Guidelines; Hospitalization; Hour; Immunization; Infection; Influenza; Influenza A virus; Influenza B Virus; Influenza vaccination; Information Systems; Intervention; Measures; Medical; Methods; Modeling; Morbidity - disease rate; Outpatients; Parents; Patients; Pharmacy facility; Play; Population; Preparation; Preventive; Primary Health Care; Private Practice; Randomized; Relative (related person); Research; Role; Seasons; Seminal; Services; Site; Study models; Subgroup; System; Telephone; Time; Vaccinated; Vaccination; Vaccines; Visit; Work; arm; base; comparative effectiveness; cost; cost effective; cost effectiveness; effectiveness trial; experience; improved; influenza outbreak; influenza virus vaccine; mortality; pandemic influenza; population based; pragmatic trial; prevent; public health relevance; seasonal influenza; standard of care; tool; trial comparing; vaccine delivery

 DESCRIPTION (provided by applicant): Annual epidemics of seasonal influenza cause substantial morbidity and mortality in the US with high rates of hospitalizations, emergency department and outpatient visits, and medical costs. Children experience significant morbidity from influenza, and also play a critical role in spreading infection to adults. Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended influenza vaccination for all children >6 months of age. However, vaccination rates remain very low-- only 56% of children 2-17 years are vaccinated. Low rates are a concern for both seasonal influenza and in preparation for pandemic influenza. One of the nationally recommended strategies for raising childhood influenza vaccination rates is to use parent reminder/recall (R/R) by phone or mail, which can raise rates by up to 20 percentage points. However, less than 16% of primary care practices use R/R despite many studies showing its effectiveness. Statewide immunization information systems (IISs) now exist in all states to track childhood vaccinations, but they have not been used for R/R for influenza vaccine because of the lack of evidence for its effectiveness and lack of a template for IIS-based R/R. We have united two leading immunization research groups (Denver, CO and Rochester, NY) to assess the impact of centralized IIS-based influenza vaccine R/R, and to evaluate the added value of mailed R/R over the less-expensive phone R/R. We will also develop tools to aid other states in creating efficient IIS R/R systems for seasonal and possible pandemic influenza outbreaks. Our study has four aims. Aim 1 is to develop the protocols, clinical decision support, and message content for state IISs to conduct reminder/recall for influenza vaccinations. Aim 2a is to compare centralized IIS autodialer (phone) R/R to standard of care control to assess the impact of IIS R/R on vaccination rates. We will use a cluster- randomized pragmatic trial in two states (CO and NY) that vary in vaccination delivery systems and will apply the RE-AIM framework to evaluate the reach, effectiveness/cost-effectiveness, adoption and implementation of IIS R/R. This RCT will involve 66,000 children 6m-17yrs from 60 practices, allowing us to assess the impact of IIS R/R on the entire population and on subgroups. Aim 2b will use a nested RCT within the above RCT to compare the impact of IIS-based R/R to the child's practice versus IIS-based R/R to the practice plus other community vaccination sites Aim 3 will evaluate the added benefit (and costs) of mailed R/R for autodialer failures (wrong number, no phone). For this aim we will use a 2-arm RCT, randomizing children within practices to autodialer-alone versus combined autodialer + mailed R/R. This RCT will involve 33,000 children from 60 practices. Aim 4 (dissemination aim) will develop a toolkit for state IIS-based influenza vaccine R/R for seasonal and pandemic influenza, and work with key stakeholders on a sustainability plan. By the end of the study we will have a feasible and cost-effective model to raise child seasonal or possibly pandemic influenza vaccination rates to prevent influenza. We will disseminate the IIS model to all states.

 描述（通过应用程序提供）：季节性影响力的年度发作在美国导致大量的发病率和死亡率，其住院率很高，急诊室和门诊就诊以及医疗费用。儿童从影响力中经历了明显的发病率，并且在向成年人传播感染方面也起着至关重要的作用。自2010年以来，免疫实践咨询委员会（ACIP）建议对所有6个月大的儿童进行影响力疫苗接种。但是，疫苗接种率仍然很低 - 只有56％的2-17岁儿童接种疫苗。低比率是季节性影响力和准备大流行性影响力的关注点。全国推荐提高儿童流感疫苗率的策略之一是通过电话或邮件使用父母提醒/召回（R/R），这可以将费率提高高达20％。但是，只有不到16％的初级保健实践使用R/R绝望地表明其有效性。目前，所有州都存在全州的免疫抑制信息系统（IISS）以跟踪儿童疫苗接种，但由于缺乏证据表明其有效性和基于IIS的R/R模板，因此尚未用于R/R进行R/R。我们拥有两个领先的免疫抑制研究小组（丹佛，CO和纽约州罗切斯特），以评估基于IIS的基于IIS的流感疫苗R/R的影响，并评估邮寄R/R的附加值相对于较低廉价的电话R/R。我们还将开发工具，以帮助其他州为季节性和可能的​​大流行影响爆发创造有效的IIS R/R系统。我们的研究有四个目标。目的1是为州IISS开发协议，临床​​决策支持和消息内容，以进行影响/召回影响力疫苗接种。 AIM 2A是将集中的IIS Autodialer（电话）R/R与护理控制标准进行比较，以评估IIS R/R对疫苗率的影响。我们将在两个州（CO和NY）中使用群集随机务实试验，该试验在疫苗输送系统中有所不同，并将应用Re-AIM框架来评估IIS R/R的覆盖范围，有效性/成本效益，采用和实施。该RCT将涉及60种实践中的66,000名儿童6M-17岁儿童，使我们能够评估IIS R/R对整个人群和子组的影响。 AIM 2B将在上述RCT中使用嵌套的RCT来比较基于IIS的R/R对孩子的实践的影响与基于IIS的R/R对实践以及其他社区疫苗接种站点AIM 3将评估邮寄R/R的额外利益（和成本）对自动级别的失败（错误的数量，无电话）。为此，我们将使用2臂RCT，在实践中随机将儿童随机化，以与自动启动器 +邮寄的R/R合并。该RCT将涉及60种习惯的33,000名儿童。 AIM 4（传播目标）将为基于州IIS的季节性和大流行影响者的基于州IIS的影响力疫苗R/R开发一种工具包，并与主要利益相关者合作制定可持续性计划。在研究结束时，我们将有一个可行且具有成本效益的模型，以提高儿童季节性或可能的大流行影响力疫苗率，以防止影响力。我们将将IIS模型传播到所有州。