Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee's Children Program.
Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee's Children Program.
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DOI：
10.1353/cpr.2016.0009
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Simpson P
中科院分区：
文献类型：
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作者：
Willis E;Sabnis S;Hamilton C;Xiong F;Coleman K;Dellinger M;Watts M;Cox R;Harrell J;Smith D;Nugent M;Simpson P
在全国范围内，19-35个月儿童的DTaP/3 HPV/1 MMR/3 HepB/3 Hib/1VZV抗原系列的免疫覆盖率接近或高于2020年健康人群目标（80%）。然而，社会经济地位较低家庭的儿童的覆盖率较低。利用基于社区的参与性研究（CBPR）的方法，社区健康改善密尔沃基儿童（CHIMC）干预，以减少儿童免疫接种的差距。CHIMC通过自我评估，以检查遵守CBPR原则的有效性。使用行为改变模型，CHIMC实施了教育，社会营销活动和计划行为干预理论。社区居民和组织代表审查了所有流程、信息和数据收集工具。在这8年期间，对《全面、建设性和可持续的伙伴关系》原则的遵守一直是积极的。CHIMC招募了565名父母/照顾者和1,533名儿童参加教育和计划行为改变（PBC）干预，并招募了另外406名接受社会营销活动调查的儿童。留存率很高（80%），参与者主要是黑人女性（90%）和失业者（64%）;儿童的平均年龄为6.2岁。在父母/照顾者中不断观察到免疫接种知识的增加。社会营销数据显示，社区开发的信息（“控制：用免疫保护你的孩子”）得到了高度认可（85%）。儿童免疫接种的障碍和促进因素显示保护因素与最新（UTD）状态呈正相关（p < 0.007）。最终，年龄在19至35个月之间的儿童，其父母/照顾者完成了教育课程，并从社区范围的社会营销信息中受益，他们的免疫状况在4年内从基线的45%增加到82%。通过多层次的干预措施，CHIMC有助于消除儿童免疫接种的差异。一个适合文化的CBPR方法是有效的，以消除免疫差距。
Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19–35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates. Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations. The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools. Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children’s median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message (“Take Control: Protect Your Child with Immunizations”). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p < 0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years. Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities.