Bridging the Gap in Childhood Immunization Rates in Milwaukee

免疫接种是现有最有效和最具成本效益的预防干预措施之一。未接 接种疫苗的机会（MO）发生在有资格接受一次或多次免疫接种的儿童访问 卫生保健提供者，但没有接种疫苗。MO几乎总是由潜在的医疗错误引起的， 它们是导致免疫不足和延迟适龄免疫接种的主要因素， 儿童，使这些儿童-以及他们的家庭和社区接触-容易受到各种各样的 严重的、可预防的传染病。研究表明，13%至60%的时间逾期 在生命的头两年，一些免疫接种是由于错过了机会， 贫困儿童的比例。因此，MOs不仅导致不良的健康结果， 社会经济和种族文化方面的健康差异沿着。较低的免疫接种率也是 这是其他预防性保健服务不足的指标。 这项建议的目的是干预供应商，家长，学校和日托，以改善 通过减少与错过疫苗接种机会相关的错误，提高免疫接种完成率。 该项目的具体目标是： 1.实施供应商教育和流程改进干预措施，并评估其有效性 减少免疫错误，包括错过机会; 2.实施家长教育和个案管理干预措施，并评估其在以下方面的有效性： 减少错过机会和延迟免疫接种，提高医疗保健利用率。 3.开展一系列社区干预活动，以减少免疫差距， 免疫率。 4.制定可持续和可转移的干预措施，以减少免疫接种方面的种族差异

Immunizations are among the most effective and cost-effective prevention interventions available. A missed opportunity (MO) for vaccination occurs when children who are eligible for one or more immunizations visit health care providers but are not vaccinated. MOs are almost always caused by underlying medical errors, and they are a major factor contributing to under-immunization and delay in age-appropriate immunization in children, leaving these children - andtheir household andcommunity contacts - vulnerable to avariety of serious, preventable communicable diseases. Research has shown that 13 to 60% of the time spent overdue for some immunizations during the first two years of life is due to missed opportunities, with higher percentages for children living in poverty. Thus, MOs contribute not only to poor health outcomes but also to health disparities along socioeconomic and racial-cultural lines. Lower rates of immunization also serve as an indicator of inadequate receipt of other preventative health care services. The purpose of this proposal is to intervene with providers, parents, schools and daycares to improve immunization completion rates by decreasing errors associated with missed opportunities for vaccination. The specific aims of this project are: 1. To implement provider education and process refinement interventions and evaluate their effectiveness in decreasing immunization errors including missed opportunities; 2. To implement parental education and case management interventions and evaluate their effectiveness in decreasing missed opportunities and delays in immunization and increasing healthcare utilization. 3. To implement a set of community intervention activities to reduce immunization disparities and increase immunization rates . 4. To develop sustainable and transferable interventions for reducing racial disparities in immunizations