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，但尚未被广泛采用。免疫接种提供者认为工作人员的时间和成本是阻碍采用提醒/召回的主要因素。这项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免疫状况的有效性。在干预期间将采用三种提醒/召回策略：对6个月大时未接种最新推荐疫苗的儿童进行7个月召回;对所有儿童进行12个月提醒，强调在出生后第二年早期接种疫苗;对未接种最新初级免疫系列的儿童进行19个月召回。对于3种策略中的每一种，干预组将与对照组配对，作为评估提醒/回忆有效性的基础。将独立执行和评估这三项战略，并就成本效益相互比较。 具体目标是：（1）针对关键年龄组制定集中提醒/召回干预措施，纳入免疫接种提供者和父母的需求和偏好，并建立在高功能全州免疫接种登记处的现有能力之上;（2）在历史上疫苗接种率较低的大城市地区进行集中提醒/召回干预措施的随机对照试验;以及3）评估每项提醒/召回干预战略的成本效益，为今后实施集中提醒/召回系统提供信息。 拟议项目的独特之处在于，它侧重于一个大的，种族和社会经济多样化的，有记录的低疫苗接种率的城市地区;它具有3种不同的提醒/召回策略，针对儿童疫苗接种计划的关键点;它包括个性化的，患者导向的提醒/召回和疫苗特定的提供者的行动提示;它采用了严格的随机对照设计。从拟议的研究结果将提供可靠的成本和效果大小的估计使用免疫信息系统集中提醒/召回的努力。