Enhancing Adolescent Immunization through Parent and Teacher Interventions

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Abstract There is a critical need to improve adolescent vaccination rates. One of the goals of CDC's Healthy People 2010 initiative is to increase adolescent vaccine coverage to >90% within 5 years of the recommendation. Despite this, national coverage remains below this level. The state of Georgia has not met this goal for any of the four recommended vaccines for adolescents: Tdap, MCV4, HPV and influenza vaccine. This proposal assesses two potential interventions that could be used to increase adolescent vaccine coverage nationally. Specifically, we will determine whether a strategy of parent-only or a strategy of multicomponent parent and adolescent focused (teacher-delivered) intervention leads to higher immunization coverage. This design will allow us to determine the best means of reaching adolescents for vaccination. This has particular relevance since the number of adolescent vaccines has increased in recent years and is likely to continue to rise. We will conduct a three-armed controlled trial using a systematic balanced replication design to compare vaccination rates in Richmond County, a large, racially diverse county of eastern Georgia. We will randomly select 2 high schools and 3 middle schools to be in one of the three arms. In the first arm, we will implement two cycles of the parent-only intervention designed to motivate parents to have their adolescent vaccinated. In the second arm, we will implement two cycles of the multicomponent intervention targeting both parents and adolescents, through a teacher delivered intervention. In the third arm, we will implement no intervention. The primary outcome will be to estimate changes in adolescent vaccination coverage. Other outcomes will include the effect of the two interventions on mediators of vaccine acceptance. Findings from this study could have important policy implications, laying the foundation for portable and relevant educational interventions that have been shown to effectively increase adolescent immunizations.