School Located Influenza Vaccinations for Children: Community-Wide Dissemination

学校为儿童接种流感疫苗：社区范围内的传播

• 批准号: 8708812
• 负责人: PETER G SZILAGYI
• 金额: $ 47.86万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8708812
• 关键词: Located; Influenza; Vaccinations; Children; Community

DESCRIPTION (provided by applicant): Annual influenza epidemics result in substantial mortality and morbidity among adults and children with more than $10 billion in direct medical costs. Although national guidelines recommend annual influenza vaccination of all school-aged children, less than half of these children are vaccinated. The major barrier is the short time window for vaccination: primary care practices are simply unable to vaccinate all of their pediatric patients within a few months. An alternative setting for child influenza vaccination is school-located influenza vaccinations (SLIV), yet <5% of children receive vaccine in schools. Three barriers impede SLIV: an ineffective paper-based parent consent system, ineffective parent reminders, and lack of experience with SLIV among adolescents. The goal of this project is to address these 3 barriers and to optimize influenza vaccination rates via SLIV. We will adapt two dissemination/implementation conceptual models (the Chronic Care Model and RE- AIM). We will work closely with schools, primary care practices, and local and state public health leaders, and with two national partners - CDC's National Center for Immunization and Respiratory Diseases (NCIRD) and the National Association of School Nurses (NASN). We propose a technical aim, a scientific aim, and a dissemination aim. The technical aim (Aim 1, Yr 1) is to develop, pilot, and evaluate a web-based consent and parent reminder system, using an innovative web-based informatics system. We will perform formative studies of parents, school staff, and providers, to create a useful system. The scientific aim (Aim 2, Yrs 2-4) is to perform effectiveness testing of SLIV, using web-based consent + reminders. We will randomize schools to SLIV vs. control in 3 successive annual RCTs, with increasing number of schools, and measure vaccination rates, school absences, and SLIV processes and costs. In Yr 2 we will include 5 schools districts (all elementary; 26 study, 28 control schools, n=25,078). In Yr 3 we will expand to 8 school districts and also middle/high schools (n=59,556 children); in Year 4 to 12 districts (n=79,713 children). The dissemination aim (Aim 3, Yrs 4-5) is to spread SLIV throughout Monroe County and diffuse SLIV best practices and technological innovations nationally. We will offer SLIV to all county schools (182 schools, n=112,034), and work with national partners to disseminate the consent/reminder system and a training program for SLIV across the US. This project addresses AHRQ priority area Prevention/Care Management, includes a focus on priority populations (adolescents, urban), and is a major redesign of primary care.

描述（由申请人提供）：每年的流感流行导致成人和儿童的大量死亡和发病，直接医疗费用超过100亿美元。尽管国家指南建议所有学龄儿童每年接种流感疫苗，但这些儿童中只有不到一半接种了疫苗。主要的障碍是接种疫苗的时间窗口很短：初级保健实践根本无法在几个月内为所有儿科患者接种疫苗。儿童流感疫苗接种的另一种选择是学校流感疫苗接种（SLIV），但<5%的儿童在学校接种疫苗。三个障碍阻碍SLIV：无效的纸质家长同意系统，无效的家长提醒，以及缺乏青少年SLIV的经验。本项目的目标是解决这3个障碍，并通过SLIV优化流感疫苗接种率。我们将采用两种传播/实施概念模型（慢性病护理模型和RE-AIM）。我们将与学校，初级保健实践，地方和州公共卫生领导人以及两个国家合作伙伴- CDC的国家免疫和呼吸系统疾病中心（NCIRD）和全国学校护士协会（NASN）密切合作。我们提出了一个技术目标、一个科学目标和一个传播目标。技术目标（目标1，第1年）是使用创新的基于网络的信息系统，开发，试点和评估基于网络的同意和家长提醒系统。我们将对家长、学校工作人员和供应商进行形成性研究，以创建一个有用的系统。科学目的（目的2，第2-4年）是使用基于网络的知情同意书+提醒进行SLIV的有效性测试。我们将在连续3个年度随机对照试验中随机选择学校进行SLIV与对照，并增加学校数量，并测量疫苗接种率，学校缺勤率以及SLIV过程和成本。在第二年，我们将包括5个学区（所有小学; 26所研究学校，28所对照学校，n= 25，078）。在第三年，我们将扩大到8个学区和初中/高中（n= 59 556名儿童）;在第四年，扩大到12个学区（n= 79 713名儿童）。传播目标（目标3，第4-5年）是在整个门罗县传播SLIV，并在全国范围内传播SLIV最佳实践和技术创新。我们将向所有县级学校（182所学校，n= 112，034）提供SLIV，并与国家合作伙伴合作，在美国各地传播同意/提醒系统和SLIV培训计划。该项目涉及AHRQ优先领域预防/护理管理，包括重点关注重点人群（青少年、城市），是对初级保健的重大重新设计。