A clinic system to improve preschool vaccinations in a low socioeconomic status population

Peter G. Harper, Diane J. Madlon-Kay, Michael G. Luxenberg, Rebekah Tempest

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objective: To determine if a clinic system to assess and vaccinate preschool-age children at every clinic visit can improve vaccination rates. Design: A nonequivalent control group design contrasting an intervention clinic with a comparison clinic. Setting: Two urban St Paul, Minn, clinics. The intervention clinic is a family practice residency clinic, and the comparison clinic is a community health center clinic. Patients: Primarily a low socioeconomic status white population. Interventions: A clinic-wide system to identify and vaccinate children at all clinic visits. Appointment personnel, medical assistants, and physicians all had roles in the intervention protocol. Main Outcome Measures: Percentage of children at the 2 clinics who were up-to-date for a primary vaccine series at age 24 months and also at the end of the study collection periods, preintervention and postintervention. Results: The intervention clinic improved the percentage of children up-to-date for a primary vaccine series at age 24 months from 42% to 56% (P=.02), while the percentage at the comparison clinic did not change significantly (P=.81). Similarly, the intervention clinic improved the percentage of children up-to-date for age at the end of the study periods from 49% preintervention to 63% postintervention (P=.02), while the percentage at the comparison clinic did not improve significantly (P=.45). The system was especially useful for children with few visits to the intervention clinic. Conclusions: Although the intervention clinic resulted in a substantial improvement in vaccination rates for pre-school-age children, rates remained well below national goals. A combination of clinic, community, and national initiatives may be needed to ensure appropriate vaccination rates for this challenging patient population.

Original languageEnglish (US)
Pages (from-to)1220-1223
Number of pages4
JournalArchives of Pediatrics and Adolescent Medicine
Volume151
Issue number12
DOIs
StatePublished - Jan 1 1997

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