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Arch Pediatr Adolesc Med. 1997 Dec;151(12):1220-3.

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

Author information

1
Department of Family and Community Medicine, St Paul-Ramsey Medical Center, Minn., USA.

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 preschool-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.

[Indexed for MEDLINE]

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