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Article
December 1997

A Clinic System to Improve Preschool Vaccinations in a Low Socioeconomic Status Population

Author Affiliations

Rebekah Tempest
From the Department of Family and Community Medicine, St Paul—Ramsey Medical Center, St Paul (Drs Harper and Madlon-Kay and Ms Tempest), and Professional Data Analysts, Minneapolis (Dr Luxenberg), Minn.

Arch Pediatr Adolesc Med. 1997;151(12):1220-1223. doi:10.1001/archpedi.1997.02170490046008
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 constrasting 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.Arch Pediatr Adolesc Med. 1997;151:1220-1223

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