The effectiveness of assessment and referral on immunization coverage in the special supplemental nutrition program for women, infants, and children
| Autor: | Francisco Averhoff, Denise C. Gee, Susan H. Ashkar, Jeffrey Higa, Judy Gomez, Lisa Thompson, Eric L. Hurwitz, Abigail Shefer, Loring G. Dales |
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| Rok vydání: | 2003 |
| Předmět: |
Pediatrics
medicine.medical_specialty Referral Urban Population Population Child Health Services Psychological intervention Ethnicity Medicine Humans Registries education Referral and Consultation education.field_of_study business.industry Immunization Programs Public health Infant Odds ratio Los Angeles Confidence interval Vaccination El Niño Child Preschool Pediatrics Perinatology and Child Health business |
| Zdroj: | Archives of pediatricsadolescent medicine. 157(5) |
| ISSN: | 1072-4710 |
| Popis: | Background The use of immunization assessment and referral (A/R) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been shown to produce dramatic improvements in vaccination coverage when coupled with parental incentive; however, data are lacking to support the use of A/R alone. Objective To determine the effectiveness of A/R in increasing immunization coverage among WIC participants. Design Participating WIC centers were assigned to1 of 3 interventions that delivered A/R of varying frequency or a control group. Setting Twenty of the largest Public Health Foundation Enterprises–WIC centers in Los Angeles County. Participants Children continuously enrolled in participating WIC centers from 6 to 24 months of age. Intervention Assessment of child's vaccination status followed by referral to a health care provider for those lacking indicated vaccinations. Main Outcome Measure Up-to-date (UTD) status at 24 months of age for all recommended vaccines. Results Baseline coverage rates were similar among all study sites (overall, 77% UTD). After the study period, compared with the controls (88% UTD), we found no differences in immunization coverage among WIC centers that administered A/R at every visit (every 2 months) to all children (90% UTD; adjusted odds ratio [OR], 1.02; 95% confidence interval [CI], 0.54-1.94), every 6 months to all children (89% UTD; OR, 0.98; 95% CI, 0.62-1.56), or every visit to children found to be behind at 8 months of age (89% UTD; OR, 0.89; 95% CI, 0.48-1.68). Conclusion In this urban population of WIC children with high baseline immunization coverage, A/R was not effective in increasing immunization coverage. |
| Databáze: | OpenAIRE |
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