New study finds reminders for immunizations challenging for pediatric practices

Jan 25, 2011

A new study led by researchers at the Children's Outcomes Research (COR) Program at The Children's Hospital and Colorado Health Outcomes Program (COHO) at the University of Colorado School of Medicine explores the barriers, facilitators and alternative approaches to providers sending reminder notices for immunization using a statewide immunization registry. Reminder or recall messages, usually in the form of postcards, letters, or phone calls, have long been regarded as an effective way to increase immunization rates within primary care settings, particularly among young children. Despite evidence of the effectiveness of recall, the study found that initiating and sustaining recall activities within private practices remains difficult.

The study, Getting under the hood: exploring the issues that affect provider-based recall using Immunization Information System, publishes today in Academic Pediatrics.

Alison W. Saville, MSPH, MSW, project manager within COR, along with Principal Investigator Allison Kempe, MD, MPH, also of COR, and their team of local and national researchers were interested in researching this to determine why recall was so underutilized by physicians in practice, despite its demonstrated effectiveness at increasing immunization rates in young children. The Colorado Immunization Information System (statewide immunization registry) offers a web-based tool to create a list of children who are behind on immunizations that can generate mailing labels or a phone list.

"This is the first study to explore the real world issues that influence private practices' decisions to implement an evidence-based intervention to increase immunizations,"
said Saville.

According to Saville, the objectives of the study were to assess (1) pediatric practices' use of provider-based recall using an Immunization Information System (IIS) eight months after training on the recall process; (2) find barriers to provider-based recall using an IIS; (3) come up with strategies that facilitated recall initiation; and (4) create recommendations for alternative approaches for conducting recall.

In 2008, 11 practices received training on the automatic recall function in Colorado's IIS (CIIS) for both infants and adolescents. The two-hour computer-based training provided an opportunity for attendees to run real-time recall reports with CIIS staff assistance. Eight months later, key informant interviews were conducted with 24 providers and staff from these practices.

Study results showed that eight months after training, only four out of 11 practices had implemented recall using CIIS—three practices recalled children two years of age and under and one practice recalled adolescent females for the Human Papillomavirus vaccine. Resistance to using the System included lack of awareness of baseline immunization rates, distrust in the accuracy of CIIS generated data, and perceived difficulties recalling adolescents. Having unrealistic expectations about recall effectiveness was a barrier to sustainability.

Strategies that facilitated recall included having a dedicated staff person for recall efforts and recalling children two years of age and under. The majority of key informants viewed population-based recall conducted by public health departments or schools as an acceptable alternative to provider-based recall.

"Even with a promising tool to assist pediatric offices, implementing provider-based recall is challenging for pediatric practices," said Saville. Given existing barriers, providers expressed support for alternative recall methods.

Currently, there is no research comparing the effectiveness of provider-based versus population-based recall. Such research is needed in order to determine the most effective and cost-effective methods for getting children up-to-date with immunizations at the population level. Researchers at COR were recently funded by the NIH to directly compare practice-based versus centralized public health based methods of recalling children at the level of the county.

Explore further: Schumacher's doctor sees progress after injury

Provided by University of Colorado Denver

not rated yet
add to favorites email to friend print save as pdf

Related Stories

E. coli-based recall of beef expanded

Jun 11, 2007

A California company has decided to expand a recall of its beef products made during a two-week period amidst concerns of E. coli contamination.

Hewlett-Packard recalling 54K laptop batteries

May 21, 2010

(AP) -- Hewlett-Packard Co. is recalling 54,000 lithium-ion batteries used in HP and Compaq computers after receiving reports of injuries from the batteries overheating and rupturing.

Why parents miss their children's immunization visits

May 05, 2009

According to a new study led by researchers at Columbia University Medical Center and NewYork-Presbyterian Hospital, there are several factors that contribute to children missing immunization visits.

White chocolate baking squares recalled

Oct 04, 2007

The U.S. Food and Drug Administration announced the nationwide recall of Baker's Premium White Chocolate Baking Squares due to possible contamination.

Recommended for you

Schumacher's doctor sees progress after injury

14 hours ago

A French physician who treated Michael Schumacher for nearly six months after the Formula One champion struck his head in a ski accident says he is no longer in a coma and predicted a possible recovery within three years.

New MCAT shifts focus, will include humanities

Oct 20, 2014

(HealthDay)—The Medical College Admission Test (MCAT) has been revised, and the latest changes, including more humanities such as social sciences, are due to be implemented next April, according to a report ...

User comments : 0