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Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates.
Arch Pediatr Adolesc Med 2011; 165(6):547-53AP

Abstract

OBJECTIVE

To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents.

DESIGN

Randomized clinical trial allocating adolescents (aged 11-15 years) to intervention vs standard of care control.

SETTING

Eight primary care practices.

PARTICIPANTS

Population-based sample of adolescents (N = 7546).

INTERVENTION

Immunization navigators at each practice implemented a tiered protocol: immunization tracking, telephone or mail reminder/recall, and home visits if participants remained unimmunized or behind on preventive care visits.

MAIN OUTCOME MEASURES

Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs.

RESULTS

The intervention and control groups were similar at baseline for demographics (mean age, 13.5 years; 63% black, 14% white, and 23% Hispanic adolescents; and 74% receiving Medicaid), immunization rates, and preventive care visit rates. Immunization rates at the end of the study were 44.7% for the intervention group and 32.4% for the control group (adjusted risk ratio, 1.4; 95% confidence interval, 1.3-1.5); preventive care visit rates were 68.0% for the intervention group and 55.2% for the control group (1.2; 1.2-1.3). Findings were similar across practices, sexes, ages, and insurance providers. The number needed to treat for immunizations and preventive care visits was 9. The intervention cost was $3.81 per adolescent per month; the cost per additional adolescent fully vaccinated was $465, and the cost per additional adolescent receiving a preventive care visit was $417.

CONCLUSION

A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00581347.

Authors+Show Affiliations

Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. peter_szilagyi@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21646588

Citation

Szilagyi, Peter G., et al. "Effectiveness of a Citywide Patient Immunization Navigator Program On Improving Adolescent Immunizations and Preventive Care Visit Rates." Archives of Pediatrics & Adolescent Medicine, vol. 165, no. 6, 2011, pp. 547-53.
Szilagyi PG, Humiston SG, Gallivan S, et al. Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates. Arch Pediatr Adolesc Med. 2011;165(6):547-53.
Szilagyi, P. G., Humiston, S. G., Gallivan, S., Albertin, C., Sandler, M., & Blumkin, A. (2011). Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates. Archives of Pediatrics & Adolescent Medicine, 165(6), pp. 547-53. doi:10.1001/archpediatrics.2011.73.
Szilagyi PG, et al. Effectiveness of a Citywide Patient Immunization Navigator Program On Improving Adolescent Immunizations and Preventive Care Visit Rates. Arch Pediatr Adolesc Med. 2011;165(6):547-53. PubMed PMID: 21646588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates. AU - Szilagyi,Peter G, AU - Humiston,Sharon G, AU - Gallivan,Sarah, AU - Albertin,Christina, AU - Sandler,Martha, AU - Blumkin,Aaron, PY - 2011/6/8/entrez PY - 2011/6/8/pubmed PY - 2011/8/16/medline SP - 547 EP - 53 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 165 IS - 6 N2 - OBJECTIVE: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking, reminder/recall, and outreach) on improving immunization and preventive care visit rates in urban adolescents. DESIGN: Randomized clinical trial allocating adolescents (aged 11-15 years) to intervention vs standard of care control. SETTING: Eight primary care practices. PARTICIPANTS: Population-based sample of adolescents (N = 7546). INTERVENTION: Immunization navigators at each practice implemented a tiered protocol: immunization tracking, telephone or mail reminder/recall, and home visits if participants remained unimmunized or behind on preventive care visits. MAIN OUTCOME MEASURES: Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs. RESULTS: The intervention and control groups were similar at baseline for demographics (mean age, 13.5 years; 63% black, 14% white, and 23% Hispanic adolescents; and 74% receiving Medicaid), immunization rates, and preventive care visit rates. Immunization rates at the end of the study were 44.7% for the intervention group and 32.4% for the control group (adjusted risk ratio, 1.4; 95% confidence interval, 1.3-1.5); preventive care visit rates were 68.0% for the intervention group and 55.2% for the control group (1.2; 1.2-1.3). Findings were similar across practices, sexes, ages, and insurance providers. The number needed to treat for immunizations and preventive care visits was 9. The intervention cost was $3.81 per adolescent per month; the cost per additional adolescent fully vaccinated was $465, and the cost per additional adolescent receiving a preventive care visit was $417. CONCLUSION: A tiered tracking, reminder/recall, and outreach intervention improved immunization and preventive care visit rates in urban adolescents. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00581347. SN - 1538-3628 UR - https://www.unboundmedicine.com/medline/citation/21646588/Effectiveness_of_a_citywide_patient_immunization_navigator_program_on_improving_adolescent_immunizations_and_preventive_care_visit_rates_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpediatrics.2011.73 DB - PRIME DP - Unbound Medicine ER -