title: An organizational strategy to improve adolescent measles-mumps-rubella vaccination in a low socioeconomic population. A method to reduce missed opportunities.
abstract: OBJECTIVE
  To determine whether a clinical organization strategy can improve measles-mumps-rubella vaccination rates in adolescents by reducing missed opportunities.
  
  
  METHODS
  Nonequivalent control group design with a treatment clinic and a comparison clinic. Measurements were made for 8 months before intervention and for 9 months after intervention.
  
  
  METHODS
  Two urban family practice clinics serving a low socioeconomic population.
  
  
  METHODS
  All clinic visits by adolescents aged 11 to 18 years.
  
  
  METHODS
  A clinic organizational strategy that systematically identified and vaccinated adolescents seen in the clinic for any reason.
  
  
  METHODS
  Two vaccination indexes were measured monthly at each clinic: the percentage of eligible visits at which measles-mumps-rubella vaccination was given and the percentage of visits that were up to date, with adolescents having received the measles-mumps-rubella vaccine at that visit or at a previous visit.
  
  
  RESULTS
  The intervention resulted in a significant increase at the treatment clinic in the mean percentage of vaccinations given (from 7.8% to 17.4%) (Student's t = 3.02; P = .0087) and the mean percentage of up-to-date visits (from 17.2% to 38.6%) (t = 8.33; P < .0001). During the same period, there was no significant change in the mean vaccination rates in the comparison clinic.
  
  
  CONCLUSIONS
  An organizational strategy appears to be a useful method to reduce missed opportunities and improve measles-mumps-rubella vaccination rates in adolescents from a low socioeconomic population.
authors.affiliation: Department of Family Medicine, St Paul (Minn) Ramsey Medical Center.
authors.forename: P G
authors.initials: PG
authors.lastname: Harper
authors.forename: D M
authors.initials: DM
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D008457:Measles / Q000517:prevention & control*; D008499:Medical Records; D009107:Mumps / Q000517:prevention & control*; D009817:Office Management; D011203:Poverty; D012409:Rubella / Q000517:prevention & control*; D012923:Social Class; D014504:Urban Health; D014611:Vaccination