title: A clinic system to improve preschool vaccinations in a low socioeconomic status population.
abstract: OBJECTIVE
  To determine if a clinic system to assess and vaccinate preschool-age children at every clinic visit can improve vaccination rates.
  
  
  METHODS
  A nonequivalent control group design contrasting an intervention clinic with a comparison clinic.
  
  
  METHODS
  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.
  
  
  METHODS
  Primarily a low socioeconomic status white population.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Family and Community Medicine, St Paul-Ramsey Medical Center, Minn., USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Harper
authors.forename: D J
authors.initials: DJ
authors.lastname: Madlon-Kay
authors.forename: M G
authors.initials: MG
authors.lastname: Luxenberg
authors.forename: R
authors.initials: R
authors.lastname: Tempest
mesh_terms: D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008297:Male; D008910:Minnesota; D011314:Preventive Health Services / Q000600:supply & distribution*; D014505:Urban Population