title: Do we practice what we teach about childhood immunization in New Jersey?
abstract: OBJECTIVE
  Although childhood immunization is a benchmark for preventive service delivery in family practices, no data have been reported on childhood immunization in New Jersey family practice residencies. This study assesses immunization coverage among 2-year-olds in nine residencies and evaluates childhood immunization knowledge and barriers in 10 residency programs.
  
  
  METHODS
  We performed a retrospective review of immunization records of 2-year-olds, using the Centers for Disease Control's Clinic Assessment Software Application, and analyzed a survey of knowledge and barriers to immunization completed by residents, nurses, and faculty.
  
  
  RESULTS
  Among 726 children with four or more office visits, the mean percent of children immunized with the combination of four diphtheria-tetanus-pertussis, three polio, and one measles-mumps-rubella was 53% (range 31%-69%). The age-appropriate immunization rate was highest at 3 months (78%) and lowest at 16 months (29%). Among the 294 survey respondents, the mean knowledge score was 75% overall and 82% for faculty, 77% for nurses, and 71% for residents. There was moderate to good correlation of audit levels with knowledge, with 49% of the variation in immunization coverage explained by variation in knowledge. Lack of immunization records was reported by 47% as the most important office-related barrier.
  
  
  CONCLUSIONS
  Immunization rates of 2-year-olds in nine New Jersey family practice residencies are below Healthy People 2000 goals. Low immunization rates in residency programs may improve with increased knowledge, an area for future study. Research into removing immunization-related barriers is also needed.
authors.affiliation: Department of Family Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA. sharknca@umdnj.edu
authors.forename: C M
authors.initials: CM
authors.lastname: Sharkness
authors.forename: B D
authors.initials: BD
authors.lastname: Goun
authors.forename: L A
authors.initials: LA
authors.lastname: Davis
authors.forename: L E
authors.initials: LE
authors.lastname: Sykes
mesh_terms: D000328:Adult; D002675:Child, Preschool; D002983:Clinical Competence; D005178:Faculty; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007396:Internship and Residency; D008297:Male; D009515:New Jersey; D009726:Nurses; D012189:Retrospective Studies