Evaluation of a campaign to improve immunization in a rural headstart program.
This study evaluated an intervention to improve immunization rates in a high poverty, medically underserved rural area employing a pretest-posttest design. The intervention expanded immunization availability, established walk-in appointment policies, and introduced intensified parent education. Formative evaluation indicated specific messages with high salience to parents. As a result, the susceptibility and severity of childhood infectious disease, the outcome efficacy of vaccines, and methods to reduce barriers to immunization were emphasized in communications with parents. Data on DTP1-4, OPV1-3, and MMR were obtained from preschools, local health departments and private medical practices before (n = 567) and after the intervention (n = 331). Following adjustment for birth order and demographics, at post-intervention a significantly greater proportion of children received 6 of 8 vaccines on time. Effect sizes were large. For example, post MMR rates were at least 2X greater than pre rates. Time-series analysis of trend data on local newspaper coverage of child health topics suggested history was not a major threat to the internal validity of this pre-post only design. The findings indicate that comprehensive intervention, targeting improvements in the availability of pediatric care, health system policies and parent behavior, can improve immunization.
Division of Behavioral Science and Health Education, School of Public Health, Saint Louis University, MO 63108-3342, USA.
J P
JP
Mayer
R
R
Housemann
B
B
Piepenbrok
D001294:Attitude to Health; D003710:Demography; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D008297:Male; D008507:Medically Underserved Area; D008923:Missouri; D011203:Poverty; D015397:Program Evaluation; D015203:Reproducibility of Results; D012423:Rural Health / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires