title: A prenatal intervention study to improve timeliness of immunization initiation in Latino infants.
abstract: This was a prospective randomized cohort study to assess the effectiveness of an educational immunization intervention with pregnant Latinas on timely initiation of infant immunization. Study participants were recruited from two community clinics in north San Diego County. A total of three hundred and fifty-two Latinas in the third trimester of pregnancy were recruited and randomly assigned to intervention or control groups. Participants received either a culturally and linguistically appropriate session on infant immunization (intervention) or a session on prevention of Sudden Infant Death Syndrome (control). The main outcome measures were pre-post immunization knowledge change and infant immunization status at 92 days. Immunization knowledge increased significantly in the intervention group [p < .0001, 95%CI (1.76, 2.47)]. No difference was found between groups in immunization series initiation: 95 percent of the children in the intervention group were up-to-date by 92 days from birth, and 93 percent of the control group was up-to-date at 92 days. The lack of significant association between receiving immunization education and infant immunization series initiation suggests that parent education may be necessary but not sufficient for timely immunization, particularly in clinics with effective well-child programs. Given the significant increase in immunization knowledge, the broader and perhaps more important implication is that language- and culturally specific infant health education messages in the prenatal period may have a positive long-term impact on the child's health and promote well-child care overall. Future studies should assess the role of prenatal well-child education in the context of clinics with low immunization levels.
authors.affiliation: Division of Community Pediatrics, University of California, San Diego, La Jolla 92093-0927, USA. mzuniga@ucsd.edu
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Zúñiga de Nuncio
authors.forename: Philip R
authors.initials: PR
authors.lastname: Nader
authors.forename: Mark H
authors.initials: MH
authors.lastname: Sawyer
authors.forename: Michelle
authors.initials: M
authors.lastname: De Guire
authors.forename: Radmila
authors.initials: R
authors.lastname: Prislin
authors.forename: John P
authors.initials: JP
authors.lastname: Elder
mesh_terms: D000328:Adult; D002140:California; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000193:education* / Q000523:psychology; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D007224:Infant Care / Q000379:methods / Q000592:standards*; D007231:Infant, Newborn; D017533:Marital Status; D010353:Patient Education as Topic / Q000458:organization & administration*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care / Q000458:organization & administration*; D015397:Program Evaluation; D012959:Socioeconomic Factors; D013398:Sudden Infant Death / Q000208:ethnology / Q000517:prevention & control*; D013997:Time Factors