title: Tailored interventions to introduce influenza vaccination among 6- to 23-month-old children at inner-city health centers.
abstract: BACKGROUND
  Because of high rates of hospitalization for influenza infections among very young children (< 2 years), the Advisory Committee on Immunization Practices initiated a new policy in 2002 that encouraged vaccination of healthy children aged 6 to 23 months against influenza.
  
  
  OBJECTIVE
  To evaluate the effectiveness of implementing tailored interventions to introduce influenza vaccination of children 6 to 23 months of age in inner-city practices.
  
  
  METHODS
  A before-after trial with historical and concurrent controls was conducted in 6 health centers in low-income urban locations.
  
  
  METHODS
  Intervention sites were selected, and interventions (directed at 1534 patients who were 6 to 23 months old) were implemented from a menu of strategies. Vaccination rates were measured from medical record reviews. Focus groups of nursing staffs provided evaluative information on strategies.
  
  
  RESULTS
  Influenza vaccination rates improved significantly at the intervention health centers compared with the control center. Preintervention (2001-2002) rates ranged from 0% to 7.6%, and intervention (2002-2003) rates ranged from 15.2% to 49.2% (P < .001). The number of interventions ranged from 6 to 11. Sites that used more interventions (odds ratio, 1.24; 95% confidence interval, 1.15-1.34) and had staff support of the vaccination effort (odds ratio, 1.91; 95% confidence interval, 1.40-2.60) had higher vaccination rates.
  
  
  CONCLUSIONS
  Tailored interventions resulted in successful introduction of influenza vaccination of 6- to 23-month-old children in inner-city health centers. More strategies and enthusiastic staff support may result in higher vaccination rates.
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh, 3518 Fifth Avenue, Pittsburgh, PA 15261, USA. tnowalk@pitt.edu
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
authors.forename: Richard Kent
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Judith A
authors.initials: JA
authors.lastname: Troy
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Diana H
authors.initials: DH
authors.lastname: Kearney
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Cleary
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011203:Poverty; D019037:Urban Health Services / Q000458:organization & administration*
chemical_list: D007252:Influenza Vaccines