Community-based strategies to reduce childhood immunization disparities.
This study demonstrates how community-based immunization promotion reduced immunization disparities. In 2002 to 2004, the coalition enrolled 3,748 children younger than 5, with 1,502 aged 19 to 35 months in April 2004. Disparity reduction was assessed by comparing coalition immunization coverage rates (4:3:1:3:3) to the National Immunization Survey 2003 rates. Logistic regression was used to assess factors contributing to up-to-date immunizations. Coverage increased from 46.0% at enrollment to 80.5%, matching nationwide rates for all (t = 0.87) or White (t = 1.99) children. The 78% for African Americans was higher than 73% for U.S. African American children (t = 2.90); 84% for Latinos was higher than 77% for U.S. Latinos (t = 2.32). Being current with age-appropriate immunizations at enrollment (OR = 9.8), being Latino (OR = 1.6), and participating through child health insurance enrollment (OR = 4.9), Women, Infants, and Children (OR = 3.1), or child care or parenting (OR = 1.9) programs increased immunization coverage. Embedding immunization promotion into existing community programs was successful in eliminating immunization disparities. Most effective programs were those with direct linkages to health care systems or that targeted young children.
Findley
Sally E
SE
Mailman School of Public Health, Columbia University and Columbia University Medical Center in New York City, New York, USA.
Irigoyen
Matilde
M
Sanchez
Martha
M
Guzman
Letty
L
Mejia
Miriam
M
Sajous
Michelle
M
Levine
Deborah A
DA
Chen
Shaofu
S
Chimkin
Frank
F
D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D003256:Community Participation; D005006:Ethnicity; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007223:Infant; D008297:Male; D009519:New York City; D011203:Poverty; D011632:Public Assistance; D044469:Racial Groups; D014505:Urban Population