title: Reminder cards and immunization rates among Latinos and the rural poor in Northeast Colorado.
abstract: OBJECTIVE
  Immunization rates are static in the United States. Risk factors for not being up to date (UTD) include ethnicity and lower socioeconomic status. Reminder cards increase immunization rates in urban settings. Their effect in poor, Latino, and rural children is unknown.
  
  
  BACKGROUND
  Language-appropriate reminder cards were sent to active patients not UTD listing the vaccines missing; the card served as the physician order for the vaccine. Missed opportunities were addressed through discussion with staff and posters in patient care rooms. UTD rates before and after intervention were measured.
  
  
  RESULTS
  Dual-purpose reminder/order cards increased the rate of UTD from 61.3% to 73.4%; children living near the clinic, patients who speak only Spanish, and Latinos overall showed preferential effectiveness. Children eligible to participate in the Vaccines for Children program had similar increases in UTD rates but had lower baseline and final UTD rates than did children not eligible for the Vaccines for Children program. The rate of missed opportunities did not change. The number of children to whom reminder cards needed to be sent for them to become fully immunized is 8 (number needed to treat).
  
  
  CONCLUSIONS
  In poor, rural, and Latino populations, language-appropriate reminder/order cards increase immunization rates.
authors.affiliation: Salud Family Health Center, Fort Lupton, CO 80621, USA. phicks@saludclinic.org
authors.forename: Paul
authors.initials: P
authors.lastname: Hicks
authors.forename: Gillian A M
authors.initials: GA
authors.lastname: Tarr
authors.forename: Ximena Prieto
authors.initials: XP
authors.lastname: Hicks
mesh_terms: D001071:Appointments and Schedules; D002675:Child, Preschool; D003120:Colorado; D054521:Cultural Competency; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007802:Language; D008297:Male; D010342:Patient Acceptance of Health Care; D011203:Poverty; D017010:Reminder Systems; D012424:Rural Population; D012959:Socioeconomic Factors