title: Multicomponent interventions to enhance influenza vaccine delivery to adolescents.
abstract: OBJECTIVE
  To compare school- versus provider-based approaches to improving influenza vaccination coverage among adolescents in rural Georgia.
  
  
  METHODS
  We used a nonrandomized, 3-armed design: (1) a middle- and high school-based influenza vaccination intervention in 1 county; (2) a provider-based influenza vaccination intervention in a second county; and (3) a standard-of-care condition in a third county. Interventions also included distribution of an educational brochure, school presentations, and community-based outreach to enhance vaccine knowledge and awareness among adolescents and their parents.
  
  
  RESULTS
  During the 2008-2009 influenza season, 70 (19%) of 370 students were vaccinated in the school-based county and 110 (15%) of 736 students were vaccinated in the provider-based county, compared with 71 (8%) of 889 students in the standard-of-care county (risk ratio [RR](school): 2.4 [95% confidence interval (CI): 1.7-3.2]; RR(provider): 1.9 [95% CI: 1.4-2.5]). During 2009-2010, seasonal influenza vaccination coverage was 114 (30.4%) of 375 of students in the school-based county, 122 (16.9%) of 663 of students in the provider-based county, and 131 (15.2%) of 861 students in the standard-of-care county (RR(school): 2.3 [95% CI: 1.9-2.9]; RR(provider): 1.2 [95% CI: 0.97-1.5]).
  
  
  CONCLUSIONS
  Special efforts to promote influenza vaccination among rural, predominantly black students were associated with increased vaccination coverage. The school-based influenza vaccination intervention was associated with the highest levels of vaccination coverage. This study revealed the efficacy of school-based influenza education to improve vaccination rates among adolescents.
authors: School of Medicine, Emory University, Atlanta, GA 30329, USA. lgargan@emory.edu
authors: Lisa M
authors: LM
authors: Gargano
authors: Karen
authors: K
authors: Pazol
authors: Jessica M
authors: JM
authors: Sales
authors: Julia E
authors: JE
authors: Painter
authors: Christopher
authors: C
authors: Morfaw
authors: LaDawna M
authors: LM
authors: Jones
authors: Paul
authors: P
authors: Weiss
authors: James W
authors: JW
authors: Buehler
authors: Dennis L
authors: DL
authors: Murray
authors: Gina M
authors: GM
authors: Wingood
authors: Walter A
authors: WA
authors: Orenstein
authors: Ralph J
authors: RJ
authors: DiClemente
authors: James M
authors: JM
authors: Hughes
mesh_terms: D000293:Adolescent; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D005845:Georgia; D006266:Health Education / Q000379:methods; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D058873:Pandemics / Q000517:prevention & control*; D010349:Patient Compliance; D015397:Program Evaluation; D012424:Rural Population; D012572:School Health Services / Q000458:organization & administration*
chemical_list: D007252:Influenza Vaccines