title: Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review.
abstract: OBJECTIVE
  To conduct a systematic review of strategies to optimize immunisation uptake within preschool children in developed countries.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Developed countries
  
  
  METHODS
  Preschool children who were due, or overdue, one or more of their routine primary immunisations.
  
  
  METHODS
  Increase in the proportion of the target population up to date with standard recommended universal vaccinations.
  
  
  RESULTS
  Forty-six studies were included for analysis, published between 1980 and 2009. Twenty-six studies were randomized controlled trials, 11 were before and after trials, and nine were controlled intervention trials. Parental reminders showed a statistically significant increase in immunisation rates in 34% of included intervention arms. These effects were reported with both generic and specific reminders and with all methods of reminders and recall. Strategies aimed at immunisation providers were also shown to improve immunisation rates with a median change in immunisation rates of 7% when reminders were used, 8% when educational programmes were used and 19% when feedback programmes were used.
  
  
  CONCLUSIONS
  General practitioners are uniquely positioned to influence parental decisions on childhood immunisation. A variety of strategies studied in primary care settings have been shown to improve immunisation rates, including parental and healthcare provider reminders.
authors: Department of Primary Care and Public Health, Imperial College London ,  London W6 8RF ,  UK.
authors: Nia
authors: N
authors: Williams
authors: Helen
authors: H
authors: Woodward
authors: Azeem
authors: A
authors: Majeed
authors: Sonia
authors: S
authors: Saxena