title: Organizational correlates of adolescent immunization: findings of a state-wide study of primary care clinics in North Carolina.
abstract: OBJECTIVE
  To analyze organizational correlates of immunization coverage among adolescents served by high-volume primary care providers in North Carolina.
  
  
  METHODS
  We randomly selected 91 clinics with at least 200 active records for patients ages 11-18 in the North Carolina Immunization Registry. For the 105,121 adolescents served by these clinics, we obtained immunization status for 6 vaccines, including human papillomavirus (HPV) vaccine (females only); meningococcal conjugate; and tetanus, diphtheria, and pertussis booster (Tdap).
  
  
  RESULTS
  Clinics specializing in pediatrics had higher coverage for meningococcal vaccine (OR=1.79, 95% CI: 1.25-2.55), Tdap vaccine (OR=1.22, 95% CI: 1.00-1.50), and childhood vaccines. However, pediatric clinics had lower coverage for HPV vaccine initiation (OR=0.70, 95% CI: 0.52-0.94). Other correlates, which varied by vaccine, included policies related to vaccine documentation and the age at which clinics recommended vaccines.
  
  
  CONCLUSIONS
  Overall, adolescents were more likely to receive vaccines, except HPV vaccine, if they attended a pediatric clinic with supportive clinical policies.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA. jlmoss@email.unc.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Moss
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Gilkey
authors.forename: Turquoise
authors.initials: T
authors.lastname: Griffith
authors.forename: J Michael
authors.initials: JM
authors.lastname: Bowling
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Dayton
authors.forename: Amy H
authors.initials: AH
authors.lastname: Grimshaw
authors.forename: Beth
authors.initials: B
authors.lastname: Quinn
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
mesh_terms: D000293:Adolescent; D002648:Child; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D008297:Male; D022401:Meningococcal Vaccines / Q000627:therapeutic use; D009657:North Carolina; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D012042:Registries; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines
keywords: Adolescent health services; Diphtheria tetanus acellular pertussis vaccine; Family practice; Human papillomavirus vaccine; Meningococcal vaccine; Pediatrics