title: Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee's Children Program.
abstract: BACKGROUND
  Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19-35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates.
  
  
  OBJECTIVE
  Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations.
  
  
  METHODS
  The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools.
  
  
  RESULTS
  Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children's median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message ("Take Control: Protect Your Child with Immunizations"). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p<0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years.
  
  
  CONCLUSIONS
  Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities.
authors.forename: Earnestine
authors.initials: E
authors.lastname: Willis
authors.forename: Svapna
authors.initials: S
authors.lastname: Sabnis
authors.forename: Chelsea
authors.initials: C
authors.lastname: Hamilton
authors.forename: Fue
authors.initials: F
authors.lastname: Xiong
authors.forename: Keli
authors.initials: K
authors.lastname: Coleman
authors.forename: Matt
authors.initials: M
authors.lastname: Dellinger
authors.forename: Michelle
authors.initials: M
authors.lastname: Watts
authors.forename: Richard
authors.initials: R
authors.lastname: Cox
authors.forename: Janice
authors.initials: J
authors.lastname: Harrell
authors.forename: Dorothy
authors.initials: D
authors.lastname: Smith
authors.forename: Melodee
authors.initials: M
authors.lastname: Nugent
authors.forename: Pippa
authors.initials: P
authors.lastname: Simpson
mesh_terms: D002648:Child; D002675:Child, Preschool; D055812:Community-Based Participatory Research / Q000379:methods*; D015438:Health Behavior; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D040241:Social Marketing; D014922:Wisconsin