Reducing Missed Opportunities to Vaccinate During Child Health Visits: How Effective Are Parent Education and Case Management?

by David L. Wood, Mark A. Schuster, Cathy D. Sherbourne, Naihua Duan, Rebecca Mazel, Neal Halfon


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This study set out to assess, as part of a larger study of effectiveness of parent education and case management (CM) in raising immunization rates, the intervention's effectiveness at reducing missed opportunities to vaccinate during child health visits. A representative sample of African American newborns and their families from south central Los Angeles, Calif., were randomly assigned to a control or a CM group and observed during the first year of life. Case managers visited and telephoned parents, educating them on the benefits and safety of immunizations, and encouraging them to request immunizations from providers. When the children were at least 1 year of age, parents were interviewed and provider records were abstracted. The report concludes that missed opportunities were minimally influenced by a home visitation and parent education program. They are primarily determined by issues under the control of the provider. Family- and child-related characteristics, however, do influence the likelihood of a missed opportunity occurring independent of provider factors.

Originally published in: Archives of Pediatrics and Adolescent Medicine, v. 152, March 1998, pp. 238-243.

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