LeBaron C W, Mercer J T, Massoudi M S, Dini E, Stevenson J, Fischer W M, Loy H, Quick L S, Warming J C, Tormey P, DesVignes-Kendrick M
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Arch Pediatr Adolesc Med. 1999 Aug;153(8):879-86. doi: 10.1001/archpedi.153.8.879.
Since 1995, states and jurisdictions receiving federal immunization funds have been required to perform annual measurements of vaccination coverage in their public clinics, based on data from Georgia where clinic coverage increased after the institution of a measurement and feedback intervention.
To determine if clinic vaccination coverage improved in localities that used the Georgia intervention model.
Retrospective examination of clinic vaccination coverage data.
Children aged 19 to 35 months enrolled in clinics in localities that had applied the intervention for 4 years or longer.
The Georgia intervention model: assessment of clinic vaccination coverage, feedback of the information to the clinic, incentives to clinics, and promotion of exchange of information among clinics (AFIX).
Change in median clinic coverage rates, based on the primary (4-3-1) vaccine series, with comparison to results of the National Immunization Survey.
Four states and 2 cities that had applied the AFIX intervention for 4 years or longer were identified. The number of clinic records reviewed annually was 4639 to 18000 in 73 to 116 clinics for states, and 714 to 5276 in 8 to 25 clinics for cities. Median clinic coverage rose in all localities: Missouri, 44% (1992) to 93% (1997); Louisiana, 61% (1992) to 83% (1997); Colorado, 55% (1993) to 75% (1997); Iowa, 71% (1994) to 89% (1997); Boston, Mass, 41% (1994) to 79% (1997); and Houston, Tex, 28% (1994) to 84% (1997). The increase in clinic coverage exceeded that of the general population in 5 localities and was identical in the sixth. The average annual coverage rise attributable to the intervention was +5 percentage points per year (Georgia, +6 per year). The average crude direct program cost was $49533 per locality per year.
The Georgia intervention model (AFIX) can be reproduced elsewhere and is associated with improvements in clinic vaccination coverage.
自1995年以来，接受联邦免疫资金的州和辖区被要求根据佐治亚州的数据，对其公共诊所的疫苗接种覆盖率进行年度测量。在佐治亚州，实施测量和反馈干预后，诊所的覆盖率有所提高。
确定采用佐治亚州干预模式的地区诊所疫苗接种覆盖率是否有所提高。
对诊所疫苗接种覆盖率数据进行回顾性检查。
在已应用该干预措施4年或更长时间的地区诊所登记的19至35个月大的儿童。
佐治亚州干预模式：评估诊所疫苗接种覆盖率，向诊所反馈信息，激励诊所，并促进诊所之间的信息交流（AFIX）。
根据主要（4-3-1）疫苗系列，比较诊所覆盖率中位数的变化，并与国家免疫调查结果进行比较。
确定了4个州和2个城市，它们应用AFIX干预措施已达4年或更长时间。各州每年审查的诊所记录数量在73至116家诊所中为4639至18000份，各城市在8至25家诊所中为714至5276份。所有地区的诊所覆盖率中位数均有所上升：密苏里州，从1992年的44%升至1997年的93%；路易斯安那州，从1992年的61%升至1997年的83%；科罗拉多州，从1993年的55%升至1997年的75%；爱荷华州，从1994年的71%升至1997年的89%；马萨诸塞州波士顿，从1994年的41%升至1997年的79%；得克萨斯州休斯顿，从1994年的28%升至1997年的84%。5个地区诊所覆盖率的增长超过了一般人群，第六个地区则相同。该干预措施导致的诊所覆盖率平均每年上升5个百分点（佐治亚州每年上升6个百分点）。平均每年每个地区的直接项目成本约为49533美元。
佐治亚州干预模式（AFIX）可以在其他地方复制，并与诊所疫苗接种覆盖率的提高相关。
