Shenson D, Quinley J, DiMartino D, Stumpf P, Caldwell M, Lee T
Department of Epidemiology & Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
J Community Health. 2001 Jun;26(3):191-201. doi: 10.1023/a:1010321128990.
This study examined the effectiveness of a community-wide outreach campaign to promote the use of pneumococcal vaccine at public flu immunization clinics, and assessed whether this intervention was more effective than simply making pneumococcal vaccination available at such clinics. In 1997, a community-wide outreach campaign promoting pneumococcal and influenza immunizations was launched in a 17 zip code area of Dutchess County, NY. The campaign was aimed at 7,961 Medicare beneficiaries urging them to obtain pneumococcal immunization from local flu clinics. Medicare reimbursement data were used to assess the countywide pneumococcal vaccination rate, and to analyze differences between rates for beneficiaries in the target area and elsewhere in the county. Between 1996 and 1997 there was a 94% increase in pneumococcal vaccination billed to Medicare beneficiaries in Dutchess County. The 1997 annual rate of pneumococcal immunization in the target area reached 16.3% versus 12.2% elsewhere in the county (p < 0.001), with an increase over the previous year of 8.7% and 5.6%, respectively. Nearly all of the increase is accounted for by pneumococcal vaccination delivered at flu clinics. It is possible to significantly increase the use of pneumococcal immunization by linking its delivery to community-based flu clinics and by developing local outreach strategies. The outreach campaign has a significant additive effect over simply making PPV available at flu shot clinics. Additional community-wide outreach can further improve pneumococcal immunization utilization rates.
本研究考察了一项社区范围的推广活动在公共流感免疫诊所促进肺炎球菌疫苗使用的效果，并评估了这一干预措施是否比仅在这些诊所提供肺炎球菌疫苗接种更有效。1997年，在纽约州达奇斯县的17个邮政编码区域开展了一项推广肺炎球菌和流感免疫接种的社区范围活动。该活动针对7961名医疗保险受益人，敦促他们从当地流感诊所获得肺炎球菌免疫接种。医疗保险报销数据用于评估全县的肺炎球菌疫苗接种率，并分析目标区域受益人和该县其他地区受益人接种率之间的差异。1996年至1997年间，达奇斯县向医疗保险受益人收取费用的肺炎球菌疫苗接种增加了94%。1997年目标区域的肺炎球菌免疫接种年率达到16.3%，而该县其他地区为12.2%（p<0.001），与上一年相比分别增加了8.7%和5.6%。几乎所有的增长都来自于流感诊所提供的肺炎球菌疫苗接种。通过将肺炎球菌疫苗接种与社区流感诊所相结合，并制定当地推广策略，可以显著提高肺炎球菌疫苗的使用。推广活动比仅在流感疫苗接种诊所提供肺炎球菌多糖疫苗（PPV）具有显著的叠加效应。额外的社区范围推广可以进一步提高肺炎球菌疫苗接种利用率。
