Findley Sally E, Irigoyen Matilde, Sanchez Martha, Guzman Letty, Mejia Miriam, Sajous Michelle, Levine Deborah A, Chen Shaofu, Chimkin Frank
Mailman School of Public Health, Columbia University and Columbia University Medical Center in New York City, New York, USA.
Health Promot Pract. 2006 Jul;7(3 Suppl):191S-200S. doi: 10.1177/1524839906288692. Epub 2006 Jun 7.
This study demonstrates how community-based immunization promotion reduced immunization disparities. In 2002 to 2004, the coalition enrolled 3,748 children younger than 5, with 1,502 aged 19 to 35 months in April 2004. Disparity reduction was assessed by comparing coalition immunization coverage rates (4:3:1:3:3) to the National Immunization Survey 2003 rates. Logistic regression was used to assess factors contributing to up-to-date immunizations. Coverage increased from 46.0% at enrollment to 80.5%, matching nationwide rates for all (t = 0.87) or White (t = 1.99) children. The 78% for African Americans was higher than 73% for U.S. African American children (t = 2.90); 84% for Latinos was higher than 77% for U.S. Latinos (t = 2.32). Being current with age-appropriate immunizations at enrollment (OR = 9.8), being Latino (OR = 1.6), and participating through child health insurance enrollment (OR = 4.9), Women, Infants, and Children (OR = 3.1), or child care or parenting (OR = 1.9) programs increased immunization coverage. Embedding immunization promotion into existing community programs was successful in eliminating immunization disparities. Most effective programs were those with direct linkages to health care systems or that targeted young children.
本研究展示了基于社区的免疫接种推广如何减少免疫接种差距。在2002年至2004年期间，该联盟招募了3748名5岁以下儿童，其中2004年4月有1502名年龄在19至35个月之间。通过将联盟免疫接种覆盖率（4:3:1:3:3）与2003年国家免疫调查率进行比较来评估差距减少情况。使用逻辑回归来评估有助于及时接种疫苗的因素。覆盖率从登记时的46.0%提高到80.5%，与所有儿童（t = 0.87）或白人儿童（t = 1.99）的全国率相匹配。非裔美国人的78%高于美国非裔儿童的73%（t = 2.90）；拉丁裔的84%高于美国拉丁裔的77%（t = 2.32）。登记时及时接种适合年龄的疫苗（OR = 9.8）、为拉丁裔（OR = 1.6）以及通过儿童健康保险登记（OR = 4.9）、妇女、婴儿和儿童项目（OR = 3.1）或儿童保育或育儿项目（OR = 1.9）参与，可提高免疫接种覆盖率。将免疫接种推广纳入现有的社区项目成功消除了免疫接种差距。最有效的项目是那些与医疗保健系统有直接联系或针对幼儿的项目。
