Boom Julie A, Nelson Cynthia S, Laufman Larry E, Kohrt Alan E, Kozinetz Claudia A
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.
Clin Pediatr (Phila). 2007 Oct;46(8):706-17. doi: 10.1177/0009922807301484. Epub 2007 May 23.
Provider education programs that use academic detailing to improve childhood immunization have been implemented in several states. The purpose of this study was to evaluate the impact of these types of programs to improve immunization-related behaviors in private provider offices. The intervention included peer-based academic detailing in which teams of 1 physician, 1 nurse, and 1 office manager visited pediatric and family practices to deliver an educational presentation and develop practice-specific action plans. Comparison of pre-post intervention surveys showed that providers' willingness to give the maximum number of immunizations due at 1 visit (P < .001) increased. More providers reported routinely screening immunization records at sickness or injury visits (P < .05) and using minimum intervals (P < .001) postintervention. Mean change in baseline and postintervention overall scores was significant for pediatric practices (0.40, P < .05), small practices (0.64, P < .01), Vaccines for Children (VFC) practices (0.74, P < .05), and non-VFC provider practices (0.67, P < .01) but not for family or large practices.
在几个州已经实施了利用学术推广来改善儿童免疫接种情况的医疗服务提供者教育项目。本研究的目的是评估这类项目对改善私人医疗服务提供者办公室中与免疫接种相关行为的影响。干预措施包括基于同行的学术推广，即由1名医生、1名护士和1名办公室经理组成的团队走访儿科和家庭医疗诊所，进行教育讲座并制定针对具体诊所的行动计划。干预前后调查结果的对比显示，医疗服务提供者在一次就诊时提供最大数量应接种疫苗的意愿有所提高（P < .001）。更多的医疗服务提供者报告称，在患者因病或受伤就诊时会常规筛查免疫接种记录（P < .05），并且在干预后会采用最短间隔时间（P < .001）。儿科诊所（0.40，P < .05）、小型诊所（0.64，P < .01）、儿童疫苗计划（VFC）诊所（0.74，P < .05）和非VFC医疗服务提供者诊所（0.67，P < .01）在基线和干预后的总体得分平均变化显著，但家庭诊所或大型诊所则不然。
