Taylor James A, Rietberg Krista, Greenfield Lauren, Bibus David, Yasuda Kyle, Marcuse Edgar K, Duchin Jeffrey S
Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.
Vaccine. 2008 Aug 5;26(33):4256-61. doi: 10.1016/j.vaccine.2008.05.047. Epub 2008 Jun 6.
To determine if the addition of a physician peer educator would lead to improved immunization quality when compared to the traditional education provided as part of a vaccines for children (VFC) site visit.
A randomized controlled trial was conducted. Study participants were private pediatric and family medicine practices. Both the intervention and control groups received a VFC visit; in intervention practices this visit was augmented by a presentation by the physician peer educator. Data on immunization rates and quality of immunization services were collected prior to the VFC visits and approximately 1 year later.
A total of 73 practices participated, including 37 in the intervention group and 36 in the control group. At follow-up there was no difference in practice immunization rates (PIR) between intervention and control practices (mean rates 71.4% and 69.6%, respectively, P=0.94). There were also no significant differences between groups for any of the quality measures except that significantly more intervention practices used the appropriate length needle for vaccine injections in 2-month-old infants at follow-up (P=0.02). When assessing the overall impact of VFC visits, no significant increase in PIR were noted from baseline to follow-up assessments. However, statistically significant improvements in several quality measures were found.
The addition of a physician peer educator did not result in improved immunization quality when compared to VFC visits alone. The educational content of the VFC site visit was associated with improved quality of immunization services delivered by primary care practices.
与作为儿童疫苗（VFC）现场访视一部分提供的传统教育相比，确定增加一名医师同伴教育者是否会提高免疫接种质量。
进行了一项随机对照试验。研究参与者为私立儿科和家庭医学诊所。干预组和对照组均接受了VFC访视；在干预诊所，此次访视因医师同伴教育者的讲座而得到加强。在VFC访视前及大约1年后收集免疫接种率和免疫接种服务质量的数据。
共有73家诊所参与，其中干预组37家，对照组36家。随访时，干预组和对照组的实际免疫接种率（PIR）无差异（平均接种率分别为71.4%和69.6%，P = 0.94）。除随访时显著更多的干预诊所对2月龄婴儿使用了适合的长度的针头进行疫苗注射外（P = 0.02），两组在任何质量指标上也无显著差异。在评估VFC访视的总体影响时，从基线评估到随访评估未发现PIR有显著增加。然而，发现了几个质量指标有统计学上的显著改善。
与单独的VFC访视相比，增加一名医师同伴教育者并未提高免疫接种质量。VFC现场访视的教育内容与初级保健诊所提供的免疫接种服务质量的提高相关。
