National Center for Immunization and Respiratory Diseases, Immunization Services Division, Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Public Health Manag Pract. 2010 Jan-Feb;16(1):E1-8. doi: 10.1097/PHH.0b013e3181b0b8bc.
State and urban immunization programs are responsible for the implementation of comprehensive programs to vaccinate populations within their geographic area. Given the variability in immunization coverage rates between geographic areas, the purpose of this two-phase study was to first identify the state and urban areas that achieved the highest increases in coverage, and then those with the highest sustained coverage, between two designated periods, and to interview key program staff members and their community counterparts to capture their perspectives on what factors may have contributed to increasing and sustaining high rates. In this article, we describe phase 1, in which we visited the seven sites that achieved the largest increases in coverage from 2001 to 2004. Results describe outcomes from the 71 semistructured key informant interviews with internal staff and external partners at the site's immunization programs. Interview transcripts were analyzed qualitatively, using a general inductive approach. Common challenges encountered among the seven sites included increasing reluctance among parents and overcoming barriers to accessing care. Common strategies to address these and other challenges included collecting and using data on immunization coverage, developing communication and education efforts, and continuously reaching out and collaborating with immunization partners. Lessons learned from these programs may help inform others who are working to improve childhood immunization delivery and coverage in their own programs.
州和城市免疫规划负责在其地理区域内实施全面的人群免疫接种计划。鉴于地理区域之间免疫接种覆盖率的差异，本两项研究的目的首先是确定在两个指定时期内覆盖率增长最高的州和城市地区，然后是那些覆盖率持续最高的地区，并采访关键的项目工作人员及其社区对应人员，了解可能有助于提高和维持高覆盖率的因素。在本文中，我们描述了第一阶段，我们访问了 2001 年至 2004 年期间覆盖率增长最大的七个地点。结果描述了 71 次半结构关键知情者访谈的结果，这些访谈涉及该地点免疫规划内部工作人员和外部合作伙伴。使用一般归纳方法对访谈记录进行了定性分析。七个地点共同面临的挑战包括家长越来越不愿意和克服获得护理的障碍。解决这些和其他挑战的共同策略包括收集和使用免疫接种覆盖率数据、制定沟通和教育计划以及不断与免疫伙伴接触和合作。从这些项目中吸取的经验教训可能有助于为其他努力改善其自身项目中的儿童免疫接种提供信息。
