Wandsworth Public Health Department, Wandsworth Town Hall, Wandsworth High Street, London, SW18 2PU, UK.
J Community Health. 2013 Jun;38(3):581-7. doi: 10.1007/s10900-013-9654-4.
To improve uptake of childhood immunizations in Wandsworth we developed a standardized call/recall system based on parents being sent three reminders and defaulters being referred to a Health Visitor. Thirty-two out of 44 primary care practices in the area implemented the intervention in September 2011. The aim of this study was to evaluate the implementation, delivery and impact on immunization uptake of the new call/recall system. To assess implementation and delivery, a mixed method approach was used including qualitative (structured interviews) and quantitative (data collected at three months post-implementation) assessment. To assess the impact, we used Student's t test to compare the difference in immunization uptake rates between intervention and non-intervention practices before and after implementation. The call/recall system was viewed positively by both parents and staff. Most children due or overdue immunizations were successfully captured by the 1st invitation reminder. After three invitations, between 87.3 % (MMR1) and 92.2 % (pre-school booster) of children identified as due or overdue immunizations successfully responded. Prior to implementation there was no difference in uptake rates between intervention and non-intervention practices. Post-implementation uptake rates for DTaP/IPV/Hib, MMR1, MMR2 and the pre-school booster were significantly greater in the intervention practices. Similar findings were seen for PCV and Hib/MenC boosters, although the differences were not statistically significant at the 5 % level. Following the successful implementation of a standardized call/recall system in Wandsworth, other regions or primary care practices may wish to consider introducing a similar system to help improve their immunization coverage levels.
为了提高旺兹沃思地区儿童疫苗接种率，我们开发了一个基于向家长发送三次提醒、对未接种者转介给健康访视员的标准化呼叫/召回系统。该地区 44 家初级保健机构中有 32 家于 2011 年 9 月实施了该干预措施。本研究旨在评估新的呼叫/召回系统的实施、交付情况及其对免疫接种率的影响。为了评估实施和交付情况，我们采用了混合方法，包括定性（结构化访谈）和定量（实施后三个月收集的数据）评估。为了评估影响，我们使用学生 t 检验比较了实施前后干预和非干预实践中免疫接种率的差异。该呼叫/召回系统得到了家长和工作人员的积极评价。通过第一次邀请提醒，大多数应接种或逾期未接种疫苗的儿童都成功被捕捉到。经过三次邀请，有 87.3%（MMR1）至 92.2%（学前加强针）的应接种或逾期未接种疫苗的儿童成功回应。在实施之前，干预和非干预实践中的接种率没有差异。实施后，DTaP/IPV/Hib、MMR1、MMR2 和学前加强针的接种率在干预实践中显著增加。PCV 和 Hib/MenC 加强针也有类似的发现，尽管在 5%的水平上差异没有统计学意义。在旺兹沃思成功实施标准化呼叫/召回系统后，其他地区或初级保健机构可能希望考虑引入类似的系统，以帮助提高其免疫接种覆盖率。
