Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina; Department of Medicine, Duke University School of Medicine, Durham, North Carolina.
Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
J Adolesc Health. 2015 May;56(5 Suppl):S14-6. doi: 10.1016/j.jadohealth.2014.10.272.
To improve adolescent immunization coverage in a rural North Carolina county.
Adolescent immunization coverage rates in an intervention and four comparison counties were compared over 1 year. We introduced practice-based interventions in seven practices centering on immunization registry-driven recall of adolescents for immunizations with postcard reminders (Phase 1), and 6 months later employed nontargeted school-generated telephone reminders to parents of adolescents (Phase 2).
Improvements in the intervention county among 11- to 12-year-olds occurred for first-dose human papillomavirus vaccine in both boys (overall change, 14.2%-32.1%) and girls (27.4%-43.4%) and the meningococcal vaccine (34.6%-49.4%). Improvements among adolescents 13-18 years were limited to human papillomavirus vaccine completion in boys (1.6%-4.2%). Improvements were greater during Phase 1 than Phase 2 and among younger adolescents. Coverage improvements in the comparison counties were smaller than those observed in the intervention county.
A resource-light two-phase intervention led to modest improvements in immunization coverage, most notably in the largest adolescent practice in the county, and suggested potential for further gains, particularly among younger adolescents.
提高北卡罗来纳州农村县青少年的免疫接种率。
在一年的时间里，比较了干预组和四个对照组的青少年免疫接种率。我们在七个以免疫登记册为基础的实践中引入了基于实践的干预措施，这些实践以明信片提醒的方式对青少年进行免疫接种的召回（第 1 阶段），6 个月后，向青少年的家长发送非针对性的学校生成的电话提醒（第 2 阶段）。
在干预组中，11 至 12 岁的男孩和女孩的人乳头瘤病毒疫苗首剂接种率都有所提高（总体变化为 14.2%-32.1%和 27.4%-43.4%），脑膜炎球菌疫苗接种率也有所提高（34.6%-49.4%）。在 13-18 岁的青少年中，人乳头瘤病毒疫苗的完成率有所提高（男孩为 1.6%-4.2%）。第 1 阶段的改善大于第 2 阶段，且在青少年中更为明显。对照组的覆盖范围改善小于干预组。
一项资源较少的两阶段干预措施导致免疫接种率适度提高，尤其是在该县最大的青少年实践中，这表明有可能进一步提高，特别是在年轻的青少年中。
