PMID: 9424040Jan 10, 1998Paper

Increasing immunization rates among inner-city, African American children. A randomized trial of case management

JAMA : the Journal of the American Medical Association
D L WoodN Duan

Abstract

Immunization rates in the inner city remain lower than in the general US population, but efforts to raise immunization levels in inner-city areas have been largely untested. To assess the effectiveness of case management in raising immunization levels among infants of inner-city, African American families. Randomized controlled trial with follow-up through 1 year of life. Low-income areas of inner-city Los Angeles, Calif. A representative sample of 419 African American infants and their families. In-depth assessment by case managers before infants were 6 weeks of age, with home visits 2 weeks prior to when immunizations were scheduled and additional follow-up visits as needed. Percentage of children with up-to-date immunizations at age 1 year, characteristics associated with improved immunization rates, and cost-effectiveness of case management intervention. A total of 365 newborns were followed up to age 1 year. Overall, the immunization completion for the case management group was 13.2 percentage points higher than the control group (63.8% vs 50.6%; P=.01). In a logistic model, the case management effect was limited to the 25% of the sample who reported 3 or fewer well-child visits (odds ratio, 3.43; 95% confidence interval, ...Continue Reading

Citations

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