KEYWORDS:
Coalitions, Community-based Partnerships, Evidence-based Practices, Immunizations, and Preventive Health Services

BACKGROUND:
While coalitions provide an important means of community empowerment to address health needs, some argue that coalitions are not capable of enacting system changes that improve health outcomes. In 1999, the Task Force on Community Preventive Services (www.thecommunityguide.org) recommended and disseminated a set of evidence-based immunization practices, also endorsed by the IOM. These evidence-based recommendations provide a new and important tool for coalitions that could be used to guide effective action.

OBJECTIVE(S):
To review the activities of immunization coalitions to assess whether they are conducting or promoting nationally recommended evidence-based practices.

METHOD(S):
In October 1999, a mail-in survey was designed and distributed to known immunization coalitions. Areas of inquiry included structure, stability, funding, status, over-view of projects and effectiveness in improving immunization rates. A secondary review of the data was conducted to assess coalition activities as they related to the recently recommended evidence-based practices.

RESULT(S):
64 coalitions responded to the survey. 72% of coalitions reported one or more initiatives that promoted evidence-based practices: Increased Community Demand, 28%; Provider-based Practices, 18%; and Increased Access to Services, 12%. A complete list of the evidence-based practices, coalition activities and a correlation to immunization outcomes will be presented.

CONCLUSIONS(S):
The development of evidence-based recommendations for preventive health services provides a new and useful tool. Our data suggest that many immunization coalitions have begun to incorporate these recommendations into strategies that affect the health system and are likely to improve health outcomes. With continued training, coalitions can enhance community capacity and affect systems change.

LEARNING OBJECTIVES:
To describe how coalitions can enhance community capacity and affect health systems changes through the use of evidence-based practices.