KEYWORDS:
immunization coverage, health insurance, day care, breast-feeding, ability to pay, parental knowledge, respondent burden

BACKGROUND:
The National Immunization Survey (NIS) measures vaccination coverage among children age 19-35 months in the U.S., the 50 states, and 28 urban areas. It uses a random-digit dialing telephone survey to identify age eligible children and seek consent to contact children's vaccination providers. The National Immunization Program (NIP) has recently examined the feasibility of expanding the NIS to assess the association between several variables and
immunization coverage.

OBJECTIVE(S):
A set of three topical modules were designed to provide NIP with needed information without creating additional burden for survey respondents

METHOD(S):
Three modules addressing three research topics associated with immunization coverage were designed and implemented as part of the NIS Computer Assisted Telephone Interview (CATI). These modules included Health Insurance and Ability to Pay, Parental Knowledge and Experience, and Day Care/Breast-feeding Practices.

RESULT(S):
The Health Insurance and Ability to Pay module took an average of 3.47 minutes to complete, Day Care/Breast-feeding Practices an average of 2.13 minutes, and Parental Knowledge and Experience an average of 6.22 minutes. The percentage of break off in mid-interview in the Topical Modules section of the questionnaire was: 1.1% for the Day Care/Breast-feeding Practices module, 1.5% for the Health Insurance and Ability to Pay, and 2.2% for the Parental
Knowledge and Experience module.

CONCLUSIONS(S):
Modules that address a variety of topics pertaining to immunization coverage can be incorporated into the NIS CATI instrument without creating additional burden for respondents.

LEARNING OBJECTIVES:
The success of adding these topical modules to the ongoing NIS is encouraging. NIP is able to collect key information for its planning and interventions without affecting the NIS response rate. NIP has the option of adding new rotating modules to the NIS.