KEYWORDS:
Outreach; High risk community

BACKGROUND:
According to a household survey performed in an African-American community in Chicago, during June, 2000, measles coverage (MCV) among 19-35 month old children was 74%. MCV in this community was lower than in Illinois (92%) and the United States (91%) as determined by the National Immunization Survey. To increase MCV in this community we implemented several interventions and we report the results of our initial intervention.

OBJECTIVE(S):
To assess the impact of home visits to improve MCV.

METHOD(S):
To identify children who received immunizations after the household survey, we reviewed immunization records of under-immunized children in the Illinois Department of Public Aid's and the Chicago Department of Public Health's (CDPH) immunization databases. Of the 138 children identified as under-immunized in the survey, 112 (83%) remained under-immunized. From 4/01-9/01, Community Health Advocates (CHAs) attempted to contact the guardians of 112 children to inform them of missing immunizations and locations to receive immunizations. Children were referred to CDPH clinics if their providers were unable to provide immunizations within one week of contact. Visits were conducted to remind parents of scheduled appointments and to confirm receipt of immunizations.

RESULT(S):
CHAs made 357 home visits. Of the 112 under-immunized children, 51 (46%) were still living at the residence identified during the household survey. After contact with CHAs, 19 (37%) of the 51 under-immunized children received all recommended immunizations, 6 (12%) received some of recommended immunizations, 15 (29%) refused to participate, and 13 (22%) were non-compliant with recommendations.

CONCLUSIONS(S):
In this community, home visits resulted in immunizations for almost half of children contacted. Unfortunately, many children were not located because they were no longer living at their previously identified residence. Timely contact of under-immunized children with home visits soon after initial assessment, may improve immunization coverage.

LEARNING OBJECTIVES:
Describe a home visit program for tracking under-immunized children