KEYWORDS:
Community outreach, Public housing

BACKGROUND:
Residents of public housing are categorically impoverished; poverty is a risk factor for low immunization rates. The Public Housing Immunization Initiative, which targeted preschool children residing in over 30 traditional public housing developments in Philadelphia. A baseline survey of immunization coverage in this population showed that coverage for these children was 67%, 13% below 80% coverage levels reported by the National Immunization Survey for Philadelphia.

OBJECTIVE(S):
To assess and raise immunization coverage levels among preschool children residing in public housing developments.

METHOD(S):
15 public housing residents were recruited and trained as Resident Outreach Coordinators (ROCs), with 5 AmeriCorps members acting as Outreach Team Leaders. A baseline survey was conducted in winter 1997-1998. Outreach teams conducted immunization outreach over a 13-month period. Children were referred for immunization outreach based upon information generated by the city’s immunization registry; outreach workers visited homes, reviewed immunization histories, and provided education, counseling and referrals to medical care as needed. A follow-up survey was conducted in autumn 1999.

RESULT(S):
1,805 referrals were generated from the city immunization registry between May 1998 and July 1999. 412 children (27%) could not be located, 41 families (2%) declined to be interviewed, and 94 families (5%) did not respond to contact attempts. Of the 1258 contacted cases, 578 (46%) were found to be up-to-date at time of contact, and 204 (16%) were brought to medical care for immunization. In 476 cases (38%) outreach workers were unable to verify immunization records.

CONCLUSIONS(S):
Changes in organization within the Philadelphia Housing Authority (PHA), including an extensive program of development renovations and family relocation, provided many challenges to the program.

LEARNING OBJECTIVES:
To explore barriers to immunization in communities of impoverished preschool children, and to evaluate the efficacy of a registry-based community outreach program to increase immunization levels to at least those of non-impoverished preschool-aged children.