KEYWORD1:
School-based intervention, hepatitis B, immunization coverage, at-risk children

BACKGROUND:
The School-based Vaccination Program has successfully vaccinated fifth grade students against the hepatitis B virus in a multi-parish area, since 1996. Generally, school-based efforts have resulted in 70% coverage, however, those children not immunized are not a random sample of the population, but, rather those most at risk for health problems, including hepatitis B. Could an enhanced version of the school-based intervention increase immunization rate in at-risk children?

OBJECTIVE:
Test whether enhanced school-based intervention increases hepatitis B immunization rates in at-risk children, resulting in greater coverage of population as a whole.

METHOD:
A quasi-experimental design was used to compare twelve schools with similar demographic characteristics (the control) to the twelve schools with low performance (the intervention). A critical comparison performance evaluation was conducted using a Chi square distribution analysis. Parental consent served as a proxy for measure of immunization rates.

RESULT:
The twelve schools that traditionally had low performance rates demonstrated an 80% parental consent response rate after the implementation of enhanced intervention, as compared to the control group with 69%.

CONCLUSION:
The enhanced intervention significantly increased immunization rates for at-risk children.
LEARNINGOBJECTIVES:
1) Apply intervention strategies to boost response to vaccination program, e.g., teacher conference; prepared lesson plans, incentives for teachers and students.
2) Incorporate enhanced intervention strategies to increase performance of low performance schools, e.g., additional contact with principals and teachers; additional attention to teachers at hepatitis B conference; class presentations by teacher consultant; phone calls to parents not returning consent forms.