BACKGROUND:
Cultural and language barriers to immunization of urban, low-income Asian American children exist. Few Chinese language speaking physicians serve the Philadelphia neighborhoods where over 30,000 non-English speaking Chinese live. Attendance by many ethnic minority children at state regulated child care mandating preventive care completeness provides an opportunity to use technology to facilitate partnerships between child care centers, parents, and physicians to improve access and minimize health disparities.

OBJECTIVE:
Pilot WellCareTracker(tm), a web-based application to I) track health records for enrolled children; ii) provide recall/reminders; and iii) refer children to their medical home for overdue services at Children’s Village, a 250 child, urban, not-for-profit child care center serving Asian-American and minority, low-income children with health disparities.

METHOD:
Measure and report age appropriate up-to-date (UTD) immunization status, and UTD status for children ages 19-35 months at initial enrollment, midyear, and the end of the program year; describe user satisfaction. Compare results with CDC-NIS national, Philadelphia PA, and the rest of Pennsylvania data.

RESULT:
80% of enrolled children at Children’s Village were age-appropriately UTD for immunizations at enrollment(Fall 2003). Anecdotal data indicates that the web-based software is efficient, effective, and user-friendly. Although Children’s Village enrollees are more UTD for immunizations than children of a similar age in the community, their UTD status is below the Healthy People 2010 Goal of 95% UTD for Children Attending Child (day) Care.

CONCLUSION:
Healthy People 2010 Immunization Goals of 95% UTD for children attending child (day) care are attainable for low-income, ethnic minority, and Asia-American children with health disparities in urban communities if effective partnerships between child (day) care, parents, and community medical homes are created. Routine use of user-friendly, health record tracking software in child care centers can facilitate these partnerships. Combining “Push-Pull” strategies can improve immunization status for children attending child (day) care. WellCareTracker™ optimizes the use of limited resources.

LEARNING OBJECTIVES:
1. Demonstrate a web-based software application enabling educators to track health records, and provide recall/reminder support for immunizations to families with unique cultural and language barriers to improve access to care.
2. Describe the challenges/benefits of using the web-app in a very large, urban, child (day) care program serving low income, ethnic minority Asian-American children with health disparities.