BACKGROUND:
In 1997, the Health Rescue Promotora Project, a public-private collaboration, began training immigrant women to improve community vaccination coverage and immunization knowledge through outreach/education, and case-management.

OBJECTIVE:
To assess the community impact of immunization promotion delivered by promotoras, as measured by immunization coverage levels and knowledge/attitudes/behaviors (KAB).

METHOD:
A home-based, promotora-administered questionnaire was delivered to one child per household in 3 zip codes with traditionally low immunization rates in children aged 2-3 years. Baseline immunization coverage levels were measured in 1997 and KAB in 1998, with an evaluation performed in 2002 in the same areas. Blocks identified with 2-3 year-olds in the census data were sampled. Information collected included vaccinations (documented by parents/guardians or doctor), parental knowledge/ beliefs about vaccine-preventable diseases (VPDs) and importance of immunizations. Data were further stratified by previous exposure to the promotoras.

RESULT:
Baseline data included 270 children in 1997 and 106 in 1998. Of 112 children identified in 2002, 91 (81%) were surveyed. Immunization coverage at age 24 months (4:3:1:3:3 series) increased 14.7% (1997: 64.4%; 2002: 79.1%). In households that had been previously educated by promotoras compared to those that had not, coverage levels were 20.9% higher (4:3:1:3:3 series). Among 2002 respondents, 19.8% knew * 4 VPDs and 75.8% agreed that immunizations work, compared to 34.5% and 54.4%, respectively, in 1998. Of the 2002 respondents who were previously educated by promotoras (n=25), 84.0% agreed immunizations work, compared to 79.3% of those who had not been educated (n=53).

CONCLUSION:
In the target zip codes, the Healthy People 2010 goal of 80% coverage was reached for the 4:3:1:3:3 series. A decrease in knowledge of VPDs was evidenced, however, indicating a need for more targeted intervention around increasing parental awareness of existing diseases.

LEARNING OBJECTIVES:
Understand the strength of public-private partnerships to increase immunizations among high-risk groups.