BACKGROUND:
Although Rhode Island has close to a 90% immunization rate in childen under age two, there are still too many children left behind. Rhode Island has a high rate of immigration from many other countries. In addition, RI is a state with a high mobility rate among families both within the state and to other states and countries. Many of the families of these groups use licensed home daycare facilities. In 2004, for the first time, RI's 1600 in-home daycare providers, one half of which are entirely non-English speaking, are being required to report the immunization status of the children in their care.

OBJECTIVE:
To increase childhood immunization in RI's in-home daycares. Educate childcare providers about the importance of childhood immunizations.

METHOD:
Created a multi disciplinary team represented by staff of the Department of Health, Department of children, youth, and families(DCYF), and other community agencies to strategize on reaching, training and obtaining compliance in immunization reporting. Conducted on-going community-based trainings and orientation for in-home daycare providers. In year 1, developed pilot with survey, in year 2 distributed to all state licensed providers. Distributed educational material to assist with survey accuracy.

RESULT:
After the pilot year, feedback was utilized to improve materials and process. In year 2, five sessions have been conducted for licensed providers and six sessions have been conducted for providers in the process of applying for a state license. Partnerships have been formed with hard to reach families and the immunization staff has worked closely with DCYF. Over 400 providers returned surveys at the time of this deadline.

CONCLUSION:
In-home daycare providers play an important role in ensuring that RI's children are appropriately immunized, but they have been left out of the process of gathering information. Given the right approach, they are willing and enthusiastic about being part of the solution to identifying children in need of timely immunization.

LEARNING OBJECTIVES:
Form partnerships and strengthen relationships with in-home daycare providers.
Organize community groups.
Provide appropriate tools and support for in-home daycare providers.
Facilitate relationships between in-home daycare providers and the families they serve.