BACKGROUND:
Recall systems have previously shown to improve immunization rates of children. However, few studies have examined the success of recall systems based on the CASA score (4:3:1:3:3) of 24-month child being age appropriately immunized.

OBJECTIVE:
Compare CASA scores of providers who schedule a next appointment vs. providers scheduling a next appointment and calling and reminding the child's guardian of their next appointment, 2) Determine if multiple recall systems influence CASA score

METHOD:
Forty-nine Wyoming private VFC providers were randomly selected and evaluated about each provider's recall system(s). A CASA score was established for each provider based on a 10% randomized selection of 24-month old children. Each provider provided information regarding type of recall system(s) they used. An independent T-test was used to compare CASA score between providers scheduling an appointment and providers scheduling an appointment and also providing a reminder phone call. Providers were also grouped based on the number of recall systems they used (Group 1: 0 or 1 system, Group 2: 2 systems, Group 3: 3 or more systems). A univariate a-NOVA was used to compare CASA score between these groups. Results were considered significant at p < 0.05

RESULT:
There was no significant difference (p=0.68) for CASA score between providers who scheduled a next appointment (CASA = 72.0% + 16.9) (n=23) vs. providers scheduling a next appointment and providing a reminder phone call (CASA = 74.5% + 20.8) (n=13).
The difference between the number of recall systems in place between groups and CASA score was not significant (p = 0.66). Group 1: (n=17) : CASA = 74%.0 + 14.8, Group 2: (n=18): casa = 70.9% + 20.2, Group 3: (n-14) : casa = 76.6% + 17.4

CONCLUSION:
The addition of a phone call recall system (in addition to appointment scheduling) does not improve provider CASA score. In addition, there was no beneft positive relationship in CASA scores as a result of providers having a greater number of recall systems.

LEARNING OBJECTIVES:
Current results suggest the staff of the VFC providers should potentially reallocate time spent on phone calls and additional recall systems on other cost effective methods of improving CASA scores. Future research should investigate what interventions may increase CASA scores.