Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to:
1. Describe predictors of Reminder/Recall and MOGE in a city with coverage below the national average
2. Describe the relationship between VFC provider practice-level immunization coverage rate and use of Reminder/Recall and MOGE
3. Describe possible interventions to improve usage of Reminder/Recall and MOGE


Background:
Houston has one of the lowest childhood immunization levels among other major metropolitan cities in the United States at 65% for the 4:3:1:3:3 vaccination series. Factors related to the uptake and use of Reminder/Recall and MOGE among VFC providers are not known.

Objectives:
To identify, measure, and report on current use of Reminder/Recall and M.O.G.E. practices comparing low (<70%) and high (>80%) VFC providers in Houston.

Methods:
The sampling frame was a list of 187 VFC providers that had scores from the 2004 CASA audit. The low immunization coverage group was identified as those practices with <70% immunization coverage while the high immunization group had >80% coverage for the 4:3:1:3:3 vaccine series among 19-35 month olds in 2004. Data were collected by a personal interview with each provider. Odds ratios and 95% CIs measured the association between predictors and coverage groups.

Results:
Of the 88 practices surveyed, 46 had low coverage and 42 had high coverage. Preliminary results show that providers in the high coverage group are more likely to use two or more Reminder/Recall methods, flag patient records, and use MOGE.

Conclusions:
Differences between VFC providers with low (<70%) and high (>80%) immunization coverage for the 4:3:1:3:3 series with regard to use of Reminder/Recall and M.O.G.E. practices has provided useful information that can be used by the health department to increase childhood immunization levels in Houston.