Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1) Distinguish the ACIP from the Done By One Schedule.
2) Understand the rationale for DBO.
3) Understand that DBO can help improve immunization rates.

Background:
Three years ago, New Mexico ranked 50th in the U.S. with only 61.2% of children 19-35 months up to date. The Clinical Prevention Initiative (CPI), a joint project of the New Mexico Medical Society and the New Mexico Department of Health, had recently formed with the goal of “facilitating integration of preventive care in physician offices and providing better services to patients across the state”. The Childhood Immunization Workgroup of CPI developed an ACIP-compatible, accelerated childhood immunization schedule named ‘Done By One' (DBO) that they began promoting statewide in the Summer of 2003 as an alternative to the standard ACIP harmonized childhood schedule. Advantages of the DBO schedule include: 1) it's simpler, 2) it get's children protected earlier, and 3) opportunities for shot deferral are minimized.

Objectives:
Evaluate the level of provider acceptance of the ‘DBO' schedule and the impact of it's use on coverage rates.

Methods:
Questions about 'DBO' use were asked during CASA/AFIX site visits and coverage rates in practices using the 'DBO' schedule were compared to coverage rates in practices not using 'DBO'.

Results:
The 'DBO' schedule is being used by a significant percentage of NM immunization providers, as confirmed by the higher 4:3:1:3:3 coverage rates at 15 months in practices who say they use the 'DBO' schedule. Furthermore, 4:3:1:3:3 and 4DTaP rates in 2 year olds have risen substantially more during the past two years in practices using 'DBO' than in practices not using 'DBO'.

Conclusions:
The 'DBO' childhood is an acceptable alternative to the ACIP, harmonized schedule and providers who use the accelerated 'DBO' childhood schedule do show improved coverage rates.