Learning Objectives for this Presentation:
By the end of the presentation participants will be able to: 1) identify and discriminate between obstacles Juvenile Justice Residential Facilities (JJRFs) face as they decide whether and how to administer vaccines to residents; 2) understand the problems intrinsic to the JJRF system with regard to immunization procedures; and 3) generate creative solutions for overcoming the five fundamental obstacles to immunizing JJRF residents.

Background:
Several million medically underserved and high-risk young people pass through the JJRF system each year, making it a potentially ideal setting for public health intervention. However, because health care is not the primary directive of JJRFs, there are many missed opportunities for providing the most basic preventive care, such as immunizations.

Setting:
Three to five JJRFs in each of ten states throughout the Nation.

Population:
Respondents from JJRFs in the pre-test states.

Project Description:
During the months of June-August 2006, interviews were conducted to pretest the biennial JRFC (Juvenile Residential Facility Census) in 3-5 JJRFs in each of ten states. Traditional cognitive interviewing techniques were used to pre-test the questions. Three investigators conducted more than 35 interviews, lasting between 2-5 hours and included multiple respondents from each facility, including nurses, clinic staff, administrators, and superintendents.

Results/Lessons Learned:
The pretest data collected from the JRFC describes the five major obstacles JJRFs face as they attempt to provide adequate preventive care to their residents. The most fundamental problem rests in the legal status of the child for whom the facility may want to seek vaccination. Other problems include cost concerns, vaccine availability, and misinformation regarding VFC. Correlates of participation in the cost-free federal Vaccination for Children Program are analyzed.