Learning Objectives for this Presentation:
By the end of the presentation participants will be able to list program characteristics associated with increasing immunization coverage;
By the end of the presentation participants will be able to identify strategies used by immunization programs to sustain high childhood coverage levels.

Background:
State and city immunization programs are made up of diverse staff working together to increase immunization coverage. Relationships with community partners and organizations help to extend the reach of immunization programs. Although research has identified key interventions as effective in increasing childhood immunization rates, no studies have conducted in-depth surveys of comprehensive immunization programs to determine program characteristics and activities that lead to increased and sustained childhood immunization coverage levels.

Setting:
Seventeen immunization program sites within the United States. Includes seven sites with greatest absolute percent increase in coverage, and ten sites with highest sustained coverage levels between 2001 and 2004, using data from the National Immunization Survey.

Population:
Immunization program staff involved in management and implementation of program activities, as well as external collaborators who work on improving immunization coverage in the same communities.

Project Description:
162 semi-structured, in-depth interviews were conducted with key program staff, as well as external partners identified by immunization program managers. A set of pre-determined questions was created and asked systematically of each interviewee. A separate set of questions was created for program staff vs. partners. Interviews were taped, transcribed, and entered into E-Z Text software for qualitative analysis. Interview responses were coded according to themes identified from the interviews (15 questions for program staff, 10 questions for external partners).

Results/Lessons Learned:
Themes that emerged from preliminary analysis include: Understand the importance of face-to-face contact with healthcare providers and partners; Continually promote immunization through partners and immunization leaders in the community; Build relationships with external organizations; Know your community; Take advantage of the data-generating capabilities of registries.