Tuesday, March 18, 2008 - 2:25 PM

Impact of a Community-Clinic Intervention on Immunization-Related Behavior

Nidhi M. Nakra, Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention, 3530 Wilshire Blvd., Suite 700, Los Angeles, CA, USA, Dulmini Kodagoda, Los Angeles County Immunization Program, 3530 Wilshire Blvd. Suite 700, Los Angeles, CA, USA, and Katie Eilers, INMED Partnerships for Children.

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to: 1) discuss the impact of a community-clinic intervention on immunization-related behavior among African Americans (AA) in South Los Angeles and 2) identify prevailing immunization misperceptions in AA communities.

In 2005, the African American Immunization Collaborative was developed to reduce immunization disparities and enhance immunization-related behaviors among AAs in South Los Angeles, through community outreach/education and clinic case-management.

To assess the community impact of immunization promotion delivered by Immunization Care Coordinators, as measured by knowledge/attitudes/behaviors (KAB).

KAB was assessed through interviewer-administered questionnaires with AA parents of children (<3 years) in four clinics/offices that were identified as trusted source of medical care and that serve a significant percentage of AAs in the target community (Total clinics in area: 7). Baseline KAB was measured in 2005, followed by a 2007 evaluation.

KAB analysis included 281 respondents in 2005 (94% response rate) and 291 in 2007 (97% response rate). Among respondents in 2007, 9% could not identify any VPDs, compared to 19% in 2005. Knowledge of between 1 and 3 VPDs increased 26% (2005: 39%; 2007: 49%). Of 2007 respondents, 62% voiced the role that immunizations play in keeping children healthy and 90% believed young children were especially at risk for VPDs, compared to 42% and 83%, respectively, in 2005. Beliefs that immunizations prevent common illnesses like colds (2005: 20%, 2007: 25%) and that some immunizations are more harmful than others (2005: 14%; 2007: 21%) persisted. Among 2007 respondents, 42% reviewed immunization records to determine when shots were due and 12% received clinic reminders, compared to 34% and 9%, respectively, in 2005.

Results indicated increases in knowledge and practices; however, immunization misperceptions among AAs persist. Multi-disciplinary, targeted interventions are critical, in order to foster behavioral change.