An Ounce of Prevention: Texans Speak up for Immunizations

Background: Texas’ population is fast growing, young and diverse.  High rates of poverty and uninsured, an aging population, and ethnic disparities present significant immunization challenges.  In 2008 and 2010, The Immunization Partnership conducted a series of stakeholder activities that fostered community engagement, built partnerships, and coordinated capacities to improve immunization outcomes.  The efforts successfully identified priorities, while building a statewide network of Texans committed to improving immunization policies and practices. 

Setting: Texas cities (rural and urban).

Population: Representatives from government, clinics, hospitals, provider offices, health plans, and community-based organizations.

Project Description: In collaboration with local coalitions and state partners, 10 qualitative meetings and a quantitative Web-based survey were conducted. Local champions recruited participants. Recruitment included electronic invitations, community outreach, newsletter promotion, and word-of-mouth referral. The meetings consisted of a 25-minute overview of immunization policy issues, a 75-minute discussion on challenges and priorities, and a 20-minute advocacy primer.  Detailed notes were taken.  Data were thematically coded and categorized. 

Results/Lessons Learned: Over 412 stakeholders participated in the meetings (Average: 40; Range: 17-68) and 536 participated in the survey.  Participants collaborated to develop consensus on issues.  Priorities varied across Texas; however, participants united on the following recommendations: 1) increase efficiency of Immunization Information Systems (IIS), 2) align IIS with health information technology and electronic medical records, 3) improve healthcare worker vaccination, 4) educate vaccine-hesitant individuals, 5) support border communities, 6) better prepare for pandemics, 7) reduce vaccine costs and increase reimbursement, 8) reduce pertussis incidence, and 9) increase access to adult vaccines.  A publication summarizing meeting findings and recommendations was developed and distributed to stakeholders at the Texas Immunization Summit.  Conclusions include the following: 1) stakeholders are active contributors to program and policy development and 2) an evidence-informed process that incorporates collaboration and engagement is effective in identifying priorities and generating recommendations.