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Provider Attitudes Toward Public-Private Collaboration to Improve Immunization Reminder/Recall: A Mixed-Methods Study

      Abstract

      Objective

      To assess primary care providers' current reminder/recall practices, preferences for collaboration with health departments in reminder/recall efforts, attitudes toward practice-based and population-based reminder/recall, and experiences with a population-based reminder/recall intervention.

      Methods

      Providers responsible for making decisions about immunization delivery at all primary care practices that participate in the Colorado Immunization Information System were surveyed. Data collection was preceded by an intervention in which half of 14 counties received a population-based reminder/recall intervention conducted by the health department. Practice staff involved in immunization activities were then selected for semistructured telephone interviews that were based on the location of their practice within specified strata, including whether they were in the intervention counties, urban/rural location, and practice type.

      Results

      A total of 282 (73.6%) of 383 of providers responded to the survey, and 253 who administered vaccines to children 19 to 35 months were retained; 82 staff members at 36 practices were interviewed. Providers' preferences for who should conduct reminder/recall were almost evenly split, with slightly more indicating that it should be conducted by the health department. Cost and feasibility issues were perceived barriers to conducting practice-based recall, particularly among urban practices. Support for population-based reminder/recall was highest among rural practices. Concern about perceived inaccuracies in immunization registry data was the major barrier to conducting population-based reminder/recall. The population-based intervention did not create an undue burden on practices.

      Conclusions

      A collaborative approach to reminder/recall involving both providers and health departments is preferable for many providers and may be a viable solution to the barriers of practice-based reminder/recall.

      Keywords

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      References

      1. AIRA Modeling of Immunization Registry Operations Work Group. Reminder/recall in immunization information systems. Available at: http://www.immregistries.org/resources/AIRA-MIROW_RR_041009.pdf. Accessed October 7, 2012.

        • Szilagyi P.G.
        • Bordley C.
        • Vann J.C.
        • et al.
        Effect of patient reminder/recall interventions on immunization rates: a review.
        JAMA. 2000; 284: 1820-1827
        • Dombkowski K.J.
        • Harrington L.B.
        • Dong S.
        • Clark S.J.
        Seasonal influenza vaccination reminders for children with high-risk conditions: a registry-based randomized trial.
        Am J Prev Med. 2012; 42: 71-75
        • Daley M.F.
        • Barrow J.
        • Pearson K.
        • et al.
        Identification and recall of children with chronic medical conditions for influenza vaccination.
        Pediatrics. 2004; 113: e26
        • Kempe A.
        • Daley M.F.
        • Barrow J.
        • et al.
        Implementation of universal influenza immunization recommendations for healthy young children: results of a randomized, controlled trial with registry-based recall.
        Pediatrics. 2005; 115: 146-154
        • Hicks P.
        • Tarr G.A.
        • Hicks X.P.
        Reminder cards and immunization rates among Latinos and the rural poor in northeast Colorado.
        J Am Board Fam Med. 2007; 20: 581-586
        • Kairys S.W.
        • Gubernick R.S.
        • Millican A.
        • Adams W.G.
        Using a registry to improve immunization delivery.
        Pediatr Ann. 2006; 35: 500-506
        • Santoli J.M.
        • Barker L.E.
        • Lyons B.H.
        • et al.
        Health department clinics as pediatric immunization providers: a national survey.
        Am J Prev Med. 2001; 20: 266-271
        • Fairbrother G.
        • Kuttner H.
        • Miller W.
        • et al.
        Findings from case studies of state and local immunization programs.
        Am J Prev Med. 2000; 19: 54-77
        • Freed G.L.
        • Clark S.J.
        • Cowan A.E.
        State-level perspectives on immunization policies, practices, and program financing in the 1990s.
        Am J Prev Med. 2000; 19: 32-44
        • Tierney C.D.
        • Yusuf H.
        • McMahon S.R.
        • et al.
        Adoption of reminder and recall messages for immunizations by pediatricians and public health clinics.
        Pediatrics. 2003; 112: 1076-1082
        • Dombkowski K.J.
        • Cowan A.E.
        • Harrington L.B.
        • et al.
        Feasibility of initiating and sustaining registry-based immunization recall in private practices.
        Acad Pediatr. 2012; 12: 104-109
        • Saville A.W.
        • Albright K.
        • Nowels C.
        • et al.
        Getting under the hood: exploring issues that affect provider-based recall using an immunization information system.
        Acad Pediatr. 2011; 11: 44-49
        • Institute of Medicine
        Primary Care and Public Health: Exploring Integration to Improve Population Health.
        National Academies Press, Washington, DC2012
        • Eskola J.
        • Kilpi T.
        Public–private collaboration in vaccine research.
        Lancet. 2011; 378: 385-386
        • Kempe A.
        • Saville A.
        • Dickinson L.M.
        • et al.
        Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial.
        Am J Public Health. 2013; 103: 1116-1123
        • Stange K.C.
        • Crabtree B.F.
        • Miller W.L.
        Publishing multimethod research.
        Ann Fam Med. 2006; 4: 292-294
        • Creswell J.W.
        • Plano Clark V.
        Designing and Conducting Mixed Methods Research.
        Sage Publications Inc, Thousand Oaks, Calif2007
        • Landsverk J.
        • Brown H.
        • Chamberlain P.
        • et al.
        Design and analysis in dissemination and implementation research.
        in: Brownson R.C. Colditz G.A. Proctor E.K. Dissemination and Implementation Research in Health: Translating Science to Practice. Oxford University Press Inc, New York2012
        • Graneheim U.H.
        • Lundman B.
        Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.
        Nurse Educ Today. 2004; 24: 105-112
      2. Stemler S. An overview of content analysis. Practical Assessment, Research, and Evaluation, 2001. Available at: http://PAREonline.net/getvn.asp?v=7&n=17. Accessed October 27, 2010.

        • Hsieh H.F.
        • Shannon S.E.
        Three approaches to qualitative content analysis.
        Qual Health Res. 2005; 15: 1277-1288
        • Charmaz K.
        Constructing Grounded Theory.
        Sage Publications, London2006
        • Teddlie C.
        • Tashakkori A.
        Foundations of Mixed Methods Research: Integrating Quantitative and Qualitative Approaches in the Social and Behavioral Sciences.
        Sage Publications, Thousand Oaks, Calif2009
        • Renfrew B.L.
        • Kempe A.
        • Lowery N.E.
        • et al.
        The impact of immunization record aggregation on up-to-date rates—implications for immunization registries in rural areas.
        J Rural Health. 2001; 17: 122-126
        • Kempe A.
        • Steiner J.F.
        • Renfrew B.L.
        • et al.
        How much does a regional immunization registry increase documented immunization rates at primary care sites in rural Colorado?.
        Ambul Pediatr. 2001; 1: 213-216