Immunization
School-Located Influenza Vaccination With Third-Party Billing: Outcomes, Cost, and Reimbursement
To assess rates of immunization; costs of conducting clinics; and reimbursements for a school-located influenza vaccination (SLIV) program that billed third-party payers.School-Located Influenza Vaccination With Third-Party Billing: What Do Parents Think?
School-located influenza vaccination (SLIV) may be instrumental in achieving high vaccination rates among children. Sustainability of SLIV programs may require third-party billing. This study assessed, among parents of elementary school students, the attitudes about SLIV and billing at school, as well as factors associated with being supportive of SLIV.Novel Immunization Reminder/Recall Approaches: Rural and Urban Differences in Parent Perceptions
To assess the following among parents of young children: 1) preferences about the source of immunization reminder/recall (R/R) messages, 2) the degree of acceptability of different R/R modalities, and 3) factors that influence preferences, including rural and urban characteristics.Children and the Patient Protection and Affordable Care Act: Opportunities and Challenges in an Evolving System
The Patient Protection and Affordable Care Act (ACA), passed in 2010, focused primarily on the problems of adults, but the changes in payment for and delivery of care it fosters will likely impact the health care of children. The evolving epidemiology of pediatric illness in the United States has resulted in a relatively small population of medically fragile children dispersed through the country and a large population of children with developmental and behavioral health issues who experience wide degrees of health disparities.School-Located Influenza Vaccination: Can Collaborative Efforts Go the Distance?
Despite a large amount of publicity about universal pediatric influenza vaccination, nationally, influenza vaccination rates among school-aged children remain low. Only 59% of 5- to 12-year-old children and 43% of 13- to 17-year-old adolescents were vaccinated during the 2012 to 2103 flu vaccination season.1 It is time to consider new paradigms to complement traditional influenza vaccinations in primary care. One “new” paradigm involves school-located influenza vaccination (SLIV), about which there is a great deal of confusion.Table of Contents
219 School-Located Influenza Vaccination: Can Collaborative Efforts Go the Distance? Sharon G. Humiston, Katherine A. Poehling, and Peter G. SzilagyiProvider Attitudes Toward Public-Private Collaboration to Improve Immunization Reminder/Recall: A Mixed-Methods Study
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.Evaluating Washington State’s Immunization Information System as a Research Tool
Immunization information systems (IISs) are powerful public health tools for vaccination activities. To date, however, their use for public health research has been limited, in part as a result of insufficient understanding on accuracy and quality of IIS data. We evaluated the completeness and accuracy of Washington State IIS (WAIIS) data, with particular attention to data elements of research interest.Table of Contents
1 Educating for Quality: Quality Improvement as an Activity of Daily Learning to Improve Educational and Patient Outcomes John Patrick T. CoThe American Academy of Pediatrics and Quality Improvement
Quality is 1 of the 3 main pillars supporting the American Academy of Pediatrics (AAP) Agenda for Children. The AAP has developed and promoted quality improvement (QI) programs to its membership for several decades. For more than 20 years, the AAP has maintained a committee of pediatrician leaders who have demonstrated an expertise in the area of QI and quality measurement, currently named the Steering Committee on Quality Improvement and Management. This committee works on developing pediatric QI measures, identifying patient safety programmatic and educational opportunities, reviewing evidence-based clinical practice guidelines, writing QI-related policy statements, and determining methodologies for implementing QI in both primary care and specialty pediatric practices.The National Improvement Partnership Network: State-Based Partnerships That Improve Primary Care Quality
Improvement partnerships (IPs) are a model for collaboration among public and private organizations that share interests in improving child health and the quality of health care delivered to children. Their partners typically include state public health and Medicaid agencies, the local chapter of the American Academy of Pediatrics, and an academic health care organization or children's hospital. Most IPs also engage other partners, including a variety of public, private, and professional organizations and individuals.Nine States' Use of Collaboratives to Improve Children's Health Care Quality in Medicaid and CHIP
We examine quality improvement (QI) collaboratives underway in 9 states participating in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program. A total of 147 diverse, child-serving practices were participating in the collaboratives. We conducted 256 semistructured interviews with key stakeholders from March to August 2012—2 years into the 5-year demonstration projects—and analyzed states’ grant applications, operating plans, and progress reports.Considering Context in Quality Improvement Interventions and Implementation: Concepts, Frameworks, and Application
Growing consensus within the health care field suggests that context matters and needs more concerted study for helping those who implement and conduct research on quality improvement interventions. Health care delivery system decision makers require information about whether an intervention tested in one context will work in another with some differences from the original site. We aimed to define key terms, enumerate candidate domains for the study of context, provide examples from the pediatric quality improvement literature, and identify potential measures for selected contexts.Quality Improvement Initiatives in Neonatal Intensive Care Unit Networks: Achievements and Challenges
Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available evidence, benchmarking, and feedback of outcomes, combined with mutual collaborative learning through a network of providers, the performance of health care systems and neonatal outcomes can be improved.HPV Vaccination of Boys in Primary Care Practices
In October 2011, the Advisory Committee on Immunization Practices (ACIP) recommended the quadrivalent human papillomavirus vaccine (HPV4) for the routine immunization schedule for 11- to 12-year-old boys. Before October 2011, HPV4 was permissively recommended for boys. We conducted a study in 2010 to provide data that could guide efforts to implement routine HPV4 immunization in boys. Our objectives were to describe primary care physicians': 1) knowledge and attitudes about human papillomavirus (HPV)-related disease and HPV4, 2) recommendation and administration practices regarding HPV vaccine in boys compared to girls, 3) perceived barriers to HPV4 administration in boys, and 4) personal and practice characteristics associated with recommending HPV4 to boys.A Randomized Trial to Increase Acceptance of Childhood Vaccines by Vaccine-Hesitant Parents: A Pilot Study
A cluster randomized trial was performed to evaluate an educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents.A Mixed Methods Study of Parental Vaccine Decision Making and Parent–Provider Trust
To describe parental vaccine decision making behaviors and characterize trust in physician advice among parents with varying childhood vaccination behaviors.Communicating With Parents About Immunization Safety: Messages for Pediatricians in the IOM Report “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies”
The report, “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies,” released by the Institute of Medicine (IOM) in January 2013, is highly relevant for the pediatric community.1 Although many studies have assessed the safety of immunizations, to our knowledge, this is the first study to address the childhood immunization schedule as a whole. The purpose of this commentary is to highlight the report's most pertinent findings and recommendations for the pediatric community.Importance of Mixed Methods in Pragmatic Trials and Dissemination and Implementation Research
With increased attention to the importance of translating research to clinical practice and policy, recent years have seen a proliferation of particular types of research, including pragmatic trials and dissemination and implementation research. Such research seeks to understand how and why interventions function in real-world settings, as opposed to highly controlled settings involving conditions not likely to be repeated outside the research study. Because understanding the context in which interventions are implemented is imperative for effective pragmatic trials and dissemination and implementation research, the use of mixed methods is critical to understanding trial results and the success or failure of implementation efforts.Table of Contents
387 Communicating With Parents About Immunization Safety: Messages for Pediatricians in the IOM Report “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies” Gerry Fairbrother, Elena Fuentes-Afflick, Lainie Friedman Ross, and Pauline A. ThomasImproving Immunization Delivery using an Electronic Health Record: The ImmProve Project
Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record–derived immunization prompting.Correlates of Patient Portal Enrollment and Activation in Primary Care Pediatrics
To identify the demographic, practice site, and clinical predictors of patient portal enrollment and activation among a pediatric primary care population.The Challenge of Reaching Adolescents to Promote Health Care
The challenge of providing appropriate preventive health services to adolescents is one familiar to all pediatricians who care for this population. Adolescents have fewer recommended preventive health medical visits than young children and may not have regular contact with the health care system. In recent years, new adolescent vaccines have been developed and recommended to provide protection against pertussis (TdaP), meningococcal meningitis (MCV4), and human papillomavirus (HPV), increasing the need for appropriate preventive health care.A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents
To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents.
