| Titre : | Population-Based Versus Practice-Based Recall for Childhood Immunizations : A Randomized Controlled Comparative Effectiveness Trial. (2013) |
| Auteurs : | Allison KEMPE ; ALBRIGHT (Karen) : USA. Department of Community and Behavioral Health. Colorado School of Public Health. University of Colorado Denver. ; Brenda BEATY ; Ned CALONGE ; Eva DIBERT ; Lmiriam DICKINSON ; EISERT (Sheri) : USA. Department of Family Medicine. University of Colorado Denver. ; Diana HERRERO ; Vicky KOEHLER ; Steven LOCKHART ; Joni REYNOLDS ; SAVILLE (Alison) : USA. Department of Pediatrics. University of Colorado Denver. ; Children's Outcomes Research Program. The Children's Hospital. Denver. CO. USA ; Colorado Health Outcomes Program. University of Colorado Denver. USA |
| Type de document : | Article |
| Dans : | American journal of public health (vol. 103, n° 6, 2013) |
| Pagination : | 1116-1123 |
| Langues: | Anglais |
| Mots-clés : | Population ; Etude comparée ; Enfant ; Essai comparatif ; Essai thérapeutique ; Randomisation ; Efficacité ; Homme ; Couverture vaccinale |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xk9HoD. Diffusion soumise à autorisation]. Objectives. We compared the effectiveness and cost-effectiveness of population-based recall (Pop-recall) versus practice-based recall (PCP-recall) at increasing immunizations among preschool children. Methods. This cluster-randomized trial involved children aged 19 to 35 months needing immunizations in 8 rural and 6 urban Colorado counties. In Pop-recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In PCP-recall counties, practices were invited to attend webinar training using CIIS and offered financial support for mailings. The percentage of up-to-date (UTD) and vaccine documentation were compared 6 months after recall. A mixed-effects model assessed the association between intervention and whether a child became UTD. Results. Ten of 195 practices (5%) implemented recall in PCP-recall counties. Among children needing immunizations, 18.7% became UTD in Pop-recall versus 12.8% in PCP-recall counties (P<. 001) ; 31.8% had documented receipt of 1 or more vaccines in Pop-recall versus 22.6% in PCP-recall counties (P<. 001). Relative risk estimates from multivariable modeling were 1.23 (95% confidence interval [CI]=1.10,1.37) for becoming UTD and 1.26 (95% CI=1.15,1.38) for receipt of any vaccine. Costs for Pop-recall versus PCP-recall were $215 versus $1981 per practice and $17 versus $62 per child brought UTD. Conclusions. Population-based recall conducted centrally was more effective and cost-effective at increasing immunization rates in preschool children. |
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