Portal de Periódicos da CAPES

The Effectiveness of Assessment and Referral on Immunization Coverage in the Special Supplemental Nutrition Program for Women, Infants, and Children

2003; American Medical Association; Volume: 157; Issue: 5 Linguagem: Inglês

10.1001/archpedi.157.5.456

1538-3628

Susan H. Ashkar, Loring G. Dales, Francisco Averhoff, Abigail Shefer, Jeffrey Higa, Lisa Thompson, Judy Gomez, Denise Gee, Eric L. Hurwitz,

Child and Adolescent Health

Background The use of immunization assessment and referral (A/R) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has been shown to produce dramatic improvements in vaccination coverage when coupled with parental incentive; however, data are lacking to support the use of A/R alone. Objective To determine the effectiveness of A/R in increasing immunization coverage among WIC participants. Design Participating WIC centers were assigned to1 of 3 interventions that delivered A/R of varying frequency or a control group. Setting Twenty of the largest Public Health Foundation Enterprises–WIC centers in Los Angeles County. Participants Children continuously enrolled in participating WIC centers from 6 to 24 months of age. Intervention Assessment of child's vaccination status followed by referral to a health care provider for those lacking indicated vaccinations. Main Outcome Measure Up-to-date (UTD) status at 24 months of age for all recommended vaccines. Results Baseline coverage rates were similar among all study sites (overall, 77% UTD). After the study period, compared with the controls (88% UTD), we found no differences in immunization coverage among WIC centers that administered A/R at every visit (every 2 months) to all children (90% UTD; adjusted odds ratio [OR], 1.02; 95% confidence interval [CI], 0.54-1.94), every 6 months to all children (89% UTD; OR, 0.98; 95% CI, 0.62-1.56), or every visit to children found to be behind at 8 months of age (89% UTD; OR, 0.89; 95% CI, 0.48-1.68). Conclusion In this urban population of WIC children with high baseline immunization coverage, A/R was not effective in increasing immunization coverage.