An Organizational Strategy to Improve Adolescent Measles-Mumps-Rubella Vaccination in a Low Socioeconomic PopulationA Method to Reduce Missed Opportunities
Peter G. Harper, MD, MPH;
David M. Murray, PhD
Arch Fam Med. 1994;3(3):257-262.
Abstract
Objective
To determine whether a clinic organizational strategy can improve measles-mumps-rubella vaccination rates in adolescents by reducing missed opportunities.
Design
Nonequivalent control group design with a treatment clinic and a comparison clinic. Measurements were made for 8 months before intervention and for 9 months after intervention.
Setting
Two urban family practice clinics serving a low socioeconomic population.
Population
All clinic visits by adolescents aged 11 to 18 years.
Intervention
A clinic organizational strategy that systematically identified and vaccinated adolescents seen in the clinic for any reason.
Main Outcome Measures
Two vaccination indexes were measured monthly at each clinic: the percentage of eligible visits at which measles-mumps-rubella vaccination was given and the percentage of visits that were up to date, with adolescents having received the measles-mumps-rubella vaccine at that visit or at a previous visit.
Results
The intervention resulted in a significant increase at the treatment clinic in the mean percentage of vaccinations given (from 7.8% to 17.4%) (Student's t=3.02; P=.0087) and the mean percentage of up-to-date visits (from 17.2% to 38.6%) (t=8.33; P<.0001). During the same period, there was no significant change in the mean vaccination rates in the comparison clinic.
Conclusions
An organizational strategy appears to be a useful method to reduce missed opportunities and improve measles-mumps-rubella vaccination rates in adolescents from a low socioeconomic population.
Author Affiliations
From the Department of Family Medicine, St Paul (Minn) Ramsey Medical Center (Dr Harper), and the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Dr Murray).
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