Community empowerment to reduce childhood immunization disparities in New York City.

Sally E. Findley · Matilde Irigoyen · Letty Guzman · Miriam Mejia · Michelle Sajous · Deborah A. Levine +2 more

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Vaccine Coverage and Hesitancy Child and Adolescent Health Community Health and Development

Abstract

This paper reports on the impact of the community-based Start Right program on childhood immunization coverage in 2 communities of color in New York City. Fully launched in 2002, Start Right operates through the major social service programs of its 23 member organizations. Immunization promotion strategies are based on the following guiding principles: community leadership; integration with community programs; parental empowerment; peer health educators; tracking and feedback; and linkage with health providers. By September 2003, 2,433 children under age 5 years (14% of that age group in the community) were enrolled in Start Right. The rates for the cohort of children enrolled in 2003 were substantially higher than for those enrolled in 2002. Among the 2003 cohort of 19- to 35-month-old children, the coverage rate was 88%, significantly more than national rates: 75% for total population, 68% for African Americans, and 73% for Hispanics. The rate for our 2003 enrollment cohort exceeded the rate for New York City (78%) but did not exceed the New York City average for Hispanics (79%). Of the 2003 enrollment cohort, the Washington Heights children had the highest rates for enrollment (89.6%), exceeding New York City rates. Parents reported a high level of satisfaction with the program.

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References

2000Can Cultural Competency Reduce Racial and Ethnic Health Disparities? A Review and Conceptual Model 2000Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.2000Culture and the patient-physician relationship: Achieving cultural competency in health care 2000Effect of Patient Reminder/Recall Interventions on Immunization Rates 2002Reducing Geographic, Racial, and Ethnic Disparities in Childhood Immunization Rates by Using Reminder/Recall Interventions in Urban Primary Care Practices 1999A Randomized Study of Tracking With Outreach and Provider Prompting to Improve Immunization Coverage and Primary Care 1990Social support, control, and the stress process.2003Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

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