@article {Zimmerman534, author = {Richard K. Zimmerman and Alejandro Hoberman and Mary Patricia Nowalk and Chyongchiou J. Lin and David P. Greenberg and Stuart T. Weinberg and Feng Shou Ko and Dwight E. Fox}, title = {Improving Influenza Vaccination Rates of High-Risk Inner-City Children Over 2 Intervention Years}, volume = {4}, number = {6}, pages = {534--540}, year = {2006}, doi = {10.1370/afm.612}, publisher = {The Annals of Family Medicine}, abstract = {PURPOSE Influenza immunization rates among children with high-risk medical conditions are disappointingly low, and relatively few data are available on raising rates, particularly over 2 years. We wanted to determine whether interventions tailored to individual practice sites improve influenza immunization rates among high-risk children in inner-city health centers over 2 years. METHOD A before-after trial to improve influenza immunization of children was conducted at 5 inner-city health centers (residencies and faith-based). Sites selected interventions from a menu (eg, standing orders, patient and clinician reminders, education) proved to increase vaccination rates, which were directed at children aged 2 to 17 years with high-risk medical conditions. Intervention influenza vaccination rates and 1 and 2 years were compared with those of the preintervention year (2001{\textendash}2002) and of a comparison site. RESULTS Influenza vaccination rates improved modestly from baseline (10.4\%) to 13.1\% during intervention year 1 and to 18.7\% during intervention year 2 (P \<.001), with rates reaching 31\% in faith-based practices. Rates increased in all racial and age-groups and in Medicaid-insured children. The increase in rates was significantly greater in intervention health centers (8.3\%) than in the comparison health center (0.7\%; P \<.001). In regression analyses that controlled for demographic factors, vaccination status was associated with intervention year 1 (odds ratio [OR], 1.9; 95\% confidence interval [CI], 1.6{\textendash}2.2) and with intervention year 2 (OR, 2.8; 95\% CI, 2.3{\textendash}3.4), as well as with practice type. Adolescents had lower vaccination rates than children 2 to 6 years old (OR, 0.6; 95\% CI, 0.5{\textendash}0.7). CONCLUSIONS Tailored interventions selected from a menu of interventions modestly increased influenza vaccination rates over 2 years at health centers serving children from low-income families. We recommend this strategy for faith-based practices and residencies with 1 practice site, but further research is needed on multisite practices and to achieve higher influenza vaccination rates.}, issn = {1544-1709}, URL = {https://www.annfammed.org/content/4/6/534}, eprint = {https://www.annfammed.org/content/4/6/534.full.pdf}, journal = {The Annals of Family Medicine} }