Collaborative Efforts to Increase Flu Vaccination (CollabFlu)
Strategies to Vaccinate All Children for Influenza in a Practice Setting
調査の概要
状態
詳細な説明
Specific Aim 1: Within each of three types of clinical sites (urban pediatric, urban family medicine, and rural family medicine) recruit a group of similar practices (Year 1) 1a. Randomize practices within each type of clinical site to either the intervention or the control group
1b. Establish private-public collaborations for influenza vaccination delivery between county public health departments, visiting nursing associations and each of the intervention practices within the three clinical site types
Specific Aim 2: Conduct focus groups among parents of children seen at intervention practices, to assess attitudes and perceived barriers to possible practice-based and collaborative strategies to promote influenza vaccination (Year 1)
Specific Aim 3: Develop (Year 1) and implement (Years 2 and 3) a plan for comprehensive and collaborative delivery of influenza vaccine at intervention practices 3a. Develop practice-based intervention strategies focusing primarily on immunization of high-risk patients 3b. Develop private-public collaborative interventions between the intervention practices, their county public health department and visiting nursing associations focusing primarily on immunization of school-aged children 3c. Implement (Years 2 and 3) both practice-based and private-public collaborative strategies in the intervention practices while monitoring only in the control practices
Specific Aim 4: Conduct a group-randomized trial to evaluate and compare the effectiveness of the comprehensive delivery model in improving influenza vaccination coverage for children 6 months to 18 years in three different types of clinical sites (urban pediatric, urban family medicine, and rural family medicine).
4a. Evaluate effectiveness of the comprehensive delivery model at each of the three types of clinical sites
- Compare the following primary outcome measures in the intervention and control groups: 1) increase in the rate of receipt of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among children 6 months to 18 years and 2) increase in the rate of children 6 months to 18 years who were fully immunized (received all required influenza injections) during the season.
- Compare the following secondary outcome measures: 1) increase in the rate of receipt of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among high-risk children and 2) increase in the rate of high-risk children who were fully immunized during the season.
- Evaluate sustainability of the comprehensive delivery model on the above outcome measures
4b. Compare the effectiveness of the comprehensive delivery model in three different types of clinical sites (urban pediatric private practice, urban family medicine private practice, and rural family medicine private practice)
Specific Aim 5: Evaluate the process of implementation of the comprehensive delivery model for influenza delivery in each of the three types of sites.
5a. Assess process measures relevant to implementation of practice-based interventions and compare by type of clinical site 5b. Assess process measures relevant to implementation of private-public collaborative interventions and compare by type of clinical site 5c. Using key informant interviews, assess perceptions regarding facilitators and barriers to private-public collaborative delivery, alternative methods and means of improving the process among practice providers, administrators and among participating public health and visiting nurse personnel
Specific Aim 6: In two urban pediatric intervention practices and one rural family medicine practice, conduct surveys examining parental attitudes about methods of influenza delivery and their experience with their practice's participation in a comprehensive and collaborative private-public model for influenza delivery
Major Hypotheses:
SA4. Hypothesis 1. Effectiveness on receipt of ≥1 influenza vaccine: The increase in the likelihood of receiving ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among children 6 months to 18 years will be greater for children in intervention practices than in control practices.
SA4. Hypothesis 2 Effectiveness - fully immunized: The increase in the likelihood of receiving all necessary influenza vaccines during the post-intervention year compared to the pre-intervention year among children 6 months to 18 years will be greater for children in intervention practices than in control practices.
SA4. Hypothesis 3. Effectiveness by age strata: The increase in the likelihood of receiving ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among children in each of the following age strata will be greater in intervention than in control practices: 1) 6 months through 5 years; 2) 6 through 8 years; 3) 9 through 12 years; 4) 13 through 18 years.
SA4. Hypothesis 4. Effectiveness in high-risk children: The increase in the likelihood of receiving of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among high-risk children 6 months to 18 years will be greater for high-risk children in intervention practices than in control practices.
SA4. Hypothesis 5. Sustainability: The increase in the likelihood of receiving ≥1 influenza vaccine during the second post-intervention year compared to the pre-intervention year among children 6 months to 18 years will be greater for children in intervention practices than in control practices. (Sustainability will also be evaluated for other outcomes above.)
SA4. Hypothesis 6. Differential effectiveness by clinical site type: The increase in the likelihood of receiving of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among children 6 months to 18 years for intervention vs. controls will differ by clinical site type
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Colorado
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Aurora、Colorado、アメリカ、80010
- Tri County Health dept
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Aurora、Colorado、アメリカ、80012
- Aurora Family Medicine
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Aurora、Colorado、アメリカ、80014
- Forum Family Medicine
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Brighton、Colorado、アメリカ、80601
- Premier Pediatrics
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Broomfield、Colorado、アメリカ、80021
- Indian Crest Pediatrics
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Centennial、Colorado、アメリカ、80112
- Pediatrics 5280
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Centennial、Colorado、アメリカ、80014
- Centennial Pediatrics
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Centennial、Colorado、アメリカ、80015
- Advanced Pediatrics
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Centennial、Colorado、アメリカ、80112
- Greenwood Pediatrics
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Centennial、Colorado、アメリカ、80112
- Pediatric Pathways
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Denver、Colorado、アメリカ、80246
- CIIS
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Englewood、Colorado、アメリカ、80113
- Hampden Medical Group
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Ft. Morgan、Colorado、アメリカ、80701
- Family Practice Clinic
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Ft. Morgan、Colorado、アメリカ、80701
- Ft. Morgan Medical Group
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Haxtun、Colorado、アメリカ、80731
- Haxtun Family Medicine
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Julesburg、Colorado、アメリカ、80737
- Valley Medical Center
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Lakewood、Colorado、アメリカ、80215
- Jefferson County Health dept
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Lakewood、Colorado、アメリカ、80226
- Kids First
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Lakewood、Colorado、アメリカ、80401
- Denver West Pediatrics
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Littleton、Colorado、アメリカ、80123
- Focus on Kids
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Lone Tree、Colorado、アメリカ、80124
- Lone Tree Family Medicine
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Parker、Colorado、アメリカ、80138
- Crown Point Pediatrics
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Sterling、Colorado、アメリカ、80751
- Northeast County Health Dept
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Thornton、Colorado、アメリカ、80260
- Mountain Land Pediatrics
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Wheat Ridge、Colorado、アメリカ、80033
- Pediatrics West
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Wray、Colorado、アメリカ、80758
- Wray Clinic
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Yuma、Colorado、アメリカ、80759
- Yuma Clinic
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Children age 6 mo - 18 yr in up to 20 practices
Exclusion Criteria:
- Infants under the age of 6 mo or adults over the age of 18
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Increasing flu vaccination
Collect from billing records in the 10 intervention practice sites to test for an increase in the rate of receipt of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among children 6 months to 18 years during the season.
The interventions include: 1. Develop practice-based intervention strategies (like use of reminder-recall of children due for influenza,2.
Develop Private/public collaboration to increase flu vaccination between the intervention practices, their county public health department and visiting nursing associations, and 3. Implement both practice-based and private-public collaborative strategies in the intervention practices while monitoring only in the control practices
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Intervention practices will develop office-based interventions including methods to identify high-risk patients within their practices and methods of maximizing the immunization of these children within the practice, use of patient reminders, after-hours influenza clinics, walk-in provision of influenza vaccine and increased focus on education regarding the need for immunization.
The practices will also collaborate with their county public health departments and visiting nursing associations to develop private-public collaborative interventions that may include large clinics for school-aged children for multiple practices and tracking of influenza supplies and redistribution of influenza vaccine between practices when supplies are delayed or inadequate.
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他の：Usual care
Patients in control practices will continue to receive usual care with no change in practice regarding influenza immunization delivery.
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This group will continue administering influenza vaccine to their patients in their practice as they normally do.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Evaluate the effectiveness of collaborations between public and private entities to increase influenza vaccination in children 6 mos to 18 yrs in 10 intervention sites in 3 counties throughout the state of CO during the '10-11 & '11-12 flu seasons.
時間枠：Up to 4 months post intervention (December 2012)
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Primary outcome measure is to increase the rate of receipt of ≥1 influenza vaccine during the post-intervention year(s) compared to the pre-intervention year among children 6 mos.-18 yrs in 10 intervention sites.
Intervention practices will collaborate with their respective health departments and/or the VNA to help assist with the increase in volume of patients needing to be vaccinated against flu in the 2010-2011 and the 2011-2012 flu seasons.
Billing data will be obtained from all 20 sites (intervention+control) and compared to evaluate the effectiveness of this collaboration.
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Up to 4 months post intervention (December 2012)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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high-risk children receipt of influenza vaccination
時間枠：baseline and intervention years 1 and 2
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increase in the rate of receipt of ≥1 influenza vaccine during the post-intervention year compared to the pre-intervention year among high-risk children
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baseline and intervention years 1 and 2
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high-risk children fully immunized during influenza season
時間枠：baseline and intervention years 1 and 2
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increase in the rate of high-risk children who were fully immunized during the season.
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baseline and intervention years 1 and 2
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協力者と研究者
捜査官
- 主任研究者：Allison Kempe, MD, MPH、University of Colorado, Children's Hospital
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 10-0589
- 1U01IP000320 (米国 NIH グラント/契約)
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