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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >A stepped intervention increases well-child care and immunization rates in a disadvantaged population.
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A stepped intervention increases well-child care and immunization rates in a disadvantaged population.

机译：采取分步干预措施可以提高弱势群体的儿童保育和免疫接种率。

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OBJECTIVE: To test a stepped intervention of reminder/recall/case management to increase infant well-child visits and immunization rates. METHODS: We conducted a randomized, controlled, practical, clinical trial with 811 infants born in an urban safety-net hospital and followed through 15 months of life. Step 1 (all infants) involved language-appropriate reminder postcards for every well-child visit. Step 2 (infants who missed an appointment or immunization) involved telephone reminders plus postcard and telephone recall. Step 3 (infants still behind on preventive care after steps 1 and 2) involved intensive case management and home visitation. RESULTS: Infants in the intervention arm, compared with control infants, had significantly fewer days without immunization coverage in the first 15 months of life (109 vs 192 days P < .01) and were more likely to have >or=5 well-child visits (65% vs 47% P < .01). In multivariate analyses, infants in the intervention arm were more likely than control infants to be up to date with 12-month immunizations and to have had >or=5 well-child visits. The cost per child was Dollars 23.30 per month. CONCLUSION: This stepped intervention of tracking and case management improved infant immunization status and receipt of preventive care in a population of high-risk urban infants of low socioeconomic status.
机译：目的：测试提醒/召回/病例管理的分步干预措施，以提高婴儿访婴率和免疫接种率。方法：我们对在城市安全网医院出生的811例婴儿进行了一项随机，对照，实用的临床试验，随访了15个月的生命。第1步（所有婴儿）在每次有孩子访问时都会使用与语言相符的提醒明信片。步骤2（错过约会或免疫接种的婴儿）涉及电话提醒以及明信片和电话召回。步骤3（在步骤1和2之后，婴儿仍落后于预防保健）涉及强化病例管理和家访。结果：与对照组婴儿相比，干预组中的婴儿在出生后的前15个月中没有免疫接种的天数显着减少（109天与192天，P <.01），并且更有可能 = 5个好孩子造访（65％vs 47％P <.01）。在多变量分析中，干预组的婴儿比对照组的婴儿更可能接受了为期12个月的免疫接种，并且接受了≥5次健康儿童访视。每个孩子的费用是每月23.30美元。结论：在社会经济地位低的高风险城市婴儿人群中，这种跟踪和病例管理的干预措施改善了婴儿的免疫状况，并提高了预防保健的接受率。

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