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How parents' negative experiences at immunization visits affect child immunization status in a community in New York
Melissa S Stockwell1, Matilde Irigoyen, Raquel Andres Martinez
1Columbia University, Division of General Pediatrics, New York, NY 10032, USA. mstockwell@columbia.edu
Insights
Negative immunization experiences in the medical home were linked to underimmunization in young children. Improving family support, staff attitudes, and reducing wait times may enhance childhood immunization rates.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- Little is known about how family experiences during immunization visits impact children's immunization status.
- This study investigates the association between negative family experiences within the medical home and underimmunization.
Purpose of the Study:
- To assess the association between negative immunization experiences within the medical home and underimmunization in children aged 2-36 months.
- To identify factors contributing to negative immunization experiences and their link to vaccination status.
Main Methods:
- Survey of 392 parents in New York City regarding immunization experiences.
- Chi-square tests, odds ratios, and multivariable analysis were used.
- Controlled for insurance, maternal education, and WIC benefits.
Main Results:
- 16.9% of families reported negative immunization experiences (child's reaction, wait time, staff attitudes).
- Negative experiences correlated with the absence of key medical home components (continuity, family-centered, compassionate, comprehensive care).
- Children in families with negative experiences were more likely to be underimmunized (adjusted OR = 2.00).
Conclusions:
- Underimmunization in young children is associated with negative immunization experiences in the medical home.
- Improving family support, staff attitudes, and reducing wait times are potential strategies to enhance immunization delivery.
Objective:
Little is known about how families' experiences with immunization visits within the medical home may affect children's immunization status. We assessed the association between families' negative immunization experiences within the medical home and underimmunization.
Methods:
We surveyed parents (n = 392) of children aged 2-36 months about immunization experiences at community health centers, hospital-based clinics, private practices, and community-based organizations in New York City. We used Chi-square tests and odds ratios (ORs) to assess the relationship between medical home elements and parental immunization experience ratings. We used multivariable analysis to determine the association between negative experiences during immunization visits and underimmunization, controlling for insurance, maternal education, and receipt of benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children.
Results:
The majority of children were of Latino race/ethnicity and had Medicaid and a medical home. One-sixth (16.9%) of families reported a previous negative immunization experience, primarily related to the child's reaction, waiting time, and attitudes of medical and office staff. Parents' negative immunization experiences were associated with the absence of four components of the medical home: continuity of care, family-centered care, compassionate care, and comprehensive care. In addition, children in families who reported a negative experience were more likely to have been underimmunized (adjusted OR = 2.00; 95% confidence interval 1.12, 3.58).
Conclusions:
In a community in New York City, underimmunization of young children was associated with negative immunization experiences. Strategies to improve family experiences with immunization visits within the medical home (particularly around support for the family), medical and ancillary staff attitudes, and reduced waiting time may lead to improved immunization delivery.
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