Related Experiment Video
Updated: Apr 1, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
An enriched medical home intervention using community health workers improves adherence to immunization schedules
Susmita Pati1, Kristi L Ladowski1, Angie T Wong1
1Department of Pediatrics, Stony Brook University, Stony Brook, NY, United States.
Importance:
Disparities in childhood vaccination rates persist.
Objective:
To evaluate the impact of an enriched medical home intervention using community health workers on improving immunization adherence among young children.
Design:
The intervention group received home visits from trained community health workers to support families in adhering to recommended care while the comparison group received usual care (i.e. no home visits/reminders). Immunization history and socio-demographic data were collected using medical records and a validated questionnaire. The doubly robust estimation of risk difference, which combines weighting via propensity score and outcome regression model, was used to compare immunization adherence rates between two groups.
Setting:
Primary care practices affiliated with a suburban tertiary care academic medical center serving a socioeconomically diverse population.
Participants:
The study sample included children ≤ 2 years of age at enrollment who crossed at least one age time point of 3, 7, 15, or 24 months during their 6 months post-enrollment period.
Main Outcomes And Measures:
The primary outcome was age-specific immunization up-to-date status defined by CDC guidelines. The primary predictor was participation in the intervention.
Results:
The analysis included 201 children in the usual care group and 110 children in the intervention group. The usual care and intervention groups were divided into subgroups of newborn and infant/toddler to account for prior immunization history. After adjusting for differences in group characteristics, we found a significant absolute increase in the up-to-date immunization likelihood for both newborns (20.9%, p=0.01) and infants/toddlers (16.8%, p=0.01) receiving the intervention when compared to their peers receiving usual clinical care.
Conclusions And Relevance:
Our findings demonstrate the positive impact of an enriched medical home intervention using community health worker home visitation on early childhood immunization up-to-date status. With further study, this model may provide a cost-effective approach to improving childhood vaccination rates, especially for vulnerable groups.
Related Concept Videos
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:30Preventive Healthcare Services
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...