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Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for
Insights
Community-based participatory research (CBPR) reduced childhood immunization disparities. Culturally tailored interventions improved vaccination rates in underserved populations, achieving 82% coverage.
Area of Science:
- Public Health
- Community Health
- Health Disparities
Background:
- National immunization coverage for key childhood antigens (DTaP, HPV, MMR, HepB, Hib, VZV) is generally high, meeting Healthy People 2020 targets.
- However, significant disparities persist, with children from lower socioeconomic backgrounds experiencing lower immunization rates.
Purpose of the Study:
- To reduce childhood immunization disparities in Milwaukee using a community-based participatory research (CBPR) approach.
- The Community Health Improvement for Milwaukee Children (CHIMC) initiative aimed to address inequities in vaccination coverage.
Main Methods:
- Implemented a self-assessment to evaluate adherence to CBPR principles over an 8-year period.
- Utilized behavior change models, including education, a social marketing campaign, and theory of planned behavior interventions.
- Ensured community residents and organizational representatives vetted all intervention components, including messages and data collection tools.
Main Results:
- High adherence (80%) to CBPR principles was maintained throughout the study.
- Interventions engaged 565 parents/caregivers and 1,533 children in educational and planned behavior change programs; 406 were surveyed for social marketing.
- Significant increase in immunization status observed: from 45% at baseline to 82% over 4 years among children (19-35 months) whose caregivers participated in education and social marketing efforts.
Conclusions:
- Multilayered interventions, guided by a culturally tailored CBPR approach, effectively eliminated immunization disparities in children.
- The CHIMC project demonstrates the success of community-driven strategies in achieving equitable vaccination coverage.
Background:
Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19-35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates.
Objective:
Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations.
Methods:
The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools.
Results:
Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children's median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message ("Take Control: Protect Your Child with Immunizations"). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p<0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years.
Conclusions:
Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities.
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