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Immunisation coverage of children in the child welfare system: a systematic review protocol
Jennifer S Hermann1, Robin M Featherstone2,3, Margaret L Russell4
1Faculty of Nursing, University of Alberta, Edmonton, Canada.
Insights
Child welfare system involvement can disrupt routine childhood immunizations. This review examines vaccine coverage and barriers for these vulnerable children to improve public health outcomes.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Children in the child welfare system face unique challenges impacting their healthcare access.
- Transitions in care and living arrangements can lead to missed preventive health services, including immunizations.
Purpose of the Study:
- To systematically review and identify issues with childhood immunization coverage among children in the child welfare system.
- To determine barriers and supports influencing vaccine uptake in this population.
Main Methods:
- A comprehensive systematic literature review of published and unpublished studies from 2000 to present.
- Searches across multiple databases (Medline, Embase, CINAHL, etc.) and grey literature, focusing on children aged 0-17 in high-income countries.
- Narrative analysis of key findings regarding immunization coverage, comparisons, and influencing factors.
Main Results:
- This section is to be populated upon completion of the systematic review.
- Expected to detail current immunization coverage rates and identify specific barriers and facilitators.
Conclusions:
- This systematic review will provide critical insights into the immunization status of children in the child welfare system.
- Findings will inform targeted interventions to improve vaccine equity and child health outcomes.
Introduction:
Children may be placed in the care of the child welfare system when they require additional supports or intervention to ensure their safety and security. Transitions in living arrangements (eg, home to foster care and return to home) and other difficult circumstances for these children may result in interruptions in routine preventive healthcare, such as childhood immunisations. The purpose of this systematic literature review is to determine whether immunisation coverage is a problem among children in the child welfare system and identify any known supports and/or barriers to vaccine uptake in this population.
Methods And Analysis:
This systematic review will encompass published and unpublished primary research studies that assess (A) immunisation coverage of children in the child welfare system, (B) how this coverage compares to the general population and/or children not in the child welfare system, and (C) supports and barriers affecting immunisation status of these children. Vaccines in the recommended childhood immunisation schedule for each study setting will be considered. Medline, Embase, Cochrane Library, CINAHL, SocINDEX and ERIC will be comprehensively searched. We will also search ProQuest dissertations and theses, the Conference Proceedings Citation Index for Science and Social Science & Humanities, and a sample of relevant provincial, national and international websites. References of included studies will be manually searched for relevant studies. English language primary studies from 2000 to current focused on immunisations of children (age 0-17 years) in the child welfare system, in a high-income country, will be included. A narrative analysis of key findings from included studies will be performed and presented.
Ethics And Dissemination:
This protocol does not require ethics approval. Planned dissemination includes peer-reviewed publication, conference presentations and briefs for policy makers.
Trial Registration Number:
This protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews, registration number CRD42016047319.
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