Applying the AFIX Quality Improvement Model to Increase Adult Immunization in Wisconsin

Area of Science:

• Public Health
• Preventive Medicine
• Health Services Research

Background:

• The Assessment, Feedback, Incentives, and eXchange (AFIX) model has successfully increased childhood immunization rates in the US.
• There is a need to adapt and evaluate quality improvement models for enhancing adult immunization coverage.

Purpose of the Study:

• To evaluate the effectiveness of an adapted AFIX model for improving adult immunization rates.
• To assess the impact of targeted interventions on adult vaccination uptake.

Main Methods:

• An adapted AFIX model was implemented in 124 Wisconsin clinics from November 2016 to May 2017.
• Outreach specialists provided clinics with immunization data reports and encouraged the adoption of 18 evidence-based strategies.
• Follow-up assessments occurred at 3, 6, and 9–18 months post-intervention, comparing intervention sites with control clinics.

Main Results:

• Clinics using the adult AFIX model showed a significantly greater increase in the median human papillomavirus vaccine series completion rate (10.4% vs. 7.7%, P = .02).
• While the median immunization rate for the pneumococcal vaccine series was higher in AFIX clinics, the difference was not statistically significant (12.6% vs. 10.7%, P = .18).

Conclusions:

• The adult AFIX model effectively increased awareness of adult immunization recommendations.
• This quality improvement model demonstrates potential as a valuable tool for increasing adult immunization rates.