CDC COMMUNITY GUIDE: Universally Recommended Vaccinations: Health Care System-Based Interventions Implemented in Combination

CDC

An Evidence-Based Practice

Description

Health care system-based interventions implemented in combination involve the use of two or more coordinated interventions to increase vaccination rates within a targeted population. Interventions are implemented primarily in health care settings, although efforts may include additional activities within the community.

The selection and implementation of coordinated interventions may result from an overall quality improvement effort in a health care setting.

The Community Preventive Services Task Force recommends health care system-based interventions implemented in combination on the basis of strong evidence of effectiveness in increasing vaccination rates in targeted client populations.

Results / Accomplishments

Results from the Systematic Review:
Sixty-two studies with 74 study arms qualified for the review. Most of the studies evaluated combinations of two or three different interventions.

• Overall change in vaccination rates from the combination of at least two interventions: absolute median increase of 8.0 percentage points (interquartile interval [IQI]: 4 to 21 percentage points; 56 studies, 68 study arms)
-Increases in vaccination rates were larger when implemented in settings with low rates at baseline.
• Change in vaccination rates from the combination of at least one intervention each from two different strategies, or from all three strategies: absolute median increase of 16.0 percentage points (IQI: 6 to 26 percentage points; 36 studies, 42 study arms)
• Health care system-based efforts were effective in increasing vaccination rates when implemented in a range of clinical settings, communities, and client populations.
• Combined approaches were effective when delivered to both young children (childhood series, and influenza vaccinations) and older adults (influenza and pneumococcal vaccinations).
• Information on implementation in rural settings was limited and only one of the studies evaluated interventions targeted at adolescents.

About this Promising Practice

Primary Contact
The Community Guide
1600 Clifton Rd, NE
MS E69
Atlanta, GA 30329
(404) 498-1827
communityguide@cdc.gov
https://www.thecommunityguide.org/
Topics
Health / Immunizations & Infectious Diseases
Source
Community Guide Branch Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention
Location
USA
For more details
http://www.thecommunityguide.org/vaccines/universa...
Target Audience
Children, Teens, Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.