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密苏里州公立门诊 密苏里州公立门诊 密苏里州公立门诊 密苏里州公立门诊 密苏里州公立门诊 密苏里州公立门诊 佐治亚州AFIX的影响 遗留的任务和问题 用于幼儿的干预措施如何应用于青少年(提供服务的基础存在差异)? 灵活运用我们的处理工具 干预如何付诸于实践? 资源使其更容易(如AFIX) 干预的精炼—操作性最好,可变性小,效率高 筹措购买疫苗资金正面临着新疫苗和功能更强大疫苗不断问世的挑战 什么因素影响我们广泛正确地使用有效干预以促进预防接种服务? 态度上的 供方和需方 经济上的 后勤上的(基础设施) * * * What are we trying to Accomplish? Yellow indicates range of recommended ages. Green indicates catch-up. Purple indicates for high-risk. This is the most recent childhood immunization schedule. You can see the vaccines listed along the left side and the ages when these vaccines are recommended along the top. One of our national objectives is to have 90% of children aged 2 years vaccinated with the recommended schedule of vaccines. Live – (viral) - MMR, varicella Inactivated – (viral) – polio, hepatitis A, flu, (bacterial) - DPT, PCV7, meningococcal, Hib * SES – Poverty is a strong predictor of low coverage Late start – children who start the first vaccinations later in the schedule less likely to be vaccinated at 2 years Information gap – parents don’t know child needs vaccine Provider practices – missed opportunities are when a provider sees an eligible child but the child is not vaccinated. Could be due to providers referring children out to get vaccinated; deferrals of vaccination because provider unaware that vaccines are due, failure to give simultaneous vaccination, and inappropriate contradindications. Office/clinic factors include office policies/administrative barriers – set up of the clinic, number of rooms, waiting time if order vaccine, need for doctor to sign every vaccine order. * Several years ago, our program was involved in a large review of the literature to identify effective interventions to increase vaccination coverage among all age groups. We collected all published/or unpublished studies that had been conducted over the last 20 years and reviewed and rated them. These ratings were then made into recommendations. These recommendations outlined a number of strategies which were
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