Evaluation of a community-based program to improve infant immunization rates in rural Minnesota

Objective: The purpose of this study Tvas to evaluate the effects of enroll ment in a community-based public health nursing program, Communities Caring for Children (CCC), on infant immunization rates in rural Minnesota. The p rogram involved health education, a registry, and a reminder system. Design: The evaluation was a collaborative effort of university, public hea lth agency, and private managed-care personnel. Two data sources were used to assess the association of program enrollment and immunization compliance : public birth certificates and a telephone survey of 421 CCC enrollees and non-enrollees. Results: Birth certificate and survey data showed that CCC enrollees were s ignificantly younger, less educated, more likely to be white, and of lower parity than non-enrollees. The average age of subjects' infants was eight m onths. The survey data showed that, overall, CCC enrollees perceived less d anger in infant immunizations than did non-enrollees and were more likely t han non-enrollees to have access to infant immunization reminder cards. CCC enrollees reported significantly higher immunization compliance for their infants than did non-enrollees. Conclusions: The area served by this program is relatively low-income and r ural. Infant immunization status was among the lowest in Minnesota prior to the implementation of CCC. The evaluation suggested that enrollment in CCC was one of the most powerful predictors of infant immunization compliance.