Increasing Immunization Coverage in Adolescents by Partnering with Dental Providers

"In an integrated medical-dental healthcare delivery system, we will test if a strong dental provider recommendation, coupled with clear step-by-step instructions for getting vaccinated, will improve adolescent vaccination rates. The Kaiser Permanente delivery system in Oregon and Washington (KPNW) has close to 17,000 11-to-17 year old members who have both dental and medical insurance. Sixty percent of these members had at least one dental visit in 2013.
Our intervention will 1) develop scripts for dental providers, 2) provide brochures or flyers for
patients and their parents, and 3) give “assisted referral” to the closest location (e.g. nurse treatment desk) offering vaccinations. Using a randomized controlled design, we will assign 8
of the 16 dental offices in KPNW to the education-plus intervention condition and 8 to the control condition. To evaluate the impact of our intervention, we will monitor vaccination coverage rates using a comprehensive electronic medical record. We will also survey parents of a select set of teens on their recent visits to the dental clinic, inquiring whether the provider recommended one or more vaccines, how they felt about the recommendation coming from a dental versus a medical provider, and whether or not they intend to vaccinate their child. We will also survey the providers to assess changes in their knowledge, behaviors, and beliefs. If successful, the proposed intervention will lead to strong recommendations for vaccination from
dental providers, fewer missed opportunities for vaccination, and increased vaccination coverage rates.

The provider training materials, intervention materials, and provider implementation interviews with utilized in this study were all informed by qualitative data captured during the pilot project funded by CRN. We are currently half way through the implementation of this intervention in eight dental clinics in KPNW."

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