Effectiveness of a physician peer educator in improving the quality of immunization services for young children in primary care practices

OBJECTIVE: To determine if the addition of a physician peer educator would lead to improved immunization quality when compared to the traditional education provided as part of a vaccines for children (VFC) site visit. METHODS: A randomized controlled trial was conducted. Study participants were private pediatric and family medicine practices. Both the intervention and control groups received a VFC visit; in intervention practices this visit was augmented by a presentation by the physician peer educator. Data on immunization rates and quality of immunization services were collected prior to the VFC visits and approximately 1 year later. RESULTS: A total of 73 practices participated, including 37 in the intervention group and 36 in the control group. At follow-up there was no difference in practice immunization rates (PIR) between intervention and control practices (mean rates 71.4% and 69.6%, respectively, P=0.94). There were also no significant differences between groups for any of the quality measures except that significantly more intervention practices used the appropriate length needle for vaccine injections in 2-month-old infants at follow-up (P=0.02). When assessing the overall impact of VFC visits, no significant increase in PIR were noted from baseline to follow-up assessments. However, statistically significant improvements in several quality measures were found. CONCLUSIONS: The addition of a physician peer educator did not result in improved immunization quality when compared to VFC visits alone. The educational content of the VFC site visit was associated with improved quality of immunization services delivered by primary care practices.