Assessing Disparities in Adult Vaccination Using Multimodal Approaches in Primary Care Offices: Methodology |
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Authors: | Richard K Zimmerman Mary Patricia Nowalk Martha Ann Terry Mahlon Raymund Melissa Tabbarah Dwight E Fox Stephen A Wilson |
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Institution: | (1) Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 5th Avenue, Pittsburgh, PA 15261, USA;(2) Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA;(3) UPMC St. Margaret Family Medicine Residency, Pittsburgh, PA, USA |
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Abstract: | Racial disparities in invasive pneumococcal disease and pneumococcal polysaccharide vaccination (PPV) persist despite significant
progress. One reason may be that minority patients receive primary care at practices with fewer resources, less efficient
office systems, and different priorities. The purposes of this paper are: (1) to describe the recruitment of a diverse array
of primary care practices in Pittsburgh, Pennsylvania serving white and minority patient populations, and the multimodal data
collection process that included surveys of key office personnel, observations of practice operations and medical record reviews
for determining PPV vaccination rates; and (2) to report the results of the sampling strategy. During 2005, 18 practices participated
in the study, six with a predominantly minority patient population, nine with a predominantly white patient population, and
three with a racial distribution similar to that of this locality. Eight were solo practices and 10 were multiprovider practices;
they included federally qualified health centers, privately owned practices and faculty and University of Pittsburgh Medical
Center community practices. Providers represented several racial and ethnic groups, as did office staffs. PPV rates determined
from 2,314 patients’ medical records averaged 60.3 ± 22.6% and ranged from 11% to 97%. Recruitment of practices with attention
to location, patient demographics, and provider types results in a diverse sample of practices and patients. Multimodal data
collection from these practices should provide a rich data source for examining the complex interplay of factors affecting
immunization disparities among older adults.
Zimmerman, Nowalk, Raymund, Tabbarah, and Fox are with the Department of Family Medicine and Clinical Epidemiology, University
of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Zimmerman and Terry are with the Department of Behavioral and Community
Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Wilson is with the UPMC St.
Margaret Family Medicine Residency, Pittsburgh, PA, USA. |
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Keywords: | Pneumococcal polysaccharide vaccine Adults Immunization Primary care |
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