Roanoke City Health Department Community Vaccination Uptake Strategic Plan
Creators: name: White, Jacqueline H.
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2012

description: The aim of this paper is to describe the process of developing a 5-year strategic plan to decrease Roanoke City Health Department (RCHD) immunization clinic no-show rates for children and to improve childhood universal vaccination coverage by 1) identifying and eliminating barriers associated with the under-immunization of children in certain minority groups, 2) enhance RCHD services offered to help decrease missed immunization opportunities, and 3) collaborate with community pediatric health care providers for continuity in service delivery. The process began by building upon my MPH practicum experience from the Gillings School of Global Public Health of the University of North Carolina whereby I developed strategic action steps to increase immunization rates through interventions for culturally diverse populations. Utilizing two public health core competencies, leadership and diversity/culture, and with a clear understanding of the RCHD’s mission I was part of a team at RCHD that began this strategic planning process by researching federal, state, and local best practices to increase immunization rates with the intention of developing an applicable strategic plan. The strategic planning process made use of guidance from the Advisory Committee on Immunization Practices (ACIP), the Centers for Disease Control and Prevention (CDC) and Healthy People 2020 guidelines and recommendations for universal vaccinations for children entering kindergarten. The goal of these agencies is to achieve and maintain effective vaccination coverage levels for 90% of children aged 19-35 months by the year 2020 (Healthy People, 2010). However, in Roanoke City, Virginia this goal has not been met for area children. Consequently, the RCHD formed an internal group, Community Health Outreach Improvement Committee (CHOICE), to further investigate why the vaccination coverage levels were not being met. CHOICE discovered Roanoke City to be a culturally diverse city where a large proportion of citizens fall within the low income range. Subsequently, area children are offered low-cost or no-cost vaccines through the health department and other community health care facilities. CHOICE assessed immunization clinic no-show trends to help identify barriers to care and look for opportunities for improvement to service delivery. Recent trend data indicate there has been no change in the RCHD’s 20-30% immunization clinic no-show rates over the past year. Further analysis of these data indicate a need for interventions to address missed vaccination opportunities, eliminate language and transportation barriers, and an increased commitment for collaboration with other community child health care providers. Interventions were developed that include combining Women, Infant, and Children (WIC) clinics with immunization clinics to help decrease missed opportunities, developing language-specific educational materials, and promoting all area providers’ access to the Virginia state-wide vaccination database, Virginia Immunization Information System (VIIS). Future planning includes implementing these interventions and measurable objectives. Additionally, this will include combining clinics to enhance vaccination coverage and broadening community involvement to seek support for vaccination opportunities. These interventions and future planning efforts do come with challenges that are still to be met; these include budgetary constraints and a lack of perceived benefits and non-adherence to the implemented interventions by both patients and providers. This strategic planning process and future planning activities are summarized in this master’s paper.