Erika Lindwall MPH515 Principles of Health Behavior VHKC Vaccines for Healthy Kids and Communities Photo by Davin Lindwall Photo by Thinkprogressorg Vaccines Public healths triumph with a bad rap ID: 554525
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Promoting Vaccinations in Children Using the PRECED-PROCEED Model
Erika Lindwall MPH515 Principles of Health Behavior
VHKC“Vaccines for Healthy Kids and Communities”
Photo by Davin Lindwall
Photo by
Thinkprogress.orgSlide2
Vaccines: Public health’s triumph with a bad rap
Vaccines are one of the greatest triumphs of public health. Millions of lives have been saved, and the occurrence of some of the former most deadly diseases has decreased by 80-100% (CDC, 2014). Vaccines are not completely effective nor perfectly safe, but they are effective at preventing disease.
For this and many other reasons, many parents are not vaccinating their children. This is becoming a BIG PROBLEM. Why is this a problem? Outbreak of formerly uncommon diseases have started to crop up in recent years due to the decreased
herd immunity. Measles, a disease that has shown less than one hundred cases per year since the vaccine came out, has broken out in certain areas of the U.S. as a result of low vaccinations (
Salzberg, 2015). Slide3
Who is not getting vaccinated and why?
Young adult parents are most likely to opt out of vaccinationsYoung adults are most likely to be against mandatory vaccinations and are more unlikely to vaccinate their children than the previous generations (Anderson, 2015).
Why are they against vaccines? Misinformation: false literature is circulating about a link between vaccines and autism (Calandrillo, 2004). Complacency: do not fully grasp the danger of being unvaccinated, as they have never seen the debilitating effects of the diseases that vaccines prevent
Cost: Those with little to no insurance may desire to vaccinate their children, but cannot afford to.
Religious beliefs and a growing sentiment of individualism: Some feel that mandatory vaccinations violate individual rightsSlide4
How do we combat this problem?
The best way to move this population from the health risk before of being against vaccines to vaccinating themselves and their children is through public health intervention.
To guide this process and direct the planning of the intervention, we will use the PRECEDE-PROCEED model. Slide5
The PRECEDE-PROCEED Model
The PRECEDE-PROCEED model was developed as a framework for structuring and planning public health interventions (DiClemente et al., 2013). It focuses on the
community as the source for health promotion, and operates on the following assumptions: Making healthy choices is voluntary, so the target population should be active participants in the health promotion program.
Public health is a community issue and is influenced by community history, economics, politics, environment, and beliefs.
Health is not just a physical state, but it is a tool that helps individuals and communities to accomplish their goals and live fulfilling lives. Slide6
The PRECEDE-PROCEED Model (continued)
This model has 2 parts: The PRECEDE which is the preparation phases and the PROCEED which is the implementation and evaluation phases.
PRECEDE: Define the end goal of the intervention
Prioritize the health risk behaviors that must be overcome to achieve the final goal.
Identify the behaviors and beliefs that contribute and perpetuate the health risk behavior.
Recognize the administrative and policy factors that will shape how the intervention can be carried out.
PROCEED:
Design
and
carry out the
intervention according to plan
Process
evaluation to determine if the intervention is being carried out as planned
Impact
evaluation
to determine if the intervention is having the desired
influence
Outcome
evaluation
to establish if the intervention is accomplishing or moving toward the ultimate goal.
Slide7
Current and Previous Vaccine Promotion Programming
Reach 2010: New York City
Focused on reaching parents of children age five and under in low income communities (Findley et al., 2009) Vaccination rates in the areas where this program took place increased to 96.8%! Childhood Immunization Support Program (CISP) Focuses on improving immunization practices in primary care facilities (CISP, 2014) Promotes and improves communication between patients and physicians about the importance of vaccines
Illinois Vaccines for Children Plus Program (VFC Plus) Targeted at physicians who want to provide vaccinations to patients free of charge (CDC, 2012) Vaccines are purchased at discounted prices by the CDC which distributes them to primary care givers who then immunize children of low-income families. Slide8
A Vaccination Promotion Intervention Proposal: VHKC
The intervention will be a five-year-long program targeted at new or expectant parents and parents of young children. This will take place in phases following the PRECEDE-PROCEED model.
P1: Define goal
P5: Make a plan
P4: Identify current policies
P3: Identify risk behaviors
P2: Prioritize
P8: Outcome Evaluation
P7: Impact Evaluation
P6: Process Evaluation
Follow up studySlide9
VHKC (continued)
Phase One: The ultimate goal of this program is to increase the knowledge of young parents about the importance of vaccines Replace false information with truth
Provide ample opportunity for them to immunize their childrenThe measurable goal is that by the year 2020, 99% of children ages 0-6 will be vaccinated according to the guidelines set by the CDC. The name of the program is “Vaccinate for Health Kids and Communities” or VHKC. PHASE 2 & 3: The health barriers that must be overcome to
achieve the goal are—False information that leads to fear of vaccines
Cost of vaccinesIgnorance/complacency about the danger of being unvaccinated
Phase Four: The main policies already in place that will shape the program are the state laws mandating vaccines for children who attend school, both private and public. Slide10
VHKC (continued)
Phase Five: The design of this intervention is to be both educational and compelling. The plan is to be carried out in two facets. Public health professionals work in the obstetrics department of hospitals.
Interact with new and expectant parents as they come in for check up and after their babies are born. Provide parents with information about vaccines, answer questions, and replace any false information that they had heard about a link between vaccines and autism with facts. Distribute
pamphlets with information about the recommended vaccines and obtain consent to get the mailing address of parents to send reminders when their child should receive certain immunizations (CDC, 2015). Public health workers partnering with schools to interact with parents getting ready to enroll their young children in school.
Help enforce the mandatory vaccines
Raise funds to help with cost barrier.Distribute posters and advertisements about the value of vaccines and the danger of not vaccinating children. Slide11
VHKC (continued)
Phase Six through Eight: Throughout the program, the effectiveness will be evaluated and adjustments will be made accordingly. This will ensure that the actions being taken are goal-directed and that the effects of the initiative are appropriate for the desired outcome. When the programs ends in 2020, a follow up study will be launched to determine the effectiveness of the intervention. Slide12
References
Anderson, M. (2015). Young adults more likely to say vaccinating kids should be a parental choice. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-
more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/Calandrillo, S. P. (2004). Vanishing vaccinations: Why are so many Americans opting out of vaccinating their children. University Of Michigan Journal Of Law Reform, 37(2), 353-440.
Centers for Disease Control and Prevention. (2015). 2015 Recommended Immunizations for Children from Birth to 6 Years Old. Retrieved from http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdfCenters for Disease Control and Prevention. (2014). Vaccines Work! Immunization Action Coalition. Retrieved from http://www.immunize.org/catg.d/p4037.pdf
Centers for Disease Control and Prevention. (2012). Vaccines for Children (VFC). Retrieved from http://www.cdc.gov/vaccines/programs/vfc/index.html
Childhood Immunization Support Program. (2014). CISP Program Facts. Retrieved from https://www2.aap.org/immunization/about/programfacts.htmlDiClemente, R., Salazar, L., and Crosby, R. (2013). Health Behavior Theory for Public Health.
Burlington, MA: Jones and Bartlett Learning
Findley, S., Sanchez, M., Ferreira, R., Pena, O., Matos, S.,
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, M., &
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, M. (2009). REACH 2010: New York City: effective strategies for integrating immunization promotion into community programs.
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(2), 128S-137s.
Salzbeg
. S. (2015). Anti-vaccine Movement Causes Worst Measles Outbreak in 20 Years.
Forbes
. Retrieved form http://www.forbes.com/sites/stevensalzberg/2015/02/01/anti-vaccine-movement-causes-worst-measles-epidemic-in-20-years
Tolsma
, E. C. (2015). Protecting Our Herd: How a National Mandatory Vaccination Policy Protects Public Health by Ensuring Herd Immunity.
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