Can Opportunities Be Enhanced for Vaccinating Children in Home Visiting Programs? A Population-Based Cohort Study

BMC Public Health 15:620, 2015, DOI: 10.1186/s12889-015-1926-8

11 Pages Posted: 26 Oct 2015

See all articles by Michael Isaac

Michael Isaac

University of Manitoba

Mariette Chartier

University of Manitoba - Max Rady College of Medicine

Marni D. Brownell

University of Manitoba - Department of Community Health Sciences (CHS); University of Manitoba - Manitoba Centre for Health Policy

Dan Chateau

University of Manitoba - Department of Community Health Sciences (CHS); University of Manitoba - Manitoba Centre for Health Policy

Nathan Nickel

University of Manitoba - Department of Community Health Sciences (CHS); University of Manitoba - Manitoba Centre for Health Policy

Patricia Martens

University of Manitoba - Department of Community Health Sciences (CHS); University of Manitoba - Manitoba Centre for Health Policy

Alan Katz

University of Manitoba - Department of Community Health Sciences (CHS); University of Manitoba - Manitoba Centre for Health Policy

Joykrishna Sarkar

University of Manitoba - Manitoba Centre for Health Policy

Milton Hu

University of Manitoba

Elaine Burland

University of Manitoba - Manitoba Centre for Health Policy

Chun Yan Goh

University of Manitoba - Manitoba Centre for Health Policy

Carole Taylor

University of Manitoba - Manitoba Centre for Health Policy

Date Written: August 14, 2015

Abstract

Background: Home visiting programs focused on improving early childhood environments are commonplace in North America. A goal of many of these programs is to improve the overall health of children, including promotion of age appropriate vaccination. In this study, population-based data are used to examine the effect of a home visiting program on vaccination rates in children.

Methods: Home visiting program data from Manitoba, Canada were linked to several databases, including a provincial vaccination registry to examine vaccination rates in a cohort of children born between 2003 and 2009. Propensity score weights were used to balance potential confounders between a group of children enrolled in the program (n = 4,562) and those who were eligible but not enrolled (n = 5,184). Complete and partial vaccination rates for one and two year old children were compared between groups, including stratification into area-level income quintiles.

Results: Complete vaccination rates from birth to age 1 and 2 were higher for those enrolled in the Families First program [Average Treatment Effect Risk Ratio (ATE RR) 1.06 (95 % CI 1.03-1.08) and 1.10 (95 % CI 1.05-1.15) respectively]. No significant differences were found between groups having at least one vaccination at age 1 or 2 [ATE RR 1.01 (95 % CI 1.00-1.02) and 1.00 (95 % CI 1.00-1.01) respectively). The interaction between program and income quintiles was not statistically significant suggesting that the program effect did not differ by income quintile.

Conclusions: Home visiting programs have the potential to increase vaccination rates for children enrolled, despite limited program content directed towards this end. Evidence-based program enhancements have the potential to increase these rates further, however more research is needed to inform policy makers of optimal approaches in this regard, especially with respect to cost-effectiveness.

Keywords: Keywords: Vaccination programs/utilization, Pediatric, Child, Humans, Home visit, Propensity score, Early childhood development programs

Suggested Citation

Isaac, Michael and Chartier, Mariette and Brownell, Marni D. and Chateau, Dan and Nickel, Nathan and Martens, Patricia and Katz, Alan and Sarkar, Joykrishna and Hu, Milton and Burland, Elaine and Goh, Chun Yan and Taylor, Carole, Can Opportunities Be Enhanced for Vaccinating Children in Home Visiting Programs? A Population-Based Cohort Study (August 14, 2015). BMC Public Health 15:620, 2015, DOI: 10.1186/s12889-015-1926-8. Available at SSRN: https://ssrn.com/abstract=2644559

Michael Isaac (Contact Author)

University of Manitoba ( email )

501 F.A. Bldg
Winnipeg R3T 5V4, Manitoba R3T 5V5
Canada

Mariette Chartier

University of Manitoba - Max Rady College of Medicine ( email )

Winnipeg
Canada

Marni D. Brownell

University of Manitoba - Department of Community Health Sciences (CHS) ( email )

750 Bannatyne Ave
Winnipeg, R3E 0W3
Canada

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Dan Chateau

University of Manitoba - Department of Community Health Sciences (CHS) ( email )

750 Bannatyne Ave
Winnipeg, R3E 0W3
Canada

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Nathan Nickel

University of Manitoba - Department of Community Health Sciences (CHS) ( email )

750 Bannatyne Ave
Winnipeg, R3E 0W3
Canada

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Patricia Martens

University of Manitoba - Department of Community Health Sciences (CHS) ( email )

750 Bannatyne Ave
Winnipeg, R3E 0W3
Canada

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Alan Katz

University of Manitoba - Department of Community Health Sciences (CHS) ( email )

750 Bannatyne Ave
Winnipeg, R3E 0W3
Canada

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Joykrishna Sarkar

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Milton Hu

University of Manitoba ( email )

501 F.A. Bldg
Winnipeg R3T 5V4, Manitoba R3T 5V5
Canada

Elaine Burland

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Chun Yan Goh

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

Carole Taylor

University of Manitoba - Manitoba Centre for Health Policy ( email )

University of Manitoba Bannatyne Campus
Winnipeg
Canada

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