Northern Manhattan Start Right Coalition

1
Northern Manhattan Start Right Coalition

• Remarks by Sally Findley
• Director, Northern Manhattan Start Right
  Coalition and Professor of Clinical Population
  and Family Health

2
The Problem Childhood Immunization Disparities
43133 series for 19-35 month olds
Sources National Immunization Survey,
2000 Northern Manhattan Immunization Partnerships
April 2000Chart Reviews
3
What parents are up against 10 Antigens with
3-4 repetitions over 24 months
4
Community-based Strategy for Immunization
Promotion

• Embed immunization promotion into major
  educational and social service programs working
  with parents of young children
• Empower staff in these programs to be competent
  to answer questions about immunization
• Link to health care providers to increase
  tracking of immunization delivery and reduce
  missed opportunities
• Evaluate using multi-method strategy

5
Coalition Members Trained n898 (as of
December 2005)
6
Enrollment by Start Right Strategy, 2000-2005




N7644 enrolled

(n 6439)
7
Start Right Immunization Coverage Rates
(43133) at Enrollment and Follow-up by
Enrollment Cohort (Children 19-35 months of age
at April 2004 follow-up)
8
Immunization coverage rates for Start Right
versus US and NYC NIS 2004 19-35 month olds UTD
43133
N1502
All differences between Start Right and US or NYC
immunization rates not significantly different
based on t-tests for total, Hispanic and Black
groups. Sources National Immunization Survey,
2004 Northern Manhattan Start Right Coalition
Database, April 2004
9
Start Right Closes the Gap

• Since 2002, children in Start Right are no longer
  under-immunized relative to NYC or US children
• Within each ethnic group, the children in Start
  Right are no longer disadvantaged relative to the
  national averages.
• In 2004, for the first time, Start Right children
  have closed the gap relative to US white
  childrens immunization rates.

10
Factors contributing to our success

• Community ownership of immunization promotion was
  key to engaging community organizations
  creativity, commitment, and energy.
• Immunization promotion has been fully embedded
  into routine social service and educational
  programs at each organization.
• Immunization competencies are out of the doctors
  office and in the community.
• Central actors are fellow community residents who
  advocate for immunizations and child health.
• Use of proven strategies of reminders, tracking,
  and positive feedback to parents.