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Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee's Children Program. Prog Community Health Partnersh 2016;10(1):19-30 PMID: 27018351 PMCID: PMC4869973

Pubmed ID





BACKGROUND: Nationally, immunization coverage for the DTaP/3HPV/1MMR/3HepB/3Hib/1VZV antigen series in children ages 19-35 months are near or above the Healthy People 2020 target (80%). However, children in lower socioeconomic families experience lower coverage rates.

OBJECTIVE: Using a community-based participatory research (CBPR) approach, Community Health Improvement for Milwaukee Children (CHIMC) intervened to reduce disparities in childhood immunizations.

METHODS: The CHIMC adopted a self-assessment to examine the effectiveness of adhering to CBPR principles. Using behavior change models, CHIMC implemented education, social marketing campaign, and theory of planned behavior interventions. Community residents and organizational representatives vetted all processes, messages, and data collection tools.

RESULTS: Adherence to the principles of CBPR was consistently positive over the 8-year period. CHIMC enrolled 565 parents/caregivers with 1,533 children into educational and planned behavior change (PBC) interventions, and enrolled another 406 surveyed for the social marketing campaign. Retention rate was high (80%) with participants being predominately Black females (90%) and the unemployed (64%); children's median age was 6.2 years. Increased knowledge about immunizations was consistently observed among parents/caregivers. Social marketing data revealed high recognition (85%) of the community-developed message ("Take Control: Protect Your Child with Immunizations"). Barriers and facilitators to immunize children revealed protective factors positively correlated with up-to-date (UTD) status (p<0.007). Ultimately, children between the ages of 19 and 35 months whose parents/caregivers completed education sessions and benefitted from a community-wide social marketing message increased their immunization status from 45% baseline to 82% over 4 years.

CONCLUSIONS: Using multilayered interventions, CHIMC contributed to the elimination of immunization disparities in children. A culturally tailored CBPR approach is effective to eliminate immunization disparities.

Author List

Willis E, Sabnis S, Hamilton C, Xiong F, Coleman K, Dellinger M, Watts M, Cox R, Harrell J, Smith D, Nugent M, Simpson P


Pippa M. Simpson PhD Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Earnestine Willis MD, MPH Chief, Professor in the Pediatrics department at Medical College of Wisconsin


2-s2.0-84961675308   1 Citations

MESH terms used to index this publication - Major topics in bold

Child, Preschool
Community-Based Participatory Research
Health Behavior
Health Education
Health Promotion
Healthcare Disparities
Immunization Programs
Infant, Newborn
Social Marketing
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70