, 2008). Despite the increased prevalence of children of Latino ethnicity and who were receiving Medicaid, this factor was not found to be significant to immunization outcomes. Limitations of this study

A major limitation of this study that was identified by the researchers was the provider's incomplete data reporting to the CIR (Findley et al., 2008). This may have resulted in an overrepresentation of the number of children who lacked proper immunization. When compared to the parent maintained immunization cards, the researchers found that 24% of immunizations were on the cards but not entered into the CIR database. This reliance on the CIR database for records may have skewed the picture of lack of follow through of immunizations to be worse.

The results of this study can be applied to the general population with caution. These designs can lack internal validity due to the inability to ensure that the groups can adequately be compared to one another and that there is not something else, confounding variables, that exists in this group that is causing the results seen (Creswell, 2009). Therefore this lack of randomization makes it difficult to determine causality. However, external validity is stronger as participants can be observed as they would in their natural environments (AllPsych and Heffner Media Group Inc., 2004).

Alternative Research Study Design

In the present study, the researchers have utilized previous research to base their assumption that community driven interventions are more effective than program based interventions and have designed a community driven program compare the effectiveness of this intervention on immunization rates of children. The research question being does community...

Another option for a research study design that would allow us to observe the relationship between this intervention and the immunization rates would be a randomized control trial. In this method, the same participants would be randomly assigned to a program driven intervention, a community driven intervention, or a control group. Immunization information would be measured at acceptance into the program and at two years following. In this design we would be able to see if it was truly the community driven intervention that resulted in increased immunization rates. Since the participants are randomly assigned to groups we will be able to eliminate the possibility of systematic differences in participant groups that could affect research outcomes (Creswell, 2009). Due to the strong internal validity of this design one is able to determine the cause and effect nature of the relationship of variables (AllPsych and Heffner Media Group, Inc., 2004).