Authors Used to Evaluate Their Study Rationale

¶ … authors used to evaluate their study rationale was a quasi-experimental, retrospective matching birth cohort. This study retrospectively analyzed demographic and immunization record data in 2006-2007. The data was gathered from 10,857 birth records of children born between April 1999 and September 2003. The researchers chose to study a Latino community located in New York City and sampled from four zip codes. Birth data was collected from the primary community hospital that serves these zip codes. The authors divided the birth study population into four groups, or cohorts. Each cohort represented birth data from children who were aged 19-35 months as of April 1st during 2002-2005. Each birth cohort was then divided into two groups: intervention and control. Demographic data was collected from the hospital database, and immunization data was collected from the New York Citywide Immunization Registry (CIR). Outcome measures included immunization timelines such as being up-to-date for a specific immunization series, and elapsed days between the last immunization dose and days overdue for the next dose. Outcome measures were analyzed using the chi-square test, unpaired 2-sample Student's t test, logistic regression and as is the case with retrospective studies, the odds ratio estimates the relative risk.

2. What was the rationale for this study?

The authors developed a community driven program, titled "Start Right," which is also a 23-partner coalition. Start Right aims to improve childhood immunization rates within the Latino community by utilizing immunization reminders, tracking, and outreach. Data has shown that these methods are the most effective methods for improving childhood immunization rates. Most of this data came from health provider driven immunization programs rather than community driven programs (Findley, et al. 2008). Prior this study, the authors did not have community-specific data with which to analyze the effectiveness of their program. In the present study, the authors assess the effectiveness of Start Right using data collected from the community as a comparison rather than exclusively relying on comparison data derived from national studies.

3. Briefly outline the methodology for this study.

Prior the Start Right program's initiatives, the Latino community had childhood immunization rates below the 50th percentile for the national average (Findley, et al. 2008). Start Right's 23 partners created a community specific, bilingual information package that contained information about, and promoted, immunizations. Additionally, Start Right trained peer health educators that helped promote and educate the community about immunizations via social services, schools, and outreach as well as having provided parent reminders, and supported provider immunization delivery (see Table 1, Findley, et al. 2008). Study participants were recruited from five different state and city parenting and/or childcare assistance programs. Responsibility for tracking and enrollment were shared amongst the 23 Start Right partners.

4. What were the conclusions of the study?

The authors concluded that Start Right was an effective community driven program in improving childhood immunization and immunization completion rates within the Latino community.

5. What were the limitations of this study in regards to its applicability to the general population?

This study limited itself to solely studying the Latino community. Extrapolating these study results to the general population discounts the fact that there are other racial and ethnic disparities in childhood immunization and immunization completion rates within this geographic location beyond the Latino community (Szilagyi, et al. 2002). In other words, the Start Right program has been shown to be effective in the Latino community only.

6. Examining the details of this research study, propose an alternative research study design that would address the same research goals of this study, and explain how the alternative study design would answer the research questions.