The Effectiveness of Combined Appointments on Influenza Immunization Rates in a Rural WIC Population

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis of data collected from September to November 2010 the chi-square test was performed to assess the relationship between group assignment and immunization receipt. Logistic regression was used to examine the relationship of the dependent variable, immunization receipt, with the potential variables of acceptability, accessibility, availability, and effectiveness.

Results: Participants who received only the educational materials and an opportunity to receive an immunization at a later date were less than half as likely to get immunized (15.6%) as those who were offered a same day influenza immunization (39.3%). There was a statistically significant association between whether or not influenza immunization was offered at the time of the WIC appointment and the rate of influenza immunization, χ2 (1)=7.905, p=.005. The acceptability scale (Tanahashi’s model) was a significant predictor (AOR = 2.261, p = .019) of immunization receipt but items measuring accessibility, availability, and effectiveness were not significant predictors (ps all > .16).

Conclusions: These findings suggest that offering immunizations at the time of a WIC appointment may increase overall rates of childhood immunizations. Further research with Tanahashi’s model is needed.