Evidence map›Paper›PMID 26767508›Full record

Trial reportAcademic pediatrics

Maintenance of Increased Childhood Influenza Vaccination Rates 1 Year After an Intervention in Primary Care Practices.

Mary Patricia Nowalk, Richard K Zimmerman, Chyongchiou Jeng Lin, Evelyn Cohen Reis, Hsin-Hui Huang, Krissy K Moehling, Kristin M Hannibal, Annamore Matambanadzo, Emeil M Shenouda, Norma J Allred

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Academic pediatrics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
  3. Article
  4. Reducing Racial Disparities in Influenza Vaccination Among Children With Asthma.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Mary Patricia NowalkDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa. Electronic address: tnowalk@pitt.edu.
Richard K ZimmermanDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Chyongchiou Jeng LinDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Evelyn Cohen ReisDepartment of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pa.
Hsin-Hui HuangDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Krissy K MoehlingDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Kristin M HannibalDepartment of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Annamore MatambanadzoDepartment of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Emeil M ShenoudaLatterman Family Health Center, McKeesport, Pa.
Norma J AllredImmunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Ga.
University of Pittsburgh · USNational Center for Immunization and Respiratory Diseases · USUPMC McKeesport · US

Funding

UNIVERSITY OF PITTSBURGH CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE: BPCAUL1RR024153 · NCRR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2006 to 2011
$73.9M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
From Innovation to Solutions: Autodialers, Use of Early Autumn Physicals and VacU01IP000321 · IP · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ZIMMERMAN, RICHARD K · 2010 to 2012
$801k
Intramural CDC HHS CC999999NCATS NIH HHS UL1 TR000005NCATS NIH HHS UL1TR000005NCIRD CDC HHS U01 IP000321NCRR NIH HHS UL1 RR024153
6 · The paper itself

Abstract

objectiveInfluenza vaccination rates among some groups of children remain below the Healthy People 2020 goal of 70%. Multistrategy interventions to increase childhood influenza vaccination have not been evaluated recently.

methodsTwenty pediatric and family medicine practices were randomly assigned to receive the intervention in either year 1 or year 2. This study focuses on influenza vaccine uptake in the 10 year 1 intervention sites during intervention and the following maintenance year. The intervention included the 4 Pillars Immunization Toolkit-a practice improvement toolkit, early delivery of donated vaccine for disadvantaged children, staff education, and feedback on progress. During the maintenance year, practices were not assisted or contacted, except to complete follow-up surveys. Student's t tests assessed vaccine uptake of children aged 6 months to 18 years, and multilevel regression modeling in repeated measures determined variables related to the likelihood of vaccination.

resultsInfluenza vaccine uptake increased 12.4 percentage points (PP; P < .01) during active intervention and uptake was sustained (+0.4 PP; P > .05) during maintenance, for an average change of 12.7 PP over all sites, increasing from 42.2% at baseline to 54.9% (P < .001) during maintenance. In regression modeling that controlled for age, race, and insurance, likelihood of vaccination was greater during intervention than baseline (odds ratio 1.47; 95% confidence interval 1.44-1.50; P < .001) and greater during maintenance than baseline (odds ratio 1.50; 95% confidence interval 1.47-1.54; P < .001).

conclusionsIn primary care practices, a multistrategy intervention that included the 4 Pillars Immunization Toolkit, early delivery of vaccine, and feedback was associated with significant improvements in childhood influenza vaccination rates that were maintained 1 year after active intervention.

Indexed as

Family PracticePediatricsPrimary Health CareQuality ImprovementAdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansImmunization ProgramsInfantInfluenza, HumanInfluenza VaccinesMaleMultilevel AnalysisInfluenza Vaccineschildrenimmunizationinfluenzapediatric influenza vaccinationvaccination

Identifiers

PMID26767508
PMCPMC8311666
OpenAlexW2228338835

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.