FOCUS AREA: IMMUNIZATIONS AND INFECTIOUS DISEASES
Program Name: Greater Grand Forks Immunization Coalition
Location: Grand Forks County, North Dakota; Polk County, Minnesota
Problem Addressed: Immunization and Infectious Diseases
Healthy People 2010 Objective: 14
Web Address: www.246t.com
SNAPSHOT
The Greater Grand Forks Immunization Coalition is a community partnership that began in 1994 with 35 participating agencies and organizations for the purpose of improving immunization rates. The 62 community partners include health care agencies, businesses, educational institutions, social service agencies, media, volunteer organizations, faith-based organizations, private foundations, and individuals from the community.
Grand Forks County in North Dakota and Polk County in Minnesota are separated by the Red River of the North, and residents receive health care from both sides of the river. The Coalition was originally funded to address the immunization rates of children from birth through two years of age in the community. The Coalition’s initial goal was to have a 90 percent up-to-date immunization rate for these children. The Coalition also recognized the need to reach out to rural health clinics to improve their immunization rate of 40 percent. Today, the up-to-date immunization rate for children two years of age and younger in rural and urban Grand Forks is 71.1 percent. In 2000, the Coalition’s goal expanded to include: achieving age-appropriate immunizations across the lifespan, connecting families to a regular source of health care, increasing community awareness of the importance of timely immunizations for all residents, and improving tracking and recall systems within health care agencies.
THE MODEL
Blueprint: The Grand Forks Public Health Department is the lead agency and fiscal agent for the Greater Grand Forks Immunization Coalition and provides administrative support for various Coalition activities. As a result, the Grand Forks Public Health Department’s Immunization Program manager is also the Coalition coordinator. Four additional health department staff members represent the Coalition through membership on community organizations. The Coalition itself has no officially paid staff. Coalition partners volunteer for committees, sharing their expertise and experience. Committees are formed to address specific Coalition activities. Partner activities may include participation on a committee, coordination of awareness efforts in a place of business, volunteering, sponsorship of materials, monetary contributions, or lending name and voice to the Coalition’s effort.
Coalition services target health care providers; parents of infants, children, and adolescents; and adults in the community. Services provided to health care professionals include presentations, onsite or satellite education and training, an Immunization Action Kit, resource library, website, and statewide immunization conference. These services are provided to health care professionals by the public health department and various Coalition partners. Each month, the Immunization Program manager conducts an “Immunization Update” for public and private providers in the community, which is videotaped and distributed to rural clinics in both states. Immunization education and training sessions are also provided annually to nurse practitioner and physician assistant students; migrant health nurses; school nurses; and Women, Infant, and Children (WIC) clinic employees. The Coalition organized and hosted two statewide immunization conferences and developed an Immunization Training Manual that was used to teach staff in a rural clinic how to administer vaccines. Prior to this training, vaccine administration was not a service offered by this rural clinic.
The services provided to parents, adolescents, and adults include health fairs; educational classes and materials; immunization reminder postcards; hospital newborn immunization information packets; a Drive-through Flu Clinic; and promotional campaigns that use newsletters and articles, public service announcements, stickers, immunization incentives, and a website. Coalition activities are designed to reach the target populations in the home, at work, through faith-based organizations, health fairs, local businesses, hospitals, daycares, clinics, and social service agencies. The Coalition developed and distributed an immunization video that was used by health care providers, schools, and WIC. Production of the video was discontinued due to the high cost of keeping the information current. Private clinics offer classes to parents about immunization, and all Coalition members educate parents during community health fairs. Educational materials were developed and distributed to daycares, emergency rooms, prenatal classes, and home-visiting agencies. These materials remain available upon request through the Public Health Department. In addition, the Coalition participates in the McDonald’s Corporation-sponsored campaign “Immunize for Life” each fall. During national immunization observances, the Coalition does promotional campaigns with local organizations and businesses. The Coalition also sponsors a Drive-through Flu Clinic in the fall. In 2002, 467 residents received the influenza vaccine through the clinic.
The Coalition developed a Company Kit for local businesses, which includes an informational letter, fliers, copies of the Coalition’s logo, a newsletter story, and a paycheck stuffer. Businesses were encouraged to promote immunizations to their employees during national health observances.
Making a Difference: The Provider Education Program has been evaluated by the attendance at presentations, number of presentations, and immunization practice surveys. Currently, there are three regularly scheduled Immunization Updates per month, with an average of 65 health care providers in attendance. In 2002, the Resource Library received 35 requests for materials. Immunization conferences were evaluated by participant surveys. Attendance for the 2003 conference increased by 50 participants over the attendance for the 2000 conference.
Parent education programs were evaluated by the number in attendance, pre- and post-tests, and surveys. Surveys were used in the community to assess parental knowledge of immunizations to develop appropriate educational materials. Immunization rates generated by the Immunization Registry were used to evaluate the effectiveness of the Reminder Postcard Program. The program focuses on children 16 months of age who are not up to date on immunizations, being caught up by age two years. The adolescent and adult programs are in the beginning stages. Similar tools (knowledge surveys, immunization rates, disease incidence) will be used to measure their success. Company Kits were evaluated by the number distributed and a survey of businesses to determine how the kits were used. The effectiveness and visibility of the media campaign and promotional materials are assessed every six to 12 months.
Beginnings: The John S. and James L. Knight Foundation provided the initial funding for the coalition from 1994 through 1999. Since then, the Coalition has relied on local grant funding and business contributions. The Public Health Department also contributes to the Coalition, but most activities are supported by in-kind contributions and do not generate revenue. Health care agencies throughout Grand Forks County, North Dakota, and neighboring Polk County, Minnesota, were the original stakeholders in the Coalition. They continue to be active partners in Coalition activities.
Challenges and Solutions: The Coalition’s greatest challenge has been its sustainability. Maintaining enthusiasm for Coalition activities is part of this challenge. New and creative activities have generated new partnerships. The Coalition has sponsored two awards luncheons, recognizing community partners’ contributions. Organizing and hosting two statewide immunization conferences brought Coalition partners to the table to work together. Recognition for Coalition achievements has renewed Coalition spirit. In 2000, the Coalition was chosen as one of five Model Immunization Coalitions by the National Coalition for Adult Immunization. The National Association of County and City Health Officers chose the Coalition’s Drive-through Flu Clinic as a 2003 Model Practice. Additionally, the Coalition was a finalist in the Promotional Products Association’s 39th Golden Pyramid Competition for its marketing efforts.
PROGRAM CONTACT INFORMATION
Kathleen R. Dunn, Program Director
151 South 4th Street, Suite N301
Grand Forks, ND 58201-4735
Phone: (701) 787-8100
Fax: (701) 787-8145