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Impact of a Learning Collaborative Approach on Influenza and Pneumococcal Immunization Rates in US Adults: A Mixed Methods Approach

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  • Impact of a Learning Collaborative Approach on Influenza and Pneumococcal Immunization Rates in US Adults: A Mixed Methods Approach

    Popul Health Manag. 2019 Jun 11. doi: 10.1089/pop.2019.0019. [Epub ahead of print]
    Impact of a Learning Collaborative Approach on Influenza and Pneumococcal Immunization Rates in US Adults: A Mixed Methods Approach.

    Ciemins EL1, Jerry M2, Powelson J3, Leaver-Schmidt E4, Joshi V5, Casanova D4, Kennedy JW6, Penso J5.
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    Abstract

    The objective of this research was to test the impact of a learning collaborative model (intervention) on adult vaccination rates for influenza and pneumococcal disease. A mixed methods approach was used to identify changes in adult vaccination rates over time and organizational factors contributing to successful programs. Provider-level propensity scores were used to match intervention to non-intervention providers to control for inherent selection bias of participating organizations. Comparative analyses were conducted between intervention and non-intervention sites on vaccination rates, using a difference-in-differences approach. Qualitative data (eg, semi-structured interviews) were analyzed using a constant comparison approach to identify themes related to successful strategies. From 2014-2016, intervention providers demonstrated greater improvement than their matched providers in pneumococcal vaccinations (PV) for patients aged 65 years and older (treatment effect: 4.3%, P < 0.05) and PV for high-risk patients (eg, with immunocompromising conditions) aged 19-64 years (2.7%, P < 0.001). Significant effects were also observed for PV for at-risk patients (eg, with diabetes) aged 19-64 years (1.7%, P < 0.05). Individual health systems demonstrated even greater improvements (eg, greater increase in PV rates for patients aged 65 years and older), with treatment effects as high as 20.4% (P < 0.05). A learning collaborative approach was demonstrated to be an effective approach to improve adult vaccination rates among participating integrated delivery systems and medical groups. Factors associated with success included organization type (ie, integrated delivery systems) and systems characterized by a positive learning climate and collaborative culture.


    KEYWORDS:

    adult immunizations; learning collaborative; mixed methods; population health

    PMID: 31184967 DOI: 10.1089/pop.2019.0019
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