Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates.

OBJECTIVE: To assess the impact of a tiered patient immunization navigator intervention (immunization tracking- reminder/recall- and outreach) on improving immunization and preventive care visit rates in urban adolescents. DESIGN: Randomized clinical trial allocating adolescents (aged 11-15 years) to intervention vs standard of care control. SETTING: Eight primary care practices. PARTICIPANTS: Population-based sample of adolescents (N = 7546). INTERVENTION: Immunization navigators at each practice implemented a tiered protocol: immunization tracking- telephone or mail reminder/recall- and home visits if participants remained unimmunized or behind on preventive care visits. MAIN OUTCOME MEASURES: Immunization rates at study end. Secondary outcomes were preventive care visit rates during the previous 12 months and costs. RESULTS: The intervention and control groups were similar at baseline for demographics (mean age- 13.5 years/ 63% black- 14% white- and 23% Hispanic adolescents/ and 74% receiving Medicaid)- im