Sylwer fod y cymhwysiad hwn dan ddatblygiad. Os ydych chi'n gweld unrhyw gamgymeriadau neu os nad yw rhywbeth yn gweithio, cysylltwch â ni yn evidence.service@wales.nhs.uk.
Adolygiad Systematig
Dywed yr awduron:
"This report aimed to determine whether implementing a combination of community-based interventions leads to an increase in vaccination rates in targeted populations."
Dywed yr awduron:
"This Task Force finding is based on evidence from a Community Guide systematic review completed in 2010 (17 studies; search period 1980 - 2010) combined with more recent evidence (1 study, search period 2010 - 2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness. All of the included studies provided a common measure of change and showed a median increase in vaccination rates of 14 percentage points (interquartile interval [IQI]: 7 to 24 percentage points).
The included studies evaluated a variety of interventions in different combinations. The Task Force examined the evidence of differences attributable to specific interventions and combinations of interventions using different strategic approaches. Fourteen studies implemented an effective combination of one or more interventions to increase community demand with one or more interventions to enhance access to vaccination services and showed a median increase in vaccination rates of 16 percentage points (IQI: 12 to 26 percentage points). Client reminder and recall systems were used in most of the evaluated programs (15 study arms). Systems were implemented by vaccination providers, established as one part of a community manual outreach and tracking program, or generated from a regional immunization information system (IIS).
The economic review identified a total of 22 studies (search period 1980-2012). Monetary values are in 2012 U.S. dollars. Nineteen studies were conducted in the United States, with single studies from Australia, Canada, and Finland, respectively. The median size of study intervention groups was 429 (IQI: 185 to 6013, 21 studies). Interventions were implemented at a median cost per person per year of $54 (IQI: $14 to $214, 19 studies) and achieved a median cost per additional person vaccinated of $461 (IQI: $51 to $798, 19 studies). Several interventions were found to be resource-intensive. Community-based efforts using manual outreach and tracking or home visits were found to have higher costs compared to community-based efforts without these components.
Resource-intensive interventions may be necessary to increase vaccination rates among populations with very low vaccination rates or communities where disparities in coverage persist. These interventions are likely to cost less if implemented as part of a stepped approach, beginning with less resource-intensive interventions such as client reminder and recall systems."
Dywed yr awduron:
"The Community Preventive Services Task Force recommends community-based interventions implemented in combination to increase vaccinations in targeted populations, on the basis of strong evidence of effectiveness in increasing vaccination rates. The conclusion of strong evidence was based on findings from 18 studies that evaluated coordinated interventions to:
• Increase community demand
• Enhance access to vaccination services, and
• Reduce missed opportunities by vaccination providers.
In 13 of the 18 studies, the community-based effort combined one or more interventions to increase community demand for vaccinations with one or more interventions to enhance access to vaccination services. The Task Force notes that implementing manual outreach and tracking or home visits can be resource-intensive and costly, relative to other options for increasing vaccination rates. Such interventions should be used only when there is demonstrated need, and resources are available."