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Systematic Review
The CPSTF recommends assessment and feedback for vaccination providers on the basis of strong evidence of effectiveness in increasing vaccination rates: (1) among adults and children; (2) when used alone or with additional interventions; and (3) across a range of settings and populations. While there was not enough evidence to determine which characteristics of assessment and feedback contributed most to its effectiveness, various strategies have been consistently effective in a wide range of contexts.
The Task Force finding is based on evidence from a Community Guide systematic review completed in 2008 (19 studies, search period 1997–2007) combined with more recent evidence (1 study, search period 2007–February 2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness.
The Task Force considered evidence from 20 studies. Of these, 16 studies with 20 study arms provided common measurements of change in vaccination rates. The median increase of 9 percentage points (IQI: 3 to 14 percentage points). Fifteen study arms provided sufficient information to calculate the change in vaccination rates and showed a median increase of 18.0% (IQI: 9.5% to 24.0%). Seven study arms evaluated the impact of assessment and feedback for providers when implemented alone and found a median increase of 11 percentage points (IQI: 7 to 12 percentage points). Thirteen study arms evaluated provider assessment and feedback with additional interventions and observed a median increase of 6 percentage points (IQI: 3 to 18 percentage points). One additional study did not provide a common measurement of change in vaccination rates, and reported no change after implementation of intervention.
The reviewed studies evaluated the impact of assessment and feedback for vaccination providers in a wide range of target populations and settings, and for most vaccines appropriate for adults or children. While no studies specifically evaluated the impact of assessment and feedback for vaccination of adolescents, evidence from this review is likely applicable to this population.
This CPSTF concludes that none of the studies identified in this review evaluated the impact of provider assessment and feedback interventions on the delivery of vaccines to adolescents. Future studies should examine the effectiveness of these interventions in increasing vaccination rates among adolescents.