Shoo the Flu. School-located Influenza Vaccination CIC Summit Sacramento, CA April 25, 2016

Transcription

1 Shoo the Flu School-located Influenza Vaccination CIC Summit Sacramento, CA April 25, 2016

2 Background

3 Shoo the Flu Family foundation approached ACPHD & OUSD to host school located influenza vaccination (SLIV) program to launch in 2014 All Oakland preschools & elementary schools invited to participate, Head Start included in 2015 Shoo the Flu is a multi-partner program including participation from both public and private entities

4 Oakland Schools All Oakland Public Schools # of K-12th Students 49,052 Charters 11,977 Oakland Unified School District 37,075 Oakland Unified School District K-12th Students Demographics Data source: OUSD Fast Facts updated

5 Oakland Demographics Population (2014): 413,775 Median household income ( ): $52,962 Persons below poverty level ( ): 21% Language other than English spoken at home ( persons age 5 years or more): 40.3% Health Disparities Data source: United States Census Bureau,

6 Key Partners Alameda County Public Health Department (ACPHD) California Department of Public Health (CDPH) Oakland Unified School District (OUSD) UC Berkeley School of Public Health (UCB) Page Family Foundation / Shoo the Flu (PFF/StF)

7 ACPHD Immunization and Public Health Emergency Preparedness programs Planning partner Clinical support/advising Technical support Hosts two StF staff positions Vaccine/med supplies storage & distribution Staffing: clinic lead, nursing and administrative CDPH - Immunization Branch Planning partner Clinical support/advising Vaccine

8 OUSD Health and Wellness Unit Planning partner Hosts one staff position and provides volunteers In 2015 provided RNs to administer vaccine Coordinates background checks Access to data UC Berkeley School of Public Health Planning partner (clinical impact study and program evaluation) Bay Area Flu Study implementation

9 Page Family Foundation / Shoo the Flu Planning partner Financial support Marketing/Public Relations Staffing Full time: Director, Program Manager, Administrative Specialist, OUSD Vaccine Clinic Liaison Part time/temporary: data entry, nurse staffing Program Evaluation Other Community Partners Sutter Health East Bay Region Nursing schools: Samuel Merritt University, Holy Names University, University of California San Francisco

10 Implementation

11 Year 2 Changes Streamlined consent and materials Scheduled with schools earlier Discontinued 2 nd dose Clearer instructions to school staff Targeted support for low participating schools Moved more logistics in-house to ACPHD Diversified nurse staffing Involved more partners

12 Overview Schools recruited late Spring, schedule confirmed by 9/1 Consents/promotional materials delivered to schools 4 weeks ahead of time Vaccine administered primarily by contracted nurses, OUSD school nurses, ACPHD nurses, & nursing students Notification form given to any student who submitted a consent, bracelet stating I got my flu vaccine at school today! was piloted with vaccinated students Vaccinations entered into CAIR by temporary staff and ACPHD staff within 10 days

13 ICS Structure Integration Engaged additional ACPHD personnel/resources and practiced emergency preparedness Adapted Point of Dispensing (POD) Guide for Small Vaccination Clinics to train for Shoo the Flu Shoo the Flu incorporated into the Statewide Medical Health Exercise in November Set precedent for annual mobilization in conjunction with Shoo the Flu Secondary benefit was that it increased providers reporting of flu vaccine distribution

14 Nurse staffing Diversified pool of nurses Contracted nurses School nurses Public health nurses (staff and temporary) Nursing students Utilized two nurse staffing agencies Determine what works Build local capacity to staff SLIV programs Flexibility and responsiveness is key

15 Consent Forms Consolidated to one page form (instructions + consent) VIS translated by 3 rd party to meet distribution deadlines Consent distributed in 6 languages, Spanish and Chinese packets were bi-lingual Parents/guardians were not offered a choice of vaccine Parents/guardians were instructed to submit a form only if they wanted their student to be vaccinated. Form included a box for parents/guardians to check to be contacted for feedback

16 2014 Consent

17 2015 Consent

18 2014 Quick Facts 57% Uninsured/ Low Income Students 8,641 Vaccines Given 110 Participating Schools 82% Nasal Mist 18% Injection 87% Students 13% Adults 26% All Schools Average Participation Rate (Range 4% - 76%)

19 2015 Quick Facts 52% Uninsured/ Low Income Students 11,277 Vaccines Given 138 Participating Schools 85% Nasal Mist 15% Injection 10,106 (90%) Students 1,171 (10%) Adults 28% All Schools Average Participation Rate (Range 5% - 67%)

20 Year 2 to Year 1 Comparison 25% increase in the number of participating schools (110 to 138) 41% increase in the total number of students vaccinated (7,151 to 10,106) VFC usage slightly decreased from 57% to 52% LAIV usage slightly increased from 82% to 85%

21 Year 2 Lessons Learned School dynamics continue to drive participation rates Bringing program aspects in-house resulted in significant cost savings + capacity building Unanticipated LAIV shortage highlighted challenge of quickly communicating with parents/guardians Vaccinating at pre-schools continues to be challenging and less cost-effective Even limited integration of school RNs is invaluable Prescreening continues to be essential

22 Plans for Year 3 School coordination test bulk communication Bring elements of PR/marketing in-house Targeted new school recruitment, tailored outreach for low participating schools Modify how VIS is distributed Work with nursing schools to take more ownership Continue to integrate OUSD school nurses Continued integration into emergency preparedness Activate more ACPHD staff Explore partnerships with EMS, Oakland CORE Approach insurers for financial support

23 Evaluation

24 UC Berkeley team independently evaluating impact of the program on flu illness, flu vaccination rates, and absenteeism. Current analysis plan includes using: Primary data collected through the Bay Area Flu Study School absenteeism data Vaccine coverage rates (mode TBD) CEIP flu surveillance data

25 Process Evaluation PFF has contracted Cardea Services for outside process evaluation Aims Assess StF implementation Assess factors affecting coverage rates Calculate program costs Methods Results

26 Program Evaluation Site reports: throughput, staffing, timing Site lead debriefs: school level factors, site preparation, site communication On-line surveys (school points of contact, parents): outreach, communication, satisfaction Data loggers: vaccine temperature Ad hoc: trends in changes in participation

27 Contact: Kate Holbrook, MSN, RN, CNS, APHN-BC Program Manager, Shoo the Flu office: Thank you!

28 Appendix

29 School Promotional Materials School Banners Program Poster Program Flyer

30 School Communication Toolkit Talking Points School Staff Letter Teacher Return Instructions Consent Form Collection Crates & Labels Teacher Re-sealable Envelope

31 Clinic Resources Parent Notification Form Wristbands Adult Consent Form Stickers