2. Northern Manhattan Start Right Coalition Remarks by Sally Findley Director, Northern Manhattan Start Right Coalition and Professor of Clinical Population and Family Health

3. The Problem: Childhood Immunization Disparities 4:3:1:3:3 series for 19-35 month olds Sources: National Immunization Survey, 2000 Northern Manhattan Immunization Partnerships April 2000Chart Reviews

4. What parents are up against: 10 Antigens with 3-4 repetitions over 24 months

5. Community-based Strategy for Immunization Promotion Embed immunization promotion into major educational and social service programs working with parents of young children Empower staff in these programs to be competent to answer questions about immunization Link to health care providers to increase tracking of immunization delivery and reduce missed opportunities Evaluate using multi-method strategy

6. Coalition Members Trained n=898 (as of December 2005)

7. Enrollment by Start Right Strategy, 2000-2005 (n= 6439) N=7644 enrolled

8. Start Right Immunization Coverage Rates (4:3:1:3:3) at Enrollment and Follow-up by Enrollment Cohort (Children 19-35 months of age at April 2004 follow-up)

9. Immunization coverage rates for Start Right versus US and NYC NIS 2004 % 19-35 month olds UTD 4:3:1:3:3 All differences between Start Right and US or NYC immunization rates not significantly different based on t-tests for total, Hispanic and Black groups. Sources: National Immunization Survey, 2004 Northern Manhattan Start Right Coalition Database, April 2004 N=1502

10. Start Right Closes the Gap Since 2002, children in Start Right are no longer under-immunized relative to NYC or US children Within each ethnic group, the children in Start Right are no longer disadvantaged relative to the national averages. In 2004, for the first time, Start Right children have closed the gap relative to US white children’s immunization rates.

11. Factors contributing to our success Community ownership of immunization promotion was key to engaging community organizations’ creativity, commitment, and energy. Immunization promotion has been fully embedded into routine social service and educational programs at each organization. Immunization competencies are out of the doctor’s office and in the community. Central actors are fellow community residents who advocate for immunizations and child health. Use of proven strategies of reminders, tracking, and positive feedback to parents.