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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. Community Engagement and Involvement

Approach. Engage with the community to discuss the importance of childhood vaccines.

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Overview. Engaging and involving the community in discussions about childhood vaccines involves establishing two-way communication channels to understand local concerns, address misinformation, and foster collective action towards increasing vaccination rates.[1] This approach leverages the power of community networks and trusted voices to build trust in vaccine science and encourage widespread immunization.[1] Identifying and collaborating with trusted community leaders, such as religious leaders, school administrators, or parent-teacher associations, allows for tailored messaging and outreach tailored to specific community needs.[1] Organizing community forums, town hall meetings, or vaccination clinics in reachable locations can provide opportunities for open discussions and address concerns directly.[1] In addition, utilizing appropriate communication materials and partnering with local media outlets can further amplify the message and ensure its reach across communities.[1] Examples of successful public health programs engaging communities include initiatives by the World Health Organization. (WHO) offering community toolkits with resources for local support efforts, and similar programs by local health departments organizing vaccination festivals with educational booths and entertainment for families.[2, 3] Peer-reviewed research suggests that community engagement can be highly effective.[1,2,3] Studies have shown that collaborative approaches involving trusted community leaders and open communication can improve vaccine acceptance, dispel myths, and ultimately increase childhood immunization rates.[4]

Evidence. Mixed Evidence. Strategies with this rating have been tested more than once with results that sometimes trend positive...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Community perception and awareness surveys
  • Community partner satisfaction surveys
  • Qualitative data from focus groups

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort
(“What/how much did we do?”)

  • Number of community organizations and partners engaged in promoting childhood vaccination. (Measures breadth of community outreach)
  • Number of community health workers and trusted messengers trained to educate families about vaccines. (Assesses capacity for community-based promotion)

Quadrant 2:
Measuring Quality of Effort
(“How well did we do it?”)

  • Percent of community engagement activities that are led by Title V in partnership with trusted community-based organizations. (Measures authentic community leadership)
  • Percent of vaccine education materials and messages that are co-developed with community members. (Assesses relevance)

Quadrant 3:
Measuring Quantity of Effect
(“Is anyone better off?”)

  • Number of community coalitions led by Title V and networks formed to strengthen vaccine education, access, and uptake that report high levels of engagement. (Measures collaborative infrastructure for sustainability)
  • Number of community members who express confidence in their ability to access vaccines and navigate the immunization system. (Shows impact on self-efficacy and health literacy)
  • Number of communities that maintain high childhood vaccination rates and community immunity over time. (Measures sustained population health impact)
  • Number of community-based organizations that expand their capacity to serve as credible and trusted voices for immunization. (Assesses community capacity-building impact)

Quadrant 4:
Measuring Quality of Effect
(“How are they better off?”)

  • Percent of community coalitions led by Title V and networks formed to strengthen vaccine education, access, and uptake that report high levels of engagement. (Measures collaborative infrastructure for sustainability)
  • Percent of community members who express confidence in their ability to access vaccines and navigate the immunization system. (Shows impact on self-efficacy and health literacy)
  • Percent of communities that maintain high childhood vaccination rates and community immunity over time. (Measures sustained population health impact)
  • Percent of community-based organizations that expand their capacity to serve as credible and trusted voices for immunization. (Assesses community capacity-building impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] World Health Organization: WHO. (2015, August 18). Vaccine hesitancy: a growing challenge for immunization programmes. https://www.who.int/news/item/18-08-2015-vaccine-hesitancy-a-growing-challenge-for-immunization-programmes

[2] Conducting community engagement for COVID-19 vaccines: Interim guidance. https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccination-community-engagement-2021.1

[3] Philadelphia Immunization Program – Immunization program of the Philadelphia Department of Public Health. (n.d.). Philadelphia Immunization Program. https://vaccines.phila.gov/

[4] Jain, M., Shisler, S., Lane, C., Bagai, A., Brown, E., Engelbert, M., ... & Parsekar, S. S. (2022). Use of community engagement interventions to improve child immunisation in low‐and middle‐income countries: A systematic review and meta‐analysis. Campbell Systematic Reviews, 18(3), e1253.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.