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Together for Tots  Immunization Initiative

Since 1995, Connecticut Primary Care Association has participated Together for Totsin the “Together for Tots Immunization Initiative” (Tots)—a national program designed to increase the number of one- and two-year-olds receiving all required vaccinations on schedule. The Bureau of Primary Health Care (BPHC) and Centers for Disease Control and Prevention (CDC) jointly funded this community-based initiative. The goal of Tots was to build both state-based and community health center systems that utilize clinical practice standards set forth by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians. Ten states received grant funding including Connecticut, which was administered by the Connecticut Primary Care Association. A total of nine community health centers representing12 sites in Connecticut joined the program.
 

According to the Bureau of Primary Health Care, the Tots Initiative has fostered improvements in clinical pediatric immunization delivery, such as establishing an accepted standard measure for immunization schedules, standardized training and curriculum, and quality improvement strategies. National average immunization rates for two-year-olds improved from 36% to 82%, across all reporting periods. In Connecticut, the average immunization coverage rate for two-year-olds rose by 52%, from 44% to 67%. The chart below shows aggregated immunization rates of one- and two-year olds at participating Connecticut community health centers:
 

Funding for Tots ends in March 2002. The program is transitioning to the national Health Disparities Collaborative, a program funded by the Bureau of Primary Health Care, which seeks to accelerate improvement in health outcomes by addressing the multiple dimensions of the health care delivery system. These dimensions are health care organization, delivery system design, clinical information systems, decision support, community and self-management. To date, there have been successful collaboratives on aAverage Coverage Rates for One and Two Year Olds at CHCs 1995-2001sthma, diabetes, cardiovascular disease and depression. Sites that have participated in Tots are well prepared to meet the challenges of the Collaborative, which draws on continuous quality improvement activities to promote positive change in health care delivery. The experiences of these community health centers and the best practices developed by these centers will contribute to a model for preventive health, currently under development. For more information on the Health Disparities Collaborative, visit “NE Collaborative” at this website.