Similarities and Contrasts Between Adopters and Nonadopters of Reminder or Recall Messages, From Qualitative Interviews With Private Practices and Public Health Clinics

Private practices (barriers: time and money were/are the greatest barriers, but adopters found ways to overcome this [grants provided]; other barriers: information technology support, staff buy-in, staff computer skills)
 Areas of similarityTop priority for practiceNot in top 5 priorities
Needs leader to be successful
Report success to practice to maintain motivationMost had access to computer systems that could track data or produce lists if desired
 Areas of contrastView underimmunization as a system problem, not an individual provider problemRely on patients to seek immunizations proactively
Measured immunization coverage rates, found problems, and implemented messages to improve coverageHad previous reports of good immunization rates, or were not interested in measuring rates
View duplication of work as a problem: immunizations logged into computer and written in chartRegistry participation is variable to low
Public health clinics (top priority; need computer support; time and money important barriers)
 Areas of similarity
Grant provided to help with costs of startupReporting: state has not measured rates
Feedback to staff is importantNot currently participating in immunization registry
Accountability to state is important
 Areas of ContrastKey to success is staff buy-in and leader to own the initiative
Funding for clinic tied to performance measures
Registry with a report function is helpful
Immunization drives the activities in the clinic