Perinatal Hepatitis B Program Evaluation PostVaccination Serology Testing

1
Perinatal Hepatitis B Program Evaluation
Post-Vaccination Serology Testing February 19,
2009 Presenter Shana Johnny, RN, MN Immunization
Program CHILD Profile
2
Overview of Washington State Perinatal Hepatitis
B Prevention Program

• 1990, Initiated with CDC funds
• Contract with 35 Local Health Jurisdictions
  (LHJs) to provide services
• Components
• State-supplied hepatitis B vaccine
• Laboratory testing
• Information, education, consultation and
  technical assistance

3
Rational for Selecting Evaluation Activity

• Identify barriers to post-vaccinations serology
  testing
• Increase understanding of barriers providers are
  facing in practice
• Develop strategies to increase post-vaccination
  serology

4
Post-Vaccination Serology Testing Data
5
Evaluation Goal

• To increase awareness, knowledge and practice
  with perinatal hepatitis B post-vaccination
  serology

6
Stakeholders and Partners
Perinatal Hepatitis B Coordinator
Local Health Jurisdictions
Evaluation Plan
Within Reach-API Hepatitis B Task Force
DOH-Immunization Program CHILD Profile Staff
Communicable Disease EPI
DOH-MCH Epidemiologist
Other Health Care Professionals
7
Objectives

• 1. By January 31, 2009, determine the number of
  providers identified by LHJs as caring for
  infants of HBsAg moms and number of providers
  with standing orders in place for post
  vaccination serology.
• 2. By March 31, 2009, survey providers identified
  as caring for infants of HBsAg moms to determine
  the percent of those providers who are
• a. aware of the value of early detection and the
  criticality of post serology testing for infants
  born to HBsAg positive moms
• b. educated on the value of early detection and
  the criticality of post serology testing for
  infants born to HBsAg positive moms.

8
Objectives (Continued)

• 3. By December 31, 2009, increase the number of
  providers identified as caring for infants of
  HBsAg positive moms who are
• a. aware of the value of early detection and the
  criticality of post serology testing for infants
  born to HBsAg positive moms by 5.
• b. educated on the value of early detection and
  the criticality of post serology testing for
  infants born to HBsAg positive moms by 5.
• By December 31, 2009, the percent of providers
  who have written standing orders for post
  serology testing for infants born to HBSAg
  positive mothers will increase by 10.
• By December 31, 2010, the rate for a three-year
  period from December 31, 2006-December 31, 2009,
  for post serology testing for infants born to
  HBsAg positive mothers will increase from 58 to
  70 (increase of 42 infants/yr).

9
(No Transcript)
10
Evaluation Activities

• Identify LHJs and geographical areas where
  post-vaccination serology is low.
• Identify providers where post vaccination
  serology is low

11
Evaluation Activities

• Plan outreach to providers to assess awareness of
  why infants born to HBsAg positive moms are not
  getting post-vaccination serology testing (
  pre-test survey)
• Use findings to develop strategies to increase
  the testing rates for these infants (post-test
  survey)

12
Short-Term Outcomes

• Providers are more aware of importance of
  post-vaccination serology testing
• Providers are educated on the value of early
  detection
• An increased number of providers who are
  conducting post-vaccination serology testing
• An increase number of LHJs providing
  consultation with providers

13
Data collection and Analysis

• Evaluation question 1
• To what degree did the number of providers who
  are aware of the value of early detection and the
  criticality of post vaccination serology testing
  for infants born to HBsAg positive mothers
  increase from March 31, 2009 to December, 2009

14
Data collection and Analysis

• Evaluation question 2
• To what degree did the number of providers who
  have been educated on the value of early
  detection and the criticality of post-vaccination
  serology testing for infants born to HBsAg
  positive mothers increase between march 31, 2009
  and December, 2009

15
Data collection and Analysis

• Evaluation Question 3
• To what degree did the number of providers have
  written standing orders for post-vaccination
  serology testing for infants born to HBsAg
  positive mothers increase from January 31, 2009
  to December, 2009

16
Data collection and Analysis

• Evaluation Question 4
• To what degree did the rate for post-vaccination
  serology testing for infants born to HBsAg
  positive mothers increase from December 2006
  (baseline collected in 2007) to December 2009
  (collected in December 2010)

17
Long term outcomes

• An increase percentage of infants born to HBsAg
  positive moms who receive post-vaccination
  serology testing
• An increase ability to track efficacy of
  Hepatitis B vaccination thru post-vaccination
  serology
• A decrease in hepatitis B disease in infants born
  to HBsAg positive moms

18
Challenges in Developing a Plan

• Agreement of consensus on plan with stakeholders
  and partners
• Methodology
• Resources. Fitting into overall workload

19
Lessons Learned

• Partnerships Work cant do it alone!
• Target efforts cant do it all.

20
Acknowledgements

• Washington State
• Department of Health
• Lin Watson
• Janna Bardi
• Marsha Fraser
• Pat DeHart
• Gary Gant
• Katherine Harris-Wollburg
• Debbie Carlson
• Chrystal Averette
• Steve Bichler
• Within Reach Organization
• Kim Nguyen

• Local Health Jurisdictions
• Shelly McKeirnan Public Health
  Seattle King County
• Jackie Ramsey
• Snohomish Health District
• Ginger Dobberthan Southwest Washington Health
  District
• Denny Hursch Yakima Health
  District
• Denise Stinson Tacoma-Pierce
  Count Health Department
• Delores Dorffeld Thurston
  County Public Health and Social Services

21
This document

• This document can be found on the CDC website
  athttp//www.cdc.gov/vaccines/programs/progeval/
  downloads/wash-eval-02-09-508.ppt