• The Pneumococcal Immunization Study

    Study Description and Methods

    In this study, we administered a pneumococcal immunizations survey to older adults, using paper and electronic forms. We assessed the ability of clinicians to collect and transmit research data electronically using handheld computers. We also obtained information regarding adult immunizations against pneumococcal disease, which will be used as baseline data for a planned future trial of methods to increase immunization rates.

    Specific Aims and Objectives

    We tested the following research hypotheses regarding data collection and

    1. Office nurses can use handheld computers effectively to collect and transmit patient data on a simple descriptive study of pneumococcal immunization of adults.
    2. We can effectively train geographically dispersed office nurses, who were previously inexperienced in use of the handheld computers from the central National Research Network office in Leawood, Kan.
    3. Data quality and completeness will be as good or better for the data collected with handheld computers compared to data collected by paper-based methods.
    4. Data collection via handheld computers will be well-accepted by the office nurses.
    5. Excluding time for set-up time and training, the overall time demand on the central office staff for implementing the data-gathering phase and data-cleaning phases will be less for the electronic methods than the paper-based methods.

    Our clinical objectives for the pneumococcal immunization study are:

    1. To estimate the prevalence of pneumococcal immunization in adults 65 years and older presenting for care in the test practices of the AAFP National Research Network;
    2. To explore reasons for refusal of pneumococcal immunization and other barriers to immunization; and
    3. To provide base line data for a large intervention trial to improve pneumococcal immunization rates in the AAFP National Research Network.


    This study was conducted from September 2001 through September 2003.


    This project has been completed. See below for Key Findings and Publications.


    “Survey Outcomes Obtained with Paper & Electronic Methods in PBRNs: The Pneumococcal Immunization Study in the AAFP NRN”. North American Primary Care Research Group (NAPCRG), October 11, 2004, Orlando, FL.

    Key Findings and Publications

    Although handheld computers produced more complete data than paper forms for the returned surveys, they were not superior because of the large amount of missing data due to technical difficulties with the PDAs. Other hardware solutions such as tablet computers or cell phones linked via a wireless network directly to a website may be better electronic solutions for the future.

    Access the complete manuscript:

    A Comparison of Data Collection Outcomes Using Paper Forms vs. PDA Forms in an Office Based Patient Survey: A Study from the AAFP National Research Network. Galliher JM, Stewart TV, Pathak PK, et al. Ann Fam Med 6:154-160 (2008).

    Contact Information

    For additional information about this study, please contact:

    AAFP National Research Network
    1-800-274-2237 x3180

    This project was funded by a grant from Agency for Healthcare Research and Quality (AHRQ), (2 U01 HS011182 02).