December 10, 2020, 1:55 pm Michael Devitt -- Although vaccines are routinely hailed as one of the most successful public health achievements of the 20th century, increasing levels of misinformation about vaccines and mistrust of health care professionals have combined to keep adult immunization rates in the United States well below the goals originally set by the federal government’s Healthy People 2020 initiative. The COVID-19 pandemic has only made this issue more challenging, as evidence suggests that concerns about coronavirus infection have resulted in fewer people visiting their primary care clinicians for immunizations and other routine forms of patient care.
The AAFP has had success in the past with implementing its Office Champions Quality Improvement model to address a variety of public health issues, including immunizations. Among other things, the model uses evidence-based strategies and interventions to help practices evaluate their processes, find opportunities for improvement and incorporate those improvements into the daily workflow.
To help address ongoing concerns about immunizations in the community, the AAFP has partnered with the CDC to recruit 35 family medicine practices to enroll in two new quality improvement initiatives geared toward improving adult immunization rates. One project focuses on minority populations as a whole, and a second focuses specifically on African American adults.
“I love this particular project,” said Margot Savoy, M.D., M.P.H., a member of the Academy’s Board of Directors who has also served on the Commission on Health of the Public and Science’s health equity subcommittee. “It challenges us to put our money where our mouth is by doing what family physicians do best — bring together patient needs with evidence to deliver the best care for our patients.
“This is the type of project that allows us to engage our teams in exploring how we can both ensure we are delivering optimal preventive care to our minority patients as well as identify best practices to help other practices across the country who are looking for ideas,” Savoy added.
The application deadline for both projects is Jan. 8, 2021. Members may apply to take part in either or both initiatives. Selected participants must be active AAFP members and practicing family physicians. Family medicine residents may also apply, but while they may be designated to serve as a practice’s office champion (who will participate in quarterly teleconferences and occasional educational webinars), they cannot serve as the physician champion (who will provide support and resources to the office champion and other practice staff).
Selected family medicine practices will complete an AAFP conflict of interest form and a memorandum of understanding, and designate both an office champion and a physician champion.
For the Improving Adult Immunization Rates Among Minority Populations QI Initiative, participants must also agree to
The 25 practices that are chosen to participate in and complete the Minority Populations project will each receive $4,000 to help offset administrative costs based on achieving a series of milestones. In addition, the physician champion and/or office champion who attends the June 2025 educational conference will be reimbursed for travel expenses.
For the Improving Immunization Rates Among African American Adults QI Initiative, participants must also agree to
Each of the 10 practices that are selected to participate in and complete the African American Adults project will receive $1,000 to cover administrative costs, with payments made based on the completion of certain milestones.
Both projects are expected to begin work in February 2021. The African American Adults project is expected to last through February 2022, while the Minority Populations project is expected to last through July 2025.
Savoy expanded on the significance of the QI initiatives.
“Projects like this are important because they shine a light on something we may assume we are doing well but the evidence would suggest otherwise,” Savoy told AAFP News. “Even vaccine champions who routinely encourage their patients to vaccinate may not have taken the time to explore whether their approaches and messages have been hitting home for everyone.
“If we want to ensure all patients have access to optimal health, we need to make sure we are reaching everyone, and that sometimes means approaching conversations differently or even challenging our (possibly untrue) beliefs that certain people just don’t get vaccines so there is no reason to keep offering them.”
Savoy also explained what she hopes the projects will accomplish, and how FPs can use the information obtained in the initiatives to improve patient care.
“I hope the selected practices take this as an opportunity to engage patients of color when planning their interventions and evaluating how the process changes went,” Savoy said.
“Messaging, perceptions and concerns are very local, and what works for one community may not be as successful in another. Learning with and from our patients about what their concerns are and past experiences have been and then identifying how we can partner to improve their health through vaccination is just one step in us creating trauma-sensitive, patient-centered health care spaces.”
Just as some patients may be hesitant to receive vaccines, some members may be hesitant about participating in these initiatives. Asked what she would say to an FP who was on the fence about submitting an application, Savoy gave a succinct answer.
“Apply!” she said. “What’s the worst that could happen?”
Applications for the Minority Populations and African American Adults initiatives are available online. Applications must be submitted by Jan. 8, 2021, to Pamela Carter-Smith, M.P.A., the Academy’s senior strategist for population and community health by emailing the form to firstname.lastname@example.org, faxing it to 913-906-6099 or mailing it to
Pamela Carter-Smith, M.P.A.
Research, Science and Health of the Public
American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2680
Academy members who have additional questions are encouraged to contact Carter-Smith for more information.