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Richard K. Zimmerman, MD, MPH, Mary Patricia Nowalk, PhD, RD, Mahlon Raymund, PhD, Melissa Tabbarah, PhD, MPH, David G. Hall, MD, J. Todd Wahrenberger, MD, Stephen A. Wilson, MD and Edmund M. Ricci, PhD

Richard K. Zimmerman, Mary Patricia Nowalk, Mahlon Raymund, and Melissa Tabbarah are with the Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa. Richard K. Zimmerman is also with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, as is Edmund M. Ricci. David G. Hall is with the East Liberty Family Health Care Center, Pittsburgh. J. Todd Wahrenberger is with the Northside Christian Health Center, Pittsburgh. Stephen A. Wilson is with the University of Pittsburgh Medical Center St. Margaret Family Practice Residency.

Correspondence: Requests for reprints should be sent to Richard K. Zimmerman, MD, MPH, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Ave, Pittsburgh, PA 15261 (e-mail: zimmer{at}pitt.edu).

Objectives. We designed and evaluated interventions to increase adult immunizations within inner-city health centers.

Methods. Interventions included reminders, standing orders, and walk-in "flu shot clinics." Patients were surveyed and records evaluated.

Results. Records from 1 center showed that immunization rates increased from 24% to 30% (P < .001) for patients aged 50 to 64 years and from 45% to 53% for patients aged 65 years and older (P < .001). Self-reported vaccination rates did not increase. In logistic regression analyses, the strongest predictor of vaccination among patients aged 50 to 64 years was the belief that unvaccinated persons will contract influenza (odds ratio [OR] = 5.4; 95% confidence interval [CI] = 2.4, 12.0). Among patients aged 65 years and older, the strongest predictor of vaccination was the belief that friends/relatives thought that they should be vaccinated (OR = 9.7; 95% CI = 4.2, 22.3).

Conclusions. Tailored interventions can improve immunization rates at inner-city health centers.

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