The MINI Project Minnesota Immunization Networking Initiative Patricia L. Peterson MPA Fairview Health Services Minneapolis, Minnesota

The MINI Project Purpose To increase influenza immunization rates among minority and uninsured populations in the greater Twin Cities area by utilizing the trust of faith-based and grass-roots community organizations

AND – MINI Purpose Establish a community based framework for pandemic response

Why the MINI Project? Health Disparities Pneumococcal example: 70% White population immunized; 22.5% African American Minnesota State Department of Health

Why the MINI Project? Infrastructure Missing AMA: Reason immunizations rates low for adults is effective adult infrastructure is lacking “Improving Immunization: Addressing Racial and Ethnic Populations”, AMA, 12/04

Why? Barriers…. Lack of insurance Mistrust of medical profession Fear of government Transportation Appointments

MINI Populations Served Latino, African American, Native American, Burmese, Sikh, Tibetan, Asian: Hmong, Laotian, Vietnamese; African: Somali, Ethiopian, Liberian: European

MINI meets seven quality standards of National Vaccine Advisory Committee Culturally appropriate materials Vaccine storage between 35F & 46F Immunization history Contraindications Recordkeeping Vaccine Administration Adverse Events

Principles in Play Local trusted organizations will “call the meeting” and host the clinic

Principles…. FBO’s/CBO’s issue the invitation for MINI to come Immunizations will be given at no cost; no one turned away All persons will sign a consent form and be given a copy of the HIPPA agreement, Vaccine Information Statements (VIS)

Promotion of Clinics Flyers posted at the site; other community settings – grocery store, community centers etc. “Find a Flu Shot” website sponsored by the MN Department of Health Verbal announcements by faith community leaders Radio, television, newspapers

Why it Worked Trust – The X Factor Community & Faith Based Organizations (CFBO’s)– churches, mosques, synagogues, centers are trusted entities, safe places. Community and faith based leaders are trusted messengers CFBO’s already deliver information and services to its specific group and larger community as part of their mission Trusted messengers…..If the priest or pastor says so, it’s true

Challenges of H1N1 –Distribution/Availability Responses varied with populations-(information from our partners) Muslims thought it involved pork(i.e. Swine Flu); also fear of autism African Americans feared government- “will be a way to get rid of us”; track them, make them sick, walk backwards Others mistrusted the name H1N1- did not know other strains had similar ID

The MINI Results 21,000 served in four seasons Injectable/FluMist 56 different sites 40% first shot first two years 65% adults – 18 + 15% 9-18 years 20% 3-9 years

A Replication Model Find Funding/Resource Intermediary Organizer Leverage Existing Networks Intermediary Organizer Secure Sites Support Delivery/Needs This is one model – others exists. In the MINI model an intermediary organization, the Consortium, found funding, invited organizations to participate and continued to pursue procurement of funding and vaccine. In this model the inter. Org. is deliberately not in the middle. This could be a wheel…the intermediary organization is not the hub but rather on the outside, helping the project to get rolling. Each of these organizations know what they need to do far better than I do. They have the expertise that is recognized and respected. The MINI project helped them fulfill their own mission to meet the needs of their respective communities. At the same time, they joined in the MINI project to fulfill a shared mission of providing this service.

Needed for Replication Project Director – point person - $$$ Health Care Partner/s with doctor’s orders Healthcare professionals (schedule staff) Vaccine, syringes, supplies, paperwork Community Partners – site selection, coordination, publicity, interpreters

Bottom Line – the Cost Year One 2006-2007 season Vaccine donated: $85,000 Nurse time donated: $20,000 + Project Director in kind: $26,000 Cash available through grants : $45,000 – 5,000 immunizations given @ $9.00 each

Lessons Learned Relationships are the foundation for successful collaboration Trust is earned; can be fragile Providing immunizations at no cost is a huge incentive for people to come Numbers increase each successive year at each site People want shots early – vaccine donations come late

Pat Peterson ppeters1@fairview.org Thank You! Pat Peterson ppeters1@fairview.org