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

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

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

MINI Evaluation Questions No names…hash marks tally only Ethnicity Latino African American Native American Somali S.E. Asian Other Age Range Under 5 years 5-9 10-18 19-26 27-49 50-65 65 and older Have you had a flu shot before? Yes No Would you come back to this site for other shots or health information? Yes No

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…. Cost – lack of insurance Mistrust of medical profession Fear of government Transportation Appointments

MINI Primary Players Family Opportunities for Living Collaboration (Somali) American Indian Community Development Corporation St. Mary’s Clinics (Latino) Stairstep Foundation (African American)

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

Principles…. Immunizations will be given at no cost No one will be turned away; evidence of need does not have to be presented All persons will sign a consent form and be given a copy of the HIPPA agreement/influenza fact sheets

FREE FLU SHOTS For adults and kids at least 3 years old Church Location Date Time Assumption Church 305 E. 77th St, Richfield, MN 55423 (612) 866-5019 Sunday February 11th 1:30- 3:30 p.m. Sacred Heart Church 840 E. 6th St., St. Paul, MN 55106 (651) 776-2741 12 – 2 p.m. St. Odilia Catholic Church 3495 Victoria Street North,Shoreview, MN 55126. (651) 484-6681 February 18th 2:00 – 3:30 p.m.

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

The MINI Results 4,149 served 50% first time 30 % adults 18+ 40 % adolescents 9-18 years 30 % Under age 9

1. Information and Education Adult Immunization Programs in Nontraditional Settings Seven Quality Standards 1. Information and Education Information, culturally and linguistically appropriate; written at reading level easily understood From: National Vaccine Advisory Committee Telma, a Spanish speaker, is doing intake.

Seven Quality Standards Vaccine Storage and Handling Vaccine stored between 35F & 46 F

Seven Quality Standards 3.Immunization History Obtain: vaccines previously received, pre-existing health conditions, allergies, adverse events that occurred after previous vaccinations. (Children: First influenza immunization – card given to parents stating need for second shot 30 days la

Seven Quality Standards 4. Contra-indications Assess presence of contra-indications Severe systemic hypersensitivity reactions to egg protein; gelatin, neomycin, streptomycin; moderate or severe illness w/without fever Live virus generally contraindicated for adults who have compromised immune system and for pregnant women (Child age 5 and older)

Seven Quality Standards 5. Recordkeeping Record the following: name, age, preexisting health conditions, type of vaccine, dose, site and route of administration, name of vaccine provider, date administered, manufacturer, lot number, date next due is due.

Seven Quality Standards 6. Vaccine Administration Properly trained health care providers; licensed

Seven Quality Standards 7. Adverse Events Health care providers trained to recognize and treat adverse reactions with supplies available. (Epinephrine, CPR, telephone for emergency personnel) Persons receiving first immunization were asked to stay for 30 minutes.

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

Lessons Learned Relationships are key Trust is the coin of the realm Providing immunizations at no cost is a huge incentive Numbers increase each successive year People want shots early – vaccine donations come late

Thanks for the Support