Lacey Eden
Academic and Mentoring Objectives
As a pedagogical strategy, the purposes of this service-learning activity were two-fold: 1) to provide students with an organized service activity that also met identified community needs; and 2) to help augment the students’ learning, giving them a broader appreciation of any given discipline, and enhance their sense of civic responsibility. Nursing students were mentored through the process of creating an online education module for parents choosing to exempt their children from immunizations and to assist county health departments to fulfill exemption requirements. The students collaborated with the state Immunization Exemption Workgroup, the Utah Association of Local Boards of Health (UALBH), school nurses, school secretaries and principles, and the Utah Immunization Program manager. Students attended meetings and collaborate with the Northern Utah Immunization Coalition (NUIC), the Salt Lake County Immunization Coalition, the Utah County Immunization Coalition (UCIC), and the Utah State Department of Health (USDH). Hence, part of the mentored experience included interfacing with professional agencies and groups in Utah.
The module includes, signs and symptoms of immunization preventable diseases, parental responsibilities in the event of a disease outbreak, and information on where to receive vaccines. Throughout the module there are comprehension quizzes to assess learning. On completion of the final draft of the module created by the nursing students, the Summit Group was contracted to create the online format to interface with the Utah Health Department.
This community-wide project resulted in an enriched service-learning environment for students while addressing an incredibly timely need in the community. Through standardized education, it is anticipated that parents will have a greater understanding of how to protect their children from communicable diseases and decrease the spread of infection, thus protecting the health of all children in our communities. The module met the requirement for HB 308 sub2 and went into effect on July 2018.
Academic Deliverables
Erin Marshall, Collette Green, Samantha Stevenson, Jacquie Salgado, Savanna Christensen, and Katie Maxwell, all participated in this mentored experience and are undergraduate nursing students. The results of this project were presented at the Utah Nurses Association conference in Salt Lake City, UT, the National Association of Pediatric Nurse Practitioners Conference in Denver, CO, and the Sigma Theta Tau International Research Conference in Melbourne, Australia. Currently a draft of a manuscript is underway and will be submitted for publication.
Results of Project
Vaccine exemptions in Utah for Kindergarten immunizations rose from 2.1% in 2007 to 4.4% in 2013, of which 95% were for philosophical reasons. With this rise in Utah exemption rates, the integrity of the herd effect in Utah has been compromised. Additionally, only 75.2% of Utah’s children, at 2 years of age, have received all recommended vaccinations. While herd immunity requires a 95% immunization rate to be effective, unimmunized infants and children are at greatest risk of acquiring highly virulent diseases, such as measles and pertussis. Consequently, Utah has experienced several outbreaks of immunization preventable diseases, such as measles and pertussis, during the last 5 years.
Studies have shown a direct and positive correlation between the ease of the personal exemption process and the request for immunization exemptions. Currently, there are 13 states that require parental education prior to exempting children from immunization requirements. However, the form of education and curriculum varies from state to state. Of the 13 states that require education, the following were cited as forms of education used for immunization exemptions: 1) signing a waiver, 2) receiving written material, 3) speaking with a healthcare professional; and 4) completing an online education module.
The state of Oregon has traditionally struggled with higher than average philosophical exemption rates. As a result, Oregon also has higher than average communicable disease outbreaks. To combat the rising philosophical exemption rate, Oregon enacted a law in 2014 that mandates parents seeking philosophical exemption to first get a Vaccine Education Certificate from their healthcare provider or after completing an online education module. While it is still too early to determine the effectiveness of required immunization education in Oregon, it should be noted that Oregon’s 2014-15 kindergarten exemption rates rapidly declined from 7.1% to 6% in one year. As a state that allows philosophical exemptions from immunization, Utah may also benefit from a standardized immunization education module.
While it is still to early to tell if the module will reduce exemption rates in Utah, unofficial results from the usability testing revealed parents gained knowledge regarding the importance of keeping unimmunized children at home during disease outbreaks.
Description of Budget
6 students x 100 hours x $12.00/hr = $ 7200
Fee to Summit Group to create module = $12,800
Total $ 20,000