Title page
Contents
About Public Health England 2
Abbreviations 3
Executive summary 4
Background 5
Tailoring Immunisation Programmes for under-served communities 6
Using the TIP approach within the London Charedi community 8
Part 1. Defining the research problem 8
Literature review 9
Part 2. Stratify and prioritise target groups 15
Parental Survey 20
Part 3. Analyse behavioural patterns 21
The Planning phase, design evidence informed responses 23
Part 6. Outlining the Recommendations 27
Recommendations 28
References 34
Appendix 1/Appendix 2. Literature review 36
Appendix 2/Appendix 3. Measles in Hackney and the Charedi community, 2006-2013 39
Protocol 44
Study title 44
A. Background 46
1. Tailoring Immunisation Programmes 46
2. The Charedi community, north London 46
3. Immunisation coverage and associated factors 47
4. Factors associated with immunisation coverage 48
5. Vaccine preventable diseases 50
6. Rationale 51
7. Stakeholder Meeting 51
8. Partners Meeting 51
9. Study Aim 55
10. Study Objectives 55
B. Study design 45
1. Summary 55
2. Study population, recruitment and sampling 55
3. Data collection 57
4. Data analysis 58
C. Study Management 59
D. Funding and insurance 59
E. Ethical considerations 59
F. Dissemination and publication plans 60
G. Timeline 60
H. Investigators & Collaborators 61
I. Appendix 1: PHE Questionnaire 63
J. Appendix 2: Study information sheet for parents 66
K. Appendix 3: Consent form 69
L. Appendix 4: Study information sheet for key informants 70
M. Appendix 5: Interview topic guide for parents 73
N. Appendix 6: Interview topic guide for key informants 75
Table 1. SWOT analysis of the local immunisation programme (conducted by participants at the Partners Meeting, July 2014) 12
Table 2. TIP initial problem statement 13
Table 3. TIP situation summary 14
Table 4. Enablers and barriers impacting immunization uptake within the Charedi community 22
Table 5. Output from stakeholder feedback meeting - suggested interventions 24
Graphs
Graph 1. Coverage of the 5-in-1 vaccinations, by 1 year, in the London borough of Hackney, according to Children Centre area (quarter 4, 2014-2015) 15
Graph 2. Coverage of the MMR vaccination by 2 years of age, in the London borough of Hackney, according to Children Centre area (quarter 4, 2014-2015) 16
Graph 3. Cases of measles, by gender, age group and year of notification, London borough of Hackney (2006-2014) 18
Graph 4. Proportion of registered patients aged 0-4 years in GP surgeries in City and Hackney Clinical Commissioning Group 19
Maps
Map 1. Proportion of the population that are likely to be Charedi by LSOA (in blue) and measles rates per 1000 population by LSOA and year, London borough of Hackney 2006 to 2013; 2010 not included... 17
Results 43
Table 1. Cases of measles (probable and confirmed) and estimated crude measles rates per 1000 population by year and by whether the population they are likely to belong to, Hackney 2006-2013 43
Table 2. Overall cases of measles and estimated crude measles rates per 100,000 population by Charedi and non Charedi population, Hackney 2006 to 2013 43
A. Background 48
Table 1. Performance data from a selection of practices based in North Hackney 48
Table 2. SWOT analysis of the local immunisation programme (conducted by participants at the Partners Meeting, July 2014) 52
Figure 1. Flow chart of study participants 78
Figure 2. Age distribution and number of children of interview participants 79
Appendix Graphs
Graph 1. Coverage of the 5-in-1 vaccinations, by 1 year, in the London borough of Hackney, according to Children Centre area (quarter 4, 2014-2015) 31
Graph 2. Coverage of the MMR vaccination by 2 years of age, in the London borough of Hackney, according to Children Centre area (quarter 4, 2014-2015) 32
Graph 3. Proportion of registered patients aged 0-4 years in GP surgeries in City and Hackney Clinical Commissioning Group 33