Login Event Calendar Careers About NACCHO Contact Us Site Map
 
Search  

Dear Visitor,

You have reached the archived version of NACCHO's website. As of February 1, 2016, the content on this site will no longer be updated and may contain outdated information. To see NACCHO's most recent and updated content, please visit our new site at www.naccho.org.

If you have additional questions, please contact us at support@naccho.org.

Programs & Activities
»
»
»
»
Cross-cutting Topics
»
»
»
»
»
»
»
»
»
»
»
Print this page Print This Page

Email this page E-Mail This Page

Bookmark and Share

Program Details


Back to main page.

Practice Type: Model
Program Name: Picture Me Healthy
Organization: Madera County Public Health Department
Web site:
Overview: The "Picture Me Healthy" photo book program provides all families utilizing Public Health Department Immunization Clinics with a cost effective, educational incentive that encourages immunization compliance.

In 1993, Madera County`s immunization rate for two year old children was one of the lowest in California. At a rate of 28%, nearly three quarters of young children were not fully immunized. Fearful of an outbreak such as occurred from 1989-1990 with Measles, where 55,000 U.S. children became ill and 123 died, staff strategized ways to address this problem. The idea of an incentive that would be attractive to parents and that would serve to improve the visit`s perception by parents, but one that would also be educational and motivational was born.

Since many of the families served by this Department are of limited income, and often are not able to afford routine photographs of their children, the "Picture Me Healthy" baby photo book program was created Public Health programs were asked to contribute outreach messages to be included in the book (tobacco, perinatal). Since the project`s inception, immunization rates have increased to over 85%.

Year Submitted: 2005
Responsiveness and Innovation: The public health issue addressed by the "Picture Me Healthy" program is that of early childhood immunization and improving immunization rates in a rural public health setting. The issue came to the forefront following the U.S. Measles outbreak in 1889 - 1990 where in our small county, we experienced over 100 documented cases. Fearful of another such event, staff made improving immunization rates in our county a top priority and set about to identify strategies which would not only be cost effective but easily implemented. The " Picture Me Healthy" program addresses this issue through a multi-faceted approach. First, parents/caregivers of children under two years of age all recieve an incentive (the photo book) at the first clinic visit. At each subsequent visit, a photo is taken and placed in the book. At completion, and if the parent chooses the family`s photo is taken and placed on the clinic bulletin board in honor of their accomplishment. Second, the book provides our nurses and program staff with an outreach and educational tool. At each immunization milestone two pages are devoted to growth/development and health information in a simple, low literacy format linked to the developmental period associated with the age the photograph was taken. Finally, below the photo is a space for the date of the next immunization to be written. This reminder is evident, everytime the parent looks at the photo or shows it to friends and family, reinforcing the need to return.

The "Picture Me Healthy" program differs from other approaches as it provides postive reinforcement to parents through a simple low cost incentive (photo book and photos). It is unique as it was created to specifically meet the needs of the clients we serve in rural central California, but it can be easily adapted to any area or to changing program needs as it is maintained on our departmental computers. Many of the families served in the clinics are very low income or migrant, with little disposable income for photos of their young children. This simple to create and reproduce project provides an incentive to parents to encourage them to complete their child`s initial immunization series. It reinforces the clinic experience in a positive way and helps families to view the experience as something to look forward to as opposed to dread. Families participating in the program, frequently bring their children "dressed up" in anticipation of the photo to be taken. Another unique aspect of the photo book is that it is easily revised or changed. Created with free clip art on our departmental computers, as immunization schedules change or we have programs that want to include outreach information we simply make the changes of the document. In addition we have shared the book via disk with local providers in the community who can then customize and print their own version. As parents seek care in the community they can continue to complete the photo series.

Agency and Community Roles: Although this practice began as an internal project it has grown and expanded over the years. Developed initially though collaboration of public health department staff, the project has been shared in the community and to other immunization programs in other counties and states. The Madera County Public Health Department updates its version periodically and provides copies (computer disk or hard copy)without charge to interested agencies. In addition, staff are happy to share our department`s experience, suggestions for equipment and how the photo process works in the department with agencies wishing to implement it. Clinic staff also provide updates to participating community service organizations during their meetings to keep them informed regarding the program. This willingess to partner and share resources has led to increased dialogue between agencies, the community and providers. It has improved the perception of the Public Health Department in the community and decreased barriers for other collaborative activities such as immunization registry implmentation, health fair participation and disaster preparedness training and coordination.

Costs and Expenditures: The "Picture Me Healthy" photo book was originally created through a grant provided by the Maternal Child Health Immunization Outreach Program, which allowed for staff time to develop and initial printing. The cost of the book for professional printing and spiral binding is $3.00 per book, photos run approximately $.13 per photograph. The total cost per child to complete the book equates to aproximately $3.50, but the cost savings can be huge if only one case of vaccine prevetable disease is avoided. It is estimated that for every dollar spent in vaccinating against Measles Mumps and Rubella, $14.00 are saved in health care costs, other vaccines administered represent similar savings. For a total project cost of less than $2,000/year, the savings and benefits far exceed the cost. Staff that are already assigned to the clinic take turns as photographer when they are not with clients, so as not to incur additonal staffing costs. As more programs have provided outreach and education information to be included, the cost of the book can now be shared by those programs as outreach materials. Local service organizations initially provided support through the provision of cameras and film, and are willing to assist as needed if funding decreases. The greatest cost to program sustainability is the printing and binding costs, but by sharing the cost between programs not only is the burden of cost reduced, other resources are now able to be leveraged and programs have been able to significantly increase their outreach and educational efforts.

Implementation: The public health issue addressed by the "Picture Me Healthy" program is that of early childhood immunization and improving immunization rates in a rural public health setting. The issue came to the forefront following the U.S. Measles outbreak in 1889 - 1990 where in our small county, we experienced over 100 documented cases. Fearful of another such event, staff made improving immunization rates in our county a top priority and set about to identify strategies which would not only be cost effective but easily implemented. The " Picture Me Healthy" program addresses this issue through a multi-faceted approach. First, parents/caregivers of children under two years of age all recieve an incentive (the photo book) at the first clinic visit. At each subsequent visit, a photo is taken and placed in the book. At completion, and if the parent chooses the family`s photo is taken and placed on the clinic bulletin board in honor of their accomplishment. Second, the book provides our nurses and program staff with an outreach and educational tool. At each immunization milestone two pages are devoted to growth/development and health information in a simple, low literacy format linked to the developmental period associated with the age the photograph was taken. Finally, below the photo is a space for the date of the next immunization to be written. This reminder is evident, everytime the parent looks at the photo or shows it to friends and family, reinforcing the need to return.

The "Picture Me Healthy" program differs from other approaches as it provides postive reinforcement to parents through a simple low cost incentive (photo book and photos). It is unique as it was created to specifically meet the needs of the clients we serve in rural central California, but it can be easily adapted to any area or to changing program needs as it is maintained on our departmental computers. Many of the families served in the clinics are very low income or migrant, with little disposable income for photos of their young children. This simple to create and reproduce project provides an incentive to parents to encourage them to complete their child`s initial immunization series. It reinforces the clinic experience in a positive way and helps families to view the experience as something to look forward to as opposed to dread. Families participating in the program, frequently bring their children "dressed up" in anticipation of the photo to be taken. Another unique aspect of the photo book is that it is easily revised or changed. Created with free clip art on our departmental computers, as immunization schedules change or we have programs that want to include outreach information we simply make the changes of the document. In addition we have shared the book via disk with local providers in the community who can then customize and print their own version. As parents seek care in the community they can continue to complete the photo series.

Sustainability:
Lessons Learned:

 

Back to main page.