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Encouraging Immunization Compliance Among Patients and their Visitors in the Emergency Department (ED)

In a clinical study, RAs, "pre-meds", will determine immunization status among patients and visitors in ED and help them get up-to-date.

Photo of Keith Bradley
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

NARAP uses the RA model for large scale studies among its Affiliate hospitals and will utilize this in research to determine immunization status among ED patients and their visitors and to help those needing recommended immunizations to get them.

Explain the idea (less than 2,000 characters)

Greater than half the people in the U.S. spends an average of 4 hours in an emergency department (ED) each year. They represent the broad demographics of the population and thus are likely to have the need for immunizations that is known to be a major public health problem. There are more than 500,000 "pre-med" undergraduates each year needing clinical experience for their discernment, qualification and development as future health professionals. What could be accomplished by linking these two groups together to give value added to the inevitable wait-time during an ED visit? NARAP brings students as Research Associates (RAs) into the emergency departments of its growing consortium of currently 17 Affiliate hospitals across the country as volunteer data collectors for clinical research. In a formal study over three academic semesters, RAs will determine the immunization status of patients and their visitors in their Affiliate's ED based on U.S. Preventive Services Task Force (USPSTF) recommendations. If a study participant is not up-to-date, they will receive options specific for their catchment area to get the needed immunizations. At 30 days, RAs will contact participants needing immunizations to find out if they are now compliant with the recommendations. The results will be submitted for publication in the medical literature. Using our previous study on tobacco cessation (2 semesters / 10 Affiliates / 19,000 participants), 25,000 participants over 3 semesters would be a conservative estimate for enrollment in the study. If successful, this project could lead to the expansion of the RA model to hospitals throughout the U.S. and to other countries, such as Canada and Australia, where undergraduate students apply to medical school. Through the extensive network of hospital emergency departments, the broad range of public health issues, including immunizations, could be efficiently addressed using this model.

Which part(s) of the world does this idea target?

  • Northern America

Geographic Focus (less than 250 Characters)

Communities in catchment areas of NARAP Affiliate hospitals across the United States

Who are your end users and how well do you know them? (750 characters)

The direct end users of our study will be the thousands of participants enrolled. From the demographic data collected, we will learn a great deal about them, even though the time a RA spends with an individual participant will generally be < 20 minutes. From our previous studies, we know that even this relatively brief interaction can have a positive impact on participants' healthcare screenings. NARAP's unique assets are the thousands of RAs volunteering through their Affiliate Programs for the public good. Not only their service as RAs, but also their grounding in public health as their first clinical experience, brings a long-term strength to large numbers of our future health professionals that cannot be done in any other way.

How is the idea unique? (750 Characters)

While 1/3 - 1/2 of emergency medicine residency programs have some form of RA Program, none are like NARAP, dedicated to exploring the emergency department as a site to facilitate primary health care or developed as a consortium to enroll unprecedented numbers in studies. Other organizations may try such public health initiatives as encouraging immunizations, but few have the "captive" audience for prolonged periods of time as the ED patients and their visitors nor the large workforce willing to volunteer for compensation other than money as the RAs. NARAP's public health studies, such as this proposed one for immunizations, can be tip of the spear for health care getting large numbers of people connected to the resources they need.

Idea Proposal Stage (Select 1)

  • Full Scale Roll Out: We have already tested and scaled this idea significantly with the intended user base (i.e. when innovation has reached 84% or above of the target population or above 1,000,000 users).

How many months are required for the project idea? (140 characters)

The study would begin about 8 months from funding. As open research, data is looked at continuously, but generally completed by 1 year.

Organization Name (less than 140 characters)

National Alliance of Research Associates Programs (NARAP)

Type of Submitter

  • We are a registered NGO or Non-Profit Organization

Organization Location (less than 140 Characters)

Fairfield, Connecticut, U.S.

What is the current scale of your organization’s work?

  • National (expansive reach within one country)

Website URL

Tell us more about your organization/company (1-2 sentences)

Through Research Associates Programs in its Affiliate hospitals, NARAP brings pre-health professions students ("pre-meds") into emergency departments around the U.S. as volunteer data collectors for clinical research. Using this model, NARAP conducts ultra-large scale studies at very low costs across the diverse population of people utilizing emergency departments for care.

Who will work alongside your organization in the project idea? (750 characters)

NARAP's growing consortium of Affiliate hospitals and their partner colleges and universities are our partners in our work. The academic institutions have sent literally thousands of students to NARAP Affiliates to serve as RAs. The departments of emergency medicine at NARAP Affiliates have utilized this model to bring numerous of their own studies to publication. Under the auspices NARAP, this collaboration has produced three major studies on the emergency department as a site to facilitate primary cancer screenings: tobacco cessation (19,000+ participants), cervical and breast cancer (13,000+) and colon-rectal cancer (8,000+). Program Directors assist with the design, execution, presentation and publication of NARAP research.

How many people are on your team?


Tell us more about you and your team

The five key members of NARAP are: Keith Bradley, MD, CEO/CMO and Founder. Working with pre-health professions students since starting Research Associates Programs in 1994 at Lincoln in the South Bronx. Gina Romanos, COO. Long experience working with non-profits. Robert Wickey, CFO. Extensive work in both for-profit and non-profit worlds Hamilton Jones, Deputy Director. Retired from a successful career in industry bringing a corporate perspective to NARAP. Beau Abar, PhD, CRO. Associate Professor of Emergency Medicine, Psychiatry and Public Health Sciences. Provides the scientific rigor for the design, conduct and presentation of NARAP's research NARAP has an ad-hoc group of 20-40 volunteers working on short and long term tasks. Everyone at NARAP is a volunteer.

1 comment

Join the conversation:

Photo of Manisha Laroia

Hey Keith Bradley 
Thank you for sharing your idea.
It is great how well you have described the context and the stakeholders.
I was curious to know more about how will your idea/study proposed help in empowering caregivers?
I feel the focus above is more on the RA and the collaboration, which is great! But for this challenge, it would be really helpful if you could define your idea with the caregiver (the adult caring for the child) and the child at the centre and how it will add value to them.
You can freely edit you idea until March 17 when we close Ideation phase.
Let us know if you have any questions.

Isaac Jumba Would love to know what you have to share.