We propose to hire an RN/MA for three  years in order to support the AFIX-based IQIP program in participating clinics throughout Central Oregon. This Immunization Quality Improvement Coordinator will work in the tri-county (Jefferson, Crook and Deschutes Counties) area, as well as in the Confederated Tribes of Warm Springs and Northern Klamath County, (limited to Gilcrist, Chemult, Crescent and Crescent Lake Junction) to reestablish connections with clinics that participated in previous AFIX grants, and reestablish the AFIX program in clinics in which the response to the COVID-19 pandemic may have redirected focus away from prioritizing early childhood immunization programs. The Coordinator will also work to identify clinics that serve children who are two years old and younger, which had not previously  participated in this program, both in the tri-county area as well as in Northern Klamath County and the Confederated Tribes of Warm Springs.

The Coordinator will work with Immunization Coordinators in Crook and Jefferson Counties, as well as OHA staff  (as available) to conduct initial Assessments, facilitate Feedback sessions at 25% or more of the clinics in each  county annually, coordinate Incentives and facilitate the eXchange (Best Practice and Immunization Coalition Meeting) portions of the program. Participating clinics will be required to run updated assessments for their clinic on a semi-annual basis with technical assistance from the Immunization Coordinators as needed. AFIX and IQIP are evidence-based programs based on AFIX, which stands for Assessment, Feedback, Incentives, and eXchange. An "Assessment" of clinic immunization rates is generated by the Oregon Immunization Program and the data is presented and discussed as a "Feedback" meeting facilitated by the Immunization Coordinator and/or State Immunization Program staff. Clinic staff choose two evidence-based strategies for implementation in their clinic  over the course of each year of the project. The Immunization Champions at each participating clinic attend a meeting twice annually for the "eXchange" portion of the project to discuss successes, challenges and best practices for quality immunization services. This project aligns with the "Upstream Prevention: Promotion of Individual Well-Being" RHIP Workgroup goal of improving immunization rates of children birth to two years of age.

We will use the expertise of Shana Falb, the Deschutes Co. Equity and Inclusion Lead, to help us identify clinics  which may primarily serve LatinX populations, and will strive to provide those clinics with additional educational  materials in Spanish. We will provide Assessment, Feedback, Incentive and eXchange materials, trainings and meetings in Spanish, either in written form or via a live translation services such as Linguava. We will actively  pursue participation for clinics that serve prioritized populations, and work to identify and overcome barriers for participation for those clinics.

We will consult with the Concilio, a multi-agency workgroup that contains members of the LatinX community, as well as Father's Group, a non-profit founded by several black fathers that works to enhance the lives of children, to help us in identifying clinics that may benefit from participation in this project, as well as elucidating barriers to vaccination that may not be readily understood. We will offer educational training on the benefits of vaccination in  partnership with a local pediatricians office on the Latino Community Association (LCA) Facebook Live platform, which has provided community education on the COVID-19 vaccine.