Original ResearchIncreasing Immunization Adherence Among Infants of Low-income Parents: The Effects of Visually Enhanced Education

•The intervention examines use of pictures of children with vaccine-preventable diseases and verbal education (visually enhanced education, VEE) as a means to increase age-specific immunization adherence.•The theory of multimedia proposes that learners who are educated through pictures and words will embed information in their memory for future use.•The analysis demonstrates visually enhanced education had a significant effect on age-specific immunization adherence.•The intervention of using pictures to increase age-specific immunization adherence should be tested in other populations (middle class and upper class), a more diverse population, larger samples, using additional pictures (measles, mumps, rubella, and varicella) for a longer time period (past 24 months of age) with random assignment.

Many children do not receive their recommended immunizations in a timely manner. In this study we compare a visually enhanced educational (VEE) intervention to usual care (UC) among infants of low-income parents. Parents in the intervention group (n = 40) received VEE, whereas control group participants (n = 40) received UC. Adherence (yes/no) to the recommended immunization schedule measured and the VEE group was significantly more adherent to the recommended immunization schedule at 2 (P = .014), 4 (P = .041), and 6 (P = .042) months compared with the control group. Using VEE may increase adherence to the recommended immunization schedule.