KEYWORD1:
Combined lead/immunization initiative
lead and immunization assessment
lead exposure
lead poisoning
AFIX

BACKGROUND:
New York State mandates that physicians screen children for lead at ages one and two years. However, only about 50% of the children have been tested for lead at these ages. To increase provider screening and assessment for lead, New York State Health Department recommended adapting the Physician Based Immunization Initiative methodology that was successfully applied to increase the rate of childhood immunizations.

OBJECTIVE:
To increase to 100% the one and two year old children who are assessed and screened for lead exposure.

METHOD:
The CASA (Computer Assessment Software Application) program was modified to include variables for lead risk assessment, lead test ordered, lead test done and lead test results for one and two year olds. A standard reporting form and letter were developed. Staff conducted combined lead/immunization assessments of provider practices using the modified software. Staff met with practitioners to review results and provide recommendations for increasing rates of childhood immunizations, lead assessments and screenings.

RESULT:
Records of 643 one and two year olds from 10 practices were reviewed: 90% of one year olds and 29% of two year olds had lead tests done; 6% of one and 0% of twos had lead assessments documented.

CONCLUSION:
Providers frequently do not test two year old children for lead although most children develop lead poisoning after age one year. Physician awareness and education is needed to increase the number of two year olds tested for lead and the number of one and two year olds assessed for lead exposure.
LEARNINGOBJECTIVES:
To increase the percentage of children age appropriately screened and tested for lead exposure, the audience will learn a method for integrating lead assessments into the provider based immunization initiative utilizing the CASA software.