KEYWORD1:
AFIX, CASA, Private Providers, REACH 2010

BACKGROUND:
The Immunize LA Kids Coalition was formed in 1999 as part of a demonstration project funded by the Centers for Disease Control and Prevention (CDC) under the Racial and Ethnic Approaches to Community Health Initiative -- REACH 2010. It is administered by South Los Angeles Health Projects, a community-based unit of the Harbor-UCLA Research and Education Institute. Project interventions include tracking and follow-up of under-immunized children identified at public and non-profit clinics, community outreach and education, and an “enhanced-AFIX” intervention administered at private providers’ offices in Central and South Los Angeles.

OBJECTIVE:
To improve immunization practices and increase access to services at private physicians’ offices by conducting an enhanced-AFIX protocol, in order to improve immunization rates among two-year-old African American and Latino children.

METHOD:
An Immunization Practices Enhancement Team administers enhanced-AFIX to 60 private providers. The protocol includes: pre-CASA interviews, CASA and MOCHA assessments, an observation checklist, feedback in-services, 3- and 6-month follow-ups, and ongoing consultation.

RESULT:
One-year follow-up assessments indicate that immunization rates have improved among the majority of participating providers. The enhanced-AFIX intervention allows for targeting specific practices most likely to make an impact. We will report the number of providers who adopt recommended standards, including use of reminder-recall systems, face sheets, and extended hours. Tools, materials, successful implementation strategies, and barriers encountered will be discussed.

CONCLUSION:
Classic AFIX interventions may be adapted to local circumstances and result in positive outcomes including improvement in a wide range of immunization-related practices.
LEARNINGOBJECTIVES:
Attendees will be able to: (1) Describe the tools and methods used in an enhanced-AFIX intervention at Private Providers’ offices; and (2) Describe the results of using this methodology in Central and South Los Angeles.