BACKGROUND:
The IMMUNIZE LA KIDS Coalition was formed in 1999 under the CDC’s 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 children identified at public and non-profit clinics and community sites, community outreach and education, and an “enhanced-AFIX” intervention.

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

METHOD:
An Immunization Practices Enhancement Team (IPE) administers an enhanced-AFIX intervention to 60 participating private providers. The protocol includes: pre-CASA interviews, CASA and MOCHA assessments, an observation checklist, feedback in-services, 3- and 6-month follow-up contacts, and ongoing consultation. Project staff and advisory group members monitor results and refine protocols when necessary to strengthen the intervention.

RESULT:
Preliminary results based on one-year and two-year follow-up assessments indicated that immunization up-to-date rates did not improve among a number of participating providers. We determined that high staff turnover, and lack of provider buy-in contributed to fragmented implementation of recommended practices. Strategies implemented to strengthen the intervention include increased emphasis on: on-going provider staff training, recognition of high performing providers and exchange of information. We will report on our efforts to assess and improve our enhanced-AFIX intervention, including adaptations in tools and materials, successful strategies and barriers encountered.

CONCLUSION:
Monitoring and refining AFIX interventions in response to changing circumstances may result in improved immunization-related practices and rates.

LEARNING OBJECTIVES:
Attendees will be able to: 1) Describe the methods utilized in an enhanced-AFIX intervention; 2) Describe strategies used to strengthen the intervention and results of implementing improved protocols.