Immunize LA Families Adapted AFIX Intervention: Assessing Adult Immunization at Community Clinics in South LA

Background: South Los Angeles Health Projects is the community health services department of Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.  Immunize LA Families (IZLAF) is funded under the CDC Racial and Ethnic Approaches to Community Health - Across the US (REACH US) Initiative.  As part of this coalition-driven project, IZLAF is working with community clinics to improve adult influenza and pneumococcal vaccination rates and to decrease racial and ethnic disparities in coverage.

Setting: Three community clinics in South Los Angeles.

Population: African-American and Latino adults 50 years of age and older who attend community clinics in South Los Angeles.

Project Description: IZLAF is implementing an adapted Assessment, Feedback, Incentive and eXchange (AFIX)  intervention at community clinics serving adults.    AFIX was initially developed for application in pediatric populations.    IZLAF staff samples between 100 and 200 patient records from each community clinic and enters immunization information into CDC Co-CASA software.   Immunization rates for influenza and pneumococcal vaccine are calculated.   AFIX feedback is individualized for each clinic.   Feedback includes recommendations for reminder recall-systems, improved documentation, standing orders, immunization-only clinics, and strategies to improve cultural competency.    IZLAF Coalition members have created a cultural competency checklist which will be used at upcoming assessments.

Results/Lessons Learned: 1.  AFIX  model can be effectively adapted  for use in community clinics to address  low adult immunization coverage. 2.  Co-CASA software needs additional refinement for use with adult populations.  3.  Community member involvement in the design of tools may improve assessment of cultural competency at community clinics. 4.  Participation in AFIX can facilitate community clinic participation in immunization registries.  5.  AFIX participation can facilitate and strengthen linkages between clinics and outside  agencies resulting in improved systems and access to lower-cost vaccine.  6.  Participation in AFIX can help community clinics identify how to improve cultural competency practices.