Results from an Ongoing AFIX Intervention In Three Community Clinics In South Los Angeles

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 works with community clinics to improve adult influenza and pneumococcal vaccination rates and to decrease racial and ethnic disparities in coverage. IZLAF is implementing an Assessment, Feedback, Incentive and eXchange (AFIX)  intervention at community clinics serving adults.   

Objectives: To use the AFIX intervention to improve immunization rates among 3 partnering South Los Angeles community clinics. 

Methods: IZLAF staff samples between 100 - 200 patient records of adults age 50 years and over from each clinic and enters immunization information into CDC Co-CASA software.   Immunization rates for influenza and pneumococcal vaccine are calculated for age and racial/ethnic groups.   AFIX feedback is individualized for each clinic.   Feedback includes recommendations for reminder recall-systems, improved documentation, standing orders, immunization-only clinics, integration with statewide registry, and strategies to improve cultural competency.   

Results: To date, the partnership has achieved an overall increase of 12.6% for annual flu immunization rates and an increase of approximately 13% for those who have ever received a pneumonia vaccination.  Among African American adults there was a 7.7% increase in annual flu vaccination rates and a 18.5% increase in having ever received a pneumonia shot.  Among Latino/a adults, there was a 15.7% increase in annual flu vaccination rates and a 2.5% increase in pneumonia vaccination rates. Various operational changes have been implemented at the clinics to increase administration of adult immunization.

Conclusions: The AFIX intervention has resulted in increased immunization rates among African-American and Latino/a clients over the age of 50 years.  IZLAF supports the community clinics with recommendations and implementation of operational and systems changes.