224443 Role of provider's perceptions on immunization in a minority prenatal Medi-Cal population in Los Angeles County

Sunday, November 7, 2010

Navdeesh Sidhu, MPH , School of Medicine, University of California, San Diego, La Jolla, CA
Diana E. Ramos, MD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Joanne Roberts, RN, BS , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Cynthia Harding, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Background: Research has shown that provider recommendations influence patients' decisions to obtain immunizations. Latinos have typically been more receptive to provider recommendations than other minority patient populations, such as African-Americans.

Objective: To assess providers' perception of probable immunization behaviors among minority populations and the role provider bias may play in immunization trends.

Methods: A 10-item electronic survey on demographics, perceived barriers to vaccination and providers' perceptions of patients' willingness to vaccinate was sent to 381 Comprehensive Perinatal Service Program providers in Los Angeles County. Responses were collected electronically over 10 days and analyzed using descriptive and inferential statistics.

Results: Eleven percent of providers completed the survey (43/381). Twenty-one percent (9/43) did not provide any immunizations and the rest offered at least one. The patient population was made up of Latinos (76%), Caucasians (8%) and African-Americans (7%). Physicians perceived Latinos more likely to obtain vaccinations (89% either likely or very likely) compared to African-Americans/Caucasians (75%). Twenty-six percent of providers (11/43) specifically rated Latinos more likely to obtain vaccinations than African-Americans.

Conclusion: Provider biases of patients' probable immunization behaviors may impact the clinical approach to vaccinations by playing a role in vaccine purchase and storage, counseling, and offering. The provider's approach, in turn, impacts patients' final immunization practices. Consistently lower rates of immunization among African-Americans may be influenced by provider behaviors towards different patient populations, and thus, the role of physician bias needs to be further explored and understood as a potential cause of perpetuating known racial/ethnic immunization disparities.

Learning Areas:
Clinical medicine applied in public health
Diversity and culture

Learning Objectives:
1. Assess current immunization practices among obstetric Medi-Cal providers in Los Angeles County. 2. Describe the possible role of provider bias in immunization disparities among different patient populations.

Keywords: Immunizations, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical student who is actively involved in public health research and programs on improving healthcare provided by obstetric providers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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