title: Texas physician immunization practices.
abstract: BACKGROUND
  Immunization levels among young children could be improved if physicians administered immunizations at both well and urgent visits, provided simultaneous vaccinations, and knew the guidelines on valid contraindications, part of the Standards for Pediatric Immunization Practices (Standards). We report on a survey measuring the immunization knowledge and practice of Texas pediatricians, family practitioners, and general practitioners.
  
  
  METHODS
  A survey was mailed to a random sample of physicians. Questionnaire items covered 8 of the 18 Standards.
  
  
  RESULTS
  The response rate was 62% (608 of 976 eligible physicians). The mean summary adherence-to-Standards score was 4.1 for pediatricians, 3.6 for family practitioners, and 3.0 for general practitioners. Specialty and practice location were significant predictors of the summary score, whereas gender, managed-care participation, and graduation year were not.
  
  
  CONCLUSIONS
  Our study results suggest that in Texas, pediatricians and rural physicians most often adhere to the Standards. Improving the reimbursement level of administrative costs for immunization delivery, educating physicians on the Standards, and encouraging the use of patient immunization tracking systems are actions that could potentially improve immunization rates.
authors.affiliation: Associateship for Disease Control and Prevention, Texas Department of Health, Austin 78756, USA. richann.roche@tdh.state.tx.us
authors.forename: R A
authors.initials: RA
authors.lastname: Roche
authors.forename: D M
authors.initials: DM
authors.lastname: Simpson
authors.forename: L
authors.initials: L
authors.lastname: Suarez
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D007114:Immunization / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011365:Professional Practice Location / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013781:Texas