Journal of Immigrant and Minority Health

, Volume 16, Issue 5, pp 839–845

Assessing Adherence to Accepted National Guidelines for Immigrant and Refugee Screening and Vaccines in an Urban Primary Care Practice: A Retrospective Chart Review

  • Barbara Waldorf
  • Christopher Gill
  • Sondra S. Crosby
Original Paper

DOI: 10.1007/s10903-013-9808-6

Cite this article as:
Waldorf, B., Gill, C. & Crosby, S.S. J Immigrant Minority Health (2014) 16: 839. doi:10.1007/s10903-013-9808-6


In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.


Practice guidelines Immigrant and refugee health Screening Provider adherence 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Barbara Waldorf
    • 1
  • Christopher Gill
    • 1
  • Sondra S. Crosby
    • 2
    • 3
  1. 1.Department of International HealthBoston University School of Public HealthBostonUSA
  2. 2.Department of MedicineBoston University School of MedicineBostonUSA
  3. 3.Department of Health Law, Bioethics and Human RightsBoston University School of Public HealthBostonUSA

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