Embed Size (px)
Citation preview
Provider and Resident Survey Results for the City and County of San Francisco
Survey commissioned by MED-Project—research independently conducted
May 2018
Table of Contents
2
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
3
Study Objectives & Methodology
StudyObjectives
Study Design
Sampling & Analysis
• San Francisco commissioned a baseline survey in November 2016. In compliance with the San Francisco Safe Drug Disposal Stewardship Ordinance, San Francisco Environment Code, Chapter 22, Division 1, Sections 2200-2219 and the San Francisco Department of the Environment Regulation # SFE-16-01-SDDSO, MED-Project commissioned a follow-up survey in early 2018 to compare any changes in results from the 2016 baseline survey.
• 1,011 residents and 311 healthcare providers were surveyed in San Francisco between January 26th and February 25th, 2018.
• Residents were surveyed via phone and web to minimize sampling bias.
• Please note that ‘Other’ and ‘Don’t know’ responses were removed from graphs throughout this report.
• The 2018 surveys were reviewed and approved by San Francisco Environment prior to administration.
• Telephone and online sampling was done at random from lists of residents and healthcare providers in San Francisco.
• When fielding was complete, the raw data was analyzed and cleaned to remove incomplete surveys. The data was then analyzed at a confidence level of 95 percent and a margin of error of 3.1 percent, which means that if the same survey was conducted 100 times, we are confident that 95 out of 100 times the results would fall within what we are reporting, plus or minus 3.1 percent.
4
Executive Summary
§ Awareness of the medicine collection program has increased by 4%. The degree of awareness has not changed.
§ Of those who are aware of the medicine collection program, 19% know a lot about it while 80% know a little.
§ Throwing unwanted or expired medicine in the trash is the most used method of disposal.
§ Most respondents from 2018 said they would use drop-off box locations for their unwanted and expired medicines if they knew where the locations were.
§ The amount of respondents who take medicine regularly has decreased from 62% in 2016 to 52% in 2018.
§ Those who take medicine regularly are 10% more likely to be aware of drop-off locations.
§ 69% of San Francisco healthcare providers are aware of medicine drop-off locations.
§ 64% encourage their patients to use drop-off locations to properly dispose of unwanted or expired medicines.
§ Almost all providers are very or somewhat likely to encourage their patients to use drop-off boxes. Awareness of drop-off locations increases the likelihood.
Providers were not asked about medicine use.
Resident Provider
Disposal Methods
Awareness
Medicine Use
Table of Contents
5
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
An increasing percentage of respondents reported using drop-off locations –from 14% in 2016 to 21% in 2018.
6
Q16: Have you used any of the following services to dispose of unwanted or expired medicines in the past year – drop-off locations.[Note: respondents could choose more than one option]Baseline Survey 2016 Q12: Have you used a designated drop-off location in San Francisco to dispose of unwanted or expired medicine in the past two years?
Overall Use of Drop-off Locations
14%
85%
1%
Yes No Don’tknow
2018n = 1,011
2016n = 1,007
21%
78%
1%
Yes No Don’tknow
Overall awareness of the drop-off program has increased slightly since November 2016.
7
Q9: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted or expired medicines at designated drop-off locations in San Francisco?Q10: About how much would you say you’ve read, seen, or heard about the opportunity to dispose of unwanted or expired medicines at designated drop-off locations in San Francisco?*Baseline Survey 2016 Q8: Have you heard, seen, or read anything recently about the opportunity to drop off unwanted and expired medicines at designated drop-off locations in San Francisco? (IF YES, ASK: “Have you hear, seen, or read a great deal or just a little?”)
2%
80%
19%
0%
73%
27%
Don't know
A little
A lot
33% 37%
67% 63%
2016 2018
2016
2018
Awareness of Drop-off Locationsn = 1,007*; 1,011
Degree of Awarenessn = 333*; 379
YesNo
YesNo
Respondents who have recently heard about drop-off locations report having used them more frequently to dispose of unwanted medicine in the past year.
8
Q9: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted and expired medicines at designated drop-off locations in San Francisco?Q16: Have you used any of the following services to dispose of unwanted or expired medicines in the past year?
4%
9%
35%
Mail-back services
Take-back events
Drop-off locations
Have recently heard about drop-off locations (n=379)
Have not recently heard about drop-off locations (n=632)
Safe Disposal Use by Awarenessn= 1,011
37%
63%
Awareness of Drop-off Locationsn = 1,011
2%
3%
13%
Mail-back services
Take-back events
Drop-off locations
Respondents who are aware of drop-off locations are more likely to agree that the program is convenient, easy to use.
9
Q17: Below is a list of words or phrases that may or may not describe of the medicine drop-off program in San Francisco. Please indicate how well you feel each word or phrase describes the medicine drop-off program.Q9: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted and expired medicines at designated drop-off locations in San Francisco?
72%75%
90%
80%
39% 38%
61%56%
Convenient Easy to Use The Right Thing to Do Public Safety
Description of Drop-off Program by AwarenessPercent of respondents who said the words ‘very well’ or ‘somewhat well’ described the medicine drop-off programn=1,011
Have recently heard about drop-off locations
Have not recently heard about drop-off locations
Most respondents from San Francisco believe the medicine drop-off program is convenient and easy to use.
10
Q17: Below is a list of words or phrases that may or may not describe of the medicine drop-off program in San Francisco. Please indicate how well you feel each word or phrase describes the medicine drop-off program.*Baseline Survey 2016 Q13:(Identical wording).Note: Only asked to those who have used a designated drop-off location
83%87%
98%
74%78%
87%
75%
Convenient Easy to Use The Right Thing to Do Public Safety
Description of Drop-off Program by YearPercent of respondents who said the words ‘very well’ or ‘somewhat well’ described the medicine drop-off program 2016
2018
N/A
n = 142*; 214n = 142*, 214 n = 142*, 214 n = 214
Most respondents remember hearing that drop-off boxes are available; almost half recall a specific location. Respondents recall more than one message.
11
Q11: In a few words of your own, what did you read, see, or hear about this subject?*Baseline Survey 2016 Q9: (Identical wording)Note: The question was asked in 2016 only allowed for one category for each response. In 2018, responses were allowed to cover more than one topic and were broader. As a result, comparisons between the two should be made with caution.
6%
7%
10%
13%
17%
42%
Not to throw them intoilet/Don't flush it/don't put
in the water
Drop-off boxes are available
Read/Heard/Saw aboutit/can't remember specific
Drop them off generally
TV/newspaper/brochure/radio
Specific Locations of drop-offboxes
Recall of Marketing Messagen = 333*; 379
20182016
6%
8%
48%
76%
Other risks of not safelydisposing of medicines
Environmental consequences ofunsafe disposal
Specific Locations of drop-offboxes
Drop-off boxes are available
Graphs display response groups >6%.
13%
18%
4%
5%
10%
14%
7%
16%
1%
17%
6%
9%
11%
14%
21%
4%
4%
4%
2%
8%
0%
12%
2%
1%
11%
4%
16%
13%
4%
26%
6%
10%
Social Media
Online / local media
Direct mail / letter
Brochures / flyers
Signs / posters
Newspapers / magazines
Radio
Television
Special events
Businesses / pharmacies
Friends / family
12
Q12: Where did you receive this information about designated drop-off locations in San Francisco?Q15: What would be your preferred method for receiving important information about how and where to dispose of unwanted or expired medicines?**N/A data labels were used for responses that appeared frequently in Q15 (preferred methods for receiving important information) but were not response options on 2016’s Q10 or 2018’s Q12.
2016 Exposuren=333
People and Events
Broadcast Media
Printed Materials
Online Resources
N/A**
Communication Channels
Exposure to messages about drop-off locations comes from a variety of sources. Respondents generally would prefer printed materials or online resources
N/A
N/AN/A
2018 Exposuren=379
2018 Preferencen=1,011
72% indicate that the communication about disposal of unwanted medicines was clear. 52% indicated that it discouraged them from disposing medicines at home.
13
Q13: Did the message(s) clearly communicate how and where to dispose of unwanted or expired medicines?Q14: Did the messages you heard discourage you from disposing of unwanted or expired medicine at home?Baseline Survey 2016 Q11: Did the messages you heard discourage you from disposing of unwanted or expired medicine at home?
Did Messages Clearly Communicate the Proper Disposal of Unwanted Medicines?
Did Messages Discourage the Disposal of Unwanted Drugs at Home?
72%
28%
44%
48%
8%
52%48%
Yes
No
Don’t know
2016n = 333
2018n = 379
2018n = 379
Table of Contents
14
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
52% of San Francisco respondents reported regularly taking medicine. This represents a 10% decrease since 2018.
15
Q18: Do you regularly take any medicines? Q19: How often do you take them?Baseline Survey 2016 Q14: (Identical wording)
62%
38%
74% 23% 86% 8%
52%47%
1%
2018n = 523
2016n = 624
2016n = 1,007
2018n = 1,011
Population Taking Medicine Regularly
Frequency Taking Medicine
Daily
Weekly
Monthly
As Needed
Yes
No
Don’t Know
Those who take medicine regularly are more aware than those who do not take medicine regularly by 10%.
16
Q9: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted and expired medicines at designated drop-off locations in San Francisco?Q18: Do you regularly take any medicines?*One respondent preferred not to answer.
42%
58%
32%
68%
Aware Not Aware
Regularly take meds
Don’t regularly take meds
Drop-off Location Awareness by Frequencyn= 1,010*
Over-the-counter medicines are the most common type, appearing in 83% of homes.
17
70%67%
19% 17%
9%
83%
72%
24% 22%
8%
Over-the-counter medicines Prescription medicines Inhalers Pet medicines EpiPens or other auto-injectors
Q20: Which of the following types of medicine do you have in your home? *Baseline Survey 2016 Q15: (Identical wording)
Types of Medicines at Homen = 1,007*, 1,011
2016
2018
30% 34% 39% 26% 23% 29%
59% 52% 53%65% 68% 57%
9% 13% 7% 9% 9% 9%Average Over-the-counter
medicinesPrescriptionmedicines
Inhalers Pet medicines EpiPens or other auto-injectors
In 2018, there was a 12% decrease in residents reporting not having unwanted or expired medicine in the home.
18
Q21: Of the following types of medicine you mentioned as having in your home, are any of them unwanted or expired?*Baseline Survey 2016 Q15: (Identical wording)
n = 836 n = 728 n = 243 n = 222 n = 82
29% 29% 33% 26% 35% 22%
71% 71% 67% 74% 65% 78%
Average Over-the-countermedicines
Prescriptionmedicines
Inhalers Pet medicines EpiPens or other auto-injectors
n = 675 n = 191 n = 171 n = 91
Unwanted or Expired Medicines at Homen = 1,007*; 1,011
2018
2016
Have unwanted or expired medicine of this type
Do not have unwanted or expired medicine of this type
Don’t know
n = 705
39%
10%
32%
20%13% 12%
40%
12%
46%
20% 21%
3%
Cured of illness Not taken as directed More than needed Changed medication Other Don’t know
For residents reporting unwanted or expired medicine at home, there was an increase in those stating that the main cause was having more than needed.
19
72%
13%3% 0%
11%
73%
22%
3% 0% 2%
A container or two Enough to fill a shoebox Enough to fill an indoorwastebasket
Enough to fill an even biggercontainer
Don't know
Q22: About how much unwanted or expired medicine do you have?Q23: Why do you have unwanted or expired medicine?*Baseline Survey 2016 Q16 & Q17: (Identical wording)
Amount of Unwanted or Expired Medicines at Homen = Not reported*; 442 2016
2018
Reasons for Unwanted Medicines at Homen = Not reported*; 442
52% of respondents haven’t gotten around to getting rid of expired medicines and 42% of respondents report saving medicines for later.
20
Q24: There are many reasons someone may keep medicines that they no longer need. Please tell me if any of the following describe why you have unwanted or expired medicine stored at home:*Baseline Survey 2016 Q18: (Identical wording)
26% 26%23%
34%
21%
52%
42%
35% 34%
20%
Haven't gotten around to it Saving for later Don't know what to do withthem
Hadn't thought about it Waiting for collection day
Reasons for Keeping Unwanted and Expired Medicinen = Not reported*; 442 2016
2018
Most San Francisco respondents would be likely to throw away their unwanted or expired medicine while 14% would use a pharmacy/drug store.
21
Q25: If you didn’t know what to do with unwanted or expired medicines, how might you dispose of them?*Baseline Survey 2016 Q19: (Identical wording)
2%
1%
3%
3%
5%
3%
11%
0%
5%
12%
51%
Take it to police station
Contact the City
Call hospital/drug store/doctor
General drop off
Take it back to a doctor, clinic, or hospital
Search the web
Take back to a pharmacy or drugstore
Don't dispose of them
Store it in your home
Flush it down the toilet
Throw it away
2%
4%
4%
6%
5%
11%
14%
4%
11%
12%
51%
Default Disposal Methodn = 1,007*; 1,011
2016 2018
Table of Contents
22
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
Throwing unwanted or expired medicine in the trash is the most used method.
23
Q26: Below is a list of potential ways to deal with unwanted or expired medicines. For each of the ways listed, please indicate how often you dispose of medicines in this way:*Baseline Survey 2016 Q20: (Identical wording)
Disposal Method FrequencyRespondents who selected all or most of the timen = 1,007*; 1,011
26%
5%
1%
14%
3% 3% 3%
32%
5% 4%
19%
5% 4% 3%
Throwing in thetrash as-is
Flushing down thetoilet
Mixing it withsomething and then
throwing it in thetrash
Medicine drop-offbox
One-day disposalevent
Mail-back envelopeor kit
Police station
2016
2018
Respondents feel like medicine drop-off boxes, one-day disposal events, mail-back envelopes and police stations are safe disposal methods.
24
18% 16% 13%
93% 85%61% 64%
Throwing in the trash as-is
Flushing down the toilet
Mixing it with something and then throwing it in the trash
Medicine drop-off box
One-day disposal event
Mail-back envelope or kit
Police station
10% 8% 8%
94% 91%69% 67%
Perceptions of Disposal Methodsn = 1,007*; 1,011
Q27: Below is the same list of potential ways to deal with unwanted or expired medicines. For each of the ways listed, please indicate if you think it is a safe way to dispose of medicines.*Baseline Survey 2016 Q21: (Identical wording)
2016
2018
Most respondents from 2018 said they would use drop-off box locations for their unwanted and expired medicines if they knew where the locations were.
25
Q28: If you knew there were drop-off boxes at a pharmacy or other location near your home in San Francisco where you could safely dispose of unwanted or expired medicines, how likely would you be to use them to dispose of your medicine?*Baseline Survey 2016 Q22 (Identical wording)
58%
28%
5% 4%
66%
27%
4% 3%
Very likely Somewhat likely Not very likely Not likely at all
Likelihood to Use Drop-Off Boxes If Awaren = 1,007*; 1,011 2016
2018
47%35%
18%
40%
34%
28%48% 46%
10%
39%32%
32%
Respondents still feel that taking unwanted medicines to a drop-box location is the most convenient disposal method.
26
Q29: Please read the list of safe ways to dispose of medicines below, and indicate how convenient each of the disposal methods are, in your opinion.*Baseline Survey 2016 Q23 (Identical wording)
Very Convenient
Somewhat Convenient
Convenience of Disposal Methodsn = 1,007*; 1,011
2016 2018
Taking it to a drop-off box location Using a pre-paid mail-back envelope or kit
Taking it to a one-day event, such as a National Drug Take-Back Day
20162018
2016 2018
16% 13%
36% 32%
26%21%
43% 46%
27
Q30: Please carefully read the list of statements about unwanted or expired medicine in your home. Please indicate your level of concern regarding each statement as it relates to unwanted or expired medicine in your home.*Baseline Survey 2016
30%24%
45% 43%
28%
24%
34% 36%
Health and Safety Concernsn = 1,007*; 1,011
In 2018, residents reported a reduction in health and safety concerns.
Extremely Concerned
Very Concerned
2016 2018
Accidental Poisonings Opportunity for Abuse Contaminationof Drinking Water
Fish/Wildlife Mutation
2016 2018
2016
20182016
2018
Table of Contents
28
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
69% of providers know about drop-off locations for unwanted or expired medicine and 64% encourage their patients to use them—55% did both.
29
Q7: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted or expired medicines at designated drop-off locations in San Francisco?Q9: Have you encouraged your patients or clients to use a designated drop-off location in San Francisco to dispose of unwanted or expired medicines in the past year?
69%
31%
64%
36%
55%
15%
10%
21%
Aware and encouraged
Aware and didn’t encourage
Not aware and encouraged
Not aware and didn’t encourage
Aware
Not aware
Encourage
Don’t encourage
Provider Awareness of Drop-off Locationsn = 311
Provider Encouragement to Usen = 311
Provider Awareness and Encouragement to Use Drop-off Locationsn = 311
92%
64%
12%
18%
19%
33%
21%
31%
5%
22%
29%
Social Media
Online / local media
Direct mail / letter
Brochures / flyers
Signs / posters
Newspapers, magazines and journals
Radio
Television
Special events
From businesses, providers, or pharmacies
From colleagues or friends or family
Providers are exposed to drop-off location information from many sources. Online resources and print media are the most common sources.
30
Q8: Where did you read, see or hear information about safe drop-off locations for unwanted or expired medicines in San Francisco?
Provider Communication Channelsn = 311
People and Events
Broadcast Media
Printed Materials
Online Resources
Most San Francisco providers believe the medicine drop-off program is convenient, easy to use, good for the environment, and increases public safety.
31
Q10: Below is a list of words or phrases that may or may not describe of the medicine drop-off program in San Francisco. Please indicate how well you feel each word or phrase describes the medicine drop-off program.*”Don’t know” has been excluded in these charts
39%46%
62% 63%
35%
32%
24% 23%
Convenient Easy to Use Environment Public safety
How Well Do Each of the Following Describe the Medicine Drop-Off Program?
n = 277 n = 284n = 271 n = 273
Very well
Somewhat well
74%78%
86% 86%
Medical practices that have been in San Francisco for more than ten years are less likely to identify flushing and trash disposal as safe.
32
Q11: Below is the same list of potential ways to deal with unwanted or expired medicines. For each of the ways listed, please indicate if you think it is a safe way to dispose of medicines.
21%17%
21%
92%
51%
84%
54%
10% 10%15%
94%
54%
88%
57%
Flushing down the toilet
Throwing in the trash as-is
Mixing it with something and then
throwing it in the trash
Medicine drop-off box
Mail-back envelope or kit
One-day disposal event
Police station
Practices present for more than 10 years n = 155
Providers Identifying Disposal Method as Safen = 311
Practices present for less than 10 years n = 156
Providers who are aware and encourage patients to use drop-off boxes are more likely to identify flushing and trash disposal as safe.
33
Q11: Below is the same list of potential ways to deal with unwanted or expired medicines. For each of the ways listed, please indicate if you think it is a safe way to dispose of medicines.Q7: Have you recently read, seen, or heard anything about the opportunity to dispose of unwanted or expired medicines at designated drop-off locations in San Francisco?Q9: About how much would you say you’ve read, seen, or heard about the opportunity to dispose of unwanted or expired medicines at designated drop-off locations in San Francisco?
22% 19%24%
92%
56%
89%
57%
7% 7%11%
94%
48%
82%
55%
Flushing down thetoilet
Throwing in thetrash as-is
Mixing it withsomething and then
throwing it in thetrash
Medicine drop-offbox
Mail-back envelopeor kit
One-day disposalevent
Police station
Providers Identifying Disposal Method as Safen = 311
Other providersn = 141
Providers aware and encouraging n = 170
Almost all providers are very or somewhat likely to encourage their patients to use drop-off boxes. Awareness of drop-off locations increases the likelihood.
34
Q12: If you knew that there were drop-off boxes at a location near your office in San Francisco where residents could safely dispose of unwanted or expired medicines, how likely would you be to ask them to use these drop-off boxes to dispose of their medicine?
77%
19%
3%0%
68%
27%
4%0%
Very likely Somewhat likely Not very likely Not likely at all
Likelihood to encourage patients to use drop-off boxesn = 311
Provider is not aware of drop-off locationsn = 141
Providers is aware of drop-off locations n = 170
Table of Contents
35
Executive Summary
Resident Awareness
General Population Medicine Use
Knowledge of Disposal Methods
Provider Awareness
Appendix - Demographics
36
Q3: Do you own or rent your place of residence?Q4: In what year were you born?Q5: For how long have you live in San Francisco?Q36: Please indicate your sex:*Baseline Survey 2016
48%52%
FemaleMale
9%18%20%15%16%21%
40+ years21 – 40 years11 – 20 years6 – 10 years1 – 5 yearsBorn andraised
47%53%8%
29%
13%16%
13%
17%
7%
22% 21% 21%
14%15%
18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65+
37%
60%
Rent Own
48%52%
9%9%12%20%19%30%
51+ years41 – 50 years31 – 40 years21 – 30 years11 – 20 years1 – 10 years
Gendern = 1,007*; 1,011
2016 2018
2016 2018
Living Situationn = 1,007*; 1,011
Agen = 1,007*; 1,011 2016
2018
2016
2018
Time in San Franciscon = 1,007*; 1,011
Appendix: Resident Demographics
37
Q32: Do you have any children under the age of 18 living at home?Q33: Are any of your children under the age of 4?Q34: Are any of your children teenagers?
25%75%
42%58%
33%
67%
Yes No
Children Under 18 at Homen = 1,011
Teenagersn = 256
Under Age 4n = 256
Appendix: Resident Demographics
38
Q31: Do you have any pets?Q35: Which of the following categories best describes your annual household income before taxes in 2016?
10%
28%
16%
11%
14%
8%
7%
6%
Prefer not to answer
$150,000+
$100,000–$149,999
$80,000–$99,999
$50,000–$79,999
$35,000–$49,999
$20,000–$34,999
Less than $20,000
42%
58%
Has pets
Does not have pets
Household Incomen = 1,011
Appendix: Resident Demographics
Petsn = 1,011
39
Q6: With which racial or ethnic group do you identify?Q7: Would you consider yourself to be of Russian decent? (If White or Caucasian was selected in Q6)Q8: More specifically, would you say that you are: (If Asian or Pacific Islander was selected in Q6)
52%
30%
10%
6%
2%
White or Caucasian
Asian or Pacific Islander
Latino or Hispanic
African-American or Black
Other ethnic or racial background
11%
88%
63%
11%6% 5% 4% 4% 4% 4%
Chinese Filipino Indian Vietnamese Mixed Race Japanese Korean Other
Russian descent
Not of Russian Descent
Don’t know
Race and Ethnicityn = 1,011
Appendix: Resident Demographics
Russian Descentn = 527
Asian Ethnicitiesn = 306
40
Q6: With which racial or ethnic group do you identify?Q7: Would you consider yourself to be of Russian decent? (If White or Caucasian was selected in Q6)Q8: More specifically, would you say that you are: (If Asian or Pacific Islander was selected in Q6)
52%
30%
10%
6%
11%
88%
2%
Russian Descent
Not of Russian Descent
Don't know
4%
4%
4%
4%
5%
6%
11%
63%
Japanese
Korean
Other
Mixed Race
Vietnamese
Indian
Filipino
Chinese
Race and Ethnicityn = 1,011
Appendix: Resident Demographics
Russian Descentn = 527
Asian Ethnicitiesn = 306
White or Caucasian
Asian or Pacific Islander
Latino or Hispanic
African-American or Black
Other ethnic or racial background
41
Q4: How long has your practice been in San Francisco?Q5: On average, how many patients or clients does your practice serve on a daily basis?Q6: In what languages does your practice offer services?
50%45%
5%
More than 10 years2-10 yearsLess than 2 years
52%
24%
5%9% 11%
0 – 25 26 – 50 51 – 75 76 – 100 101 or more
98%
60%
27% 27%17% 17%
English Spanish Cantonese Mandarin Tagalog / Filipino Russian
Languages Offeredn = 311
Appendix: Provider Demographics
Patients Served per Dayn = 311
Practice Time in San Franciscon = 311
