A decade after the promulgation of universal screening guidelines, IPA screening practices were found to differ from recommended protocols. The evidence to date indicates that patients are not generally being screened for IPA. Provider training was the most commonly investigated influence on IPA screening. Health-care providers who had IPA training were significantly more likely to screen for it than those who had no such training. Age and years in practice, likely proxies for training, were also associated with screening practice; older providers were less likely to screen for IPA than younger providers. Training alone, however, has not been sufficient to cause positive change in screening for IPA. The greatest improvements in IPA screening occurred when pamphlet distribution, poster displays, and adjustments to medical charts to prompt screening accompanied training. This paper recommends that IPA training focus on clinicians-in-training. Education, feedback, and practice reinforcement are readily integrated into this stage of professional work. In addition, it is more efficient to establish desired practices early than to attempt to change the established practices of seasoned clinicians. The study further recommends that screening techniques be tailored to different practice settings and patient presentations. 6 tables and 56 references