title: Are immunizations an incentive for well-child visits?
abstract: OBJECTIVE
  To assess the beliefs of parents and the visit patterns of their children to determine whether immunizations act as an incentive to use well-child care.
  
  
  METHODS
  Medical record audits provided data on immunizations and well-child visits. Two questions from a parent interview were used to identify 4 groups of parents: (1) motivated and (2) unmotivated to keep a well-child care appointment regardless of whether immunizations are scheduled, (3) vaccine-motivated and (4) checkup-motivated (parents who were influenced negatively by the prospect of receiving vaccinations). The percentage of children with a visit at each age window for well-child visits and the percentage up-to-date for their immunizations at given ages were compared across the 4 groups. The 4 groups were also compared for other parental attitudes about immunizations and well-child visits, and on sociodemographic and access characteristics.
  
  
  RESULTS
  Most (73.3%) of the 502 parents surveyed were classified as motivated and 5% as unmotivated to keep a well-child care appointment regardless of whether an immunization was scheduled. Only 18.3% were categorized as vaccine-motivated and 3.4% as checkup-motivated. For all 4 groups, there was no discernible difference in attendance between immunization and nonimmunization visits. Attendance in the windows for well-child visits and percentage of children up-to-date on immunizations declined with increasing age.
  
  
  CONCLUSIONS
  In this inner-city population, attendance patterns at visits did not support the incentive hypothesis. This finding should reassure clinicians that providing immunizations outside of regular well-child care visits will not necessarily decrease attendance at visits for well-child care.
authors.affiliation: Department of Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA. nhughart@phnet.sph.jhu.edu
authors.forename: N
authors.initials: N
authors.lastname: Hughart
authors.forename: P
authors.initials: P
authors.lastname: Vivier
authors.forename: A
authors.initials: A
authors.lastname: Ross
authors.forename: D
authors.initials: D
authors.lastname: Strobino
authors.forename: E
authors.initials: E
authors.lastname: Holt
authors.forename: W
authors.initials: W
authors.lastname: Hou
authors.forename: B
authors.initials: B
authors.lastname: Guyer
mesh_terms: D015142:Baltimore; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D006801:Humans; D007114:Immunization; D007223:Infant; D009042:Motivation; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014505:Urban Population