Are immunizations an incentive for well-child visits?
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.
Hughart
N
N
Department of Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA. nhughart@phnet.sph.jhu.edu
Vivier
P
P
Ross
A
A
Strobino
D
D
Holt
E
E
Hou
W
W
Guyer
B
B
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