title: Failure to return: parental, practice, and social factors affecting missed immunization visits for urban children.
abstract: OBJECTIVE
  To assess parental, practice, and social factors associated with missed immunization visits by young, urban children.
  
  
  METHODS
  Parents of children ≤ 36 months(n = 705) were surveyed. The primary outcome was missed immunization visit, by parental report. Key parent, practice, and social factors were assessed using hierarchical logistical regression. Results. Families were predominantly Latino and publicly insured. Parents who rescheduled (adjusted odds ratio [AOR] = 3.27; 95% confidence interval [95% CI] = 1.76-6.09) or had problems scheduling appointments (AOR = 4.00; 95% CI = 1.49-10.75) were more likely to miss an immunization visit, as were those with vaccine safety fears (AOR = 3.76; 95% CI = 1.23-11.5) or more limited communication with their provider (AOR = 2.38; 95% CI = 1.05-5.36). Having friends and families with positive immunization views was protective (AOR = 0.030; 95% CI = 0.002-0.41).
  
  
  CONCLUSIONS
  This study highlights factors that may help urban families keep immunization visits: open communication with providers, flexibility in scheduling appointments, and individual and community education.
authors.affiliation: 1Columbia University, New York, NY, USA.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Stockwell
authors.forename: Matilde
authors.initials: M
authors.lastname: Irigoyen
authors.forename: Raquel
authors.initials: R
authors.lastname: Andres Martinez
authors.forename: Sally E
authors.initials: SE
authors.lastname: Findley
mesh_terms: D002675:Child, Preschool; D003142:Communication; D006282:Health Personnel; D006630:Hispanic or Latino; D006801:Humans; D007114:Immunization; D007115:Immunization Schedule; D016015:Logistic Models; D010290:Parents / Q000523:psychology; D014481:United States; D014505:Urban Population
keywords: access to health care; ambulatory care; vaccinations