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Community Clinical Linkages


A Status Report from 1996–2004: Are More Effective Immunization Interventions Being Used in the Women, Infants, and Children (WIC) Program?

Since 1998, the CDC has monitored the WIC/immunization linkages assessment and referral (with and without the more aggressive strategy of monthly voucher pickup, client outreach and tracking, and parental incentives) and three other immunization supporting activities (computerized systems to assess immunization status, collocation of WIC and immunization services, and coordination of WIC and immunization services). Through an annual survey of state immunization and WIC programs, the authors conducted a trend analysis for the years 1998 through 2004 to determine changes in the use and frequency of WIC/immunization linkage activities.


Predictors of Oral Health Counseling by WIC Providers

The authors assessed selected predictors for the inclusion of oral health counseling by Illinois WIC providers. The results suggested that when WIC providers had some oral health training, they were more likely to provide counseling about dental disease and its prevention.


Reducing Disparities in Dental Care for Low-Income Hispanic Children

This study used a social ecological model to examine the influences of sociodemographic factors, mothers; attitudes, financial barriers, and the healthcare delivery system on the use of dental services for 4- to 8-year-old Hispanic children. The results showed that initiating dental care during the preschool years was significantly related to the mothers; beliefs and their social networks ; beliefs in the value of preventive dental care. In addition, extended clinic hours increased the likelihood of returning to the dentist. Provider availability, dental insurance, and family income were related to frequency of planned visits.


Determinants of Dental Referral Practices among WIC Nutritionists in North Carolina

The purpose of the study was to examine the effects of knowledge and confidence on dental referral practices among WIC nutritionists in North Carolina. The study showed that the more confident WIC nutritionists felt about their ability to assess oral health risk, the more likely they were to make dental referrals. Because a child's first point of contact with a health professional is frequently at a WIC clinic, WIC workers might improve children's access to dental care, by providing screenings and referrals.


Underimmunization in Chicago Children who Dropped Out of WIC

This retrospective cohort study determined whether children who remained active at WIC immunization-linked sites after their first birthday were more likely to be immunized by ages 19 months and 25 months than those who had dropped out. The study concluded that children who participated in WIC were more likely to be immunized, compared with children who had dropped out of WIC.


Racial/ethnic disparities in preschool immunizations: United States, 1996 – 2001

The authors analyzed current racial and ethnic differences in immunization coverage rates among US preschool children. During the 6-year study period, the immunization coverage gap between white and black children widened by an average of 1.1% each year, and the gap between white and Hispanic children widened by an average of 0.5% each year. The gap between white and Asian children narrowed by an average of 0.8% each year.


Improving Client Provider Communication: Evaluation of a Training Program for Women, Infants, and Children (WIC) Professionals in New York State

This study evaluated an intensive 1-day training program to improve the growth monitoring counseling skills of WIC providers.  The researchers; patient-centered approach focused on a seven-step technique that emphasized eliciting the clients perspective on the child's health and negotiating follow-up strategies. Study results suggested that counseling skills of non-physician health providers could change after a 1-day focused training: Providers were more client centered in their discussions. Limitations and implications of the study were also discussed.


Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

This study examines coverage rates and factors associated with underimmunization at 3 months of age in four medically underserved areas. Vaccination coverage levels at 3 months of age varied across sites: They were 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in rural Colorado. Among children who were not up to date, the majority (65.7% to 71.5%, per site) had not received vaccines because of missed opportunities.