Well baby examinations (WBE) and immunizations (IMZ) received according to established guidelines have been shown to be highly effective in preventing disease and identifying early problems among infants and children (American Academy of Pediatrics (AAP), 2005). Among Latinos, however, social, economic, and ethnic disparities reduce access to health care, and these disparities are especially great for infants and children. Several studies have documented that infants of low income, less acculturated Latino mothers may not receive adequate preventive health care and have unacceptable rates of preventable diseases (Flores, Abreu, Olivar, & Kastner, 1998; Flores, et. al, 2002; Gundelman, English, & Chavez, 1995). The purpose of this study is to assess the effectiveness and feasibility of a relatively low-cost intervention, using primarily lay health advisors (LHAs), to improve the use and timeliness of WBE and IMZ by low-income, foreign-born Latino mothers.
Specific aims : Following AAP guidelines for the standard schedule of WBE and IMZ infant visits at two-, four-, and six-months of age, the proposed study will deliver by phone to the intervention group at three time points WBE/IMZ care reminders, problem assessment, and problem solving, and will: 1. Examine the effects of the intervention on mothers achieving three WBE and IMZ visits within two weeks of recommended age. We hypothesize that those mothers receiving the intervention will be more successful at on-time achievement of the WBE and IMZ visits than controls, over the three time points of the intervention. 2. Within the intervention group, explore the relationship between the predisposing, migration, enabling, and need factors of mothers who respond and those who do not respond to the intervention. 3. Within the intervention group, explore the relationship between the predisposing, migration, enabling, and need factors of mothers and the intervention intensity; that is: the number of problems each mother notes that limit her ability to achieve timely WBE and IMZ for their infants and the total time spent by the LHA assisting the mother. 4. Describe the feasibility of delivering this intervention principally by LHAs to Latino mothers. The study data will inform the development of an R01 proposal that will, using a larger sample, more comprehensively examine the effectiveness of the intervention and build predictive models indicating which mothers are most likely to need and benefit from the intervention. A long-term goal is to develop culturally appropriate and cost-effective interventions that increase health care access for Latinos. The purpose of this study is to assess the feasibility and effectiveness of a relatively low-cost intervention, using primarily lay health advisors (LHAs), to improve the use and timeliness of well baby examinations (WBE) and immunizations (IMZ) by low-income, foreign-born Latino mothers. Following American Academy of Pediatrics 2005 guidelines for the standard schedule of WBE and IMZ infant visits at 2, 4, and 6 months of age, the study will deliver by phone to the intervention group, two weeks prior to each expected infant examination, appointment reminders, problem assessment, and problem solving. ? ? ? ?
