What mothers in the Women, Infants, and Children (WIC) program feel about WIC and immunization linkage activities. A summary of focus groups in Wisconsin.

BACKGROUND: Although studies indicate that strategies to improve immunization coverage among preschool-age children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are effective, the attitudes of parents of children enrolled in WIC toward the linkage between WIC and immunization programs is unknown. OBJECTIVE: To gain a better understanding of how parents using WIC resources feel about the association of WIC and immunization services, their attitudes toward WIC immunization activities, factors that may cause clients to drop out of the program, and the effects of racial background on parent attitudes. PARTICIPANTS AND METHODS: We conducted 8 focus group sessions with mothers whose children receive WIC services in Milwaukee, Wis. Mothers were between 18 and 35 years old, with at least 1 child between 6 and 24 months of age. The 47 mothers participating were each assigned to 1 of 8 focus groups, including 2 groups each of Asian, white, African American, and Hispanic mothers. A systematic content analysis was conducted for themes and key points within and across ethnic groups. RESULTS: Socially disadvantaged mothers reported their overall experiences in WIC to be very positive. Lengthy waiting time during a WIC visit was identified as the most important barrier to participation. Mothers believed strongly that it was the responsibility of parents to get their children vaccinated, but that WIC staff and the primary care provider should work together to remind parents when vaccinations were due. Mothers expressed very positive attitudes toward the linking of WIC and immunization activities. Telephone reminders and education were mentioned as the best ways to encourage mothers to get their child vaccinated on time. Immunization linkage activities and the requirement that a parent report to a WIC center more frequently if the child was underimmunized were not mentioned as reasons for dropping out of the WIC program; indeed, more frequent visits to a WIC center were actually viewed as a potentially effective strategy by several mothers. Some mothers found obtaining immunizations and WIC services at the same time and place to be very convenient. There did not seem to be any significant differences among ethnic groups in attitudes toward immunization linkage activities being performed in WIC. CONCLUSIONS: Mothers with preschool-age children enrolled in WIC feel that the linkage of immunization activities with WIC services is a helpful way to improve the health of their children. This linkage was not identified as a contributing factor for leaving the WIC program.

A technology transfer model for effective HIV/AIDS interventions: science and practice.

The widespread use of effective, science-based interventions to motivate and sustain behavior change provides an important approach to reducing the spread of HIV. The process of disseminating information about effective interventions and building capacity for implementing them in field settings must be improved, however. Starting with a review of diffusion of innovations and technology transfer literature, we offer a technology transfer model for HIV interventions. We identify participants and activities directed toward the use of effective interventions by prevention services providers (e.g., health departments and community-based organizations) in each phase of technology transfer: preimplementation, implementation, and maintenance and evolution. Preimplementation activities focus on selecting an intervention and preparing for implementation. Implementation activities include initial implementation and process evaluation. Maintenance and evolution are ongoing with continued support for and evaluation of the intervention. This article takes the perspective of providers. Other perspectives are presented elsewhere in this issue.

Strengthening HIV prevention: application of a research-to-practice framework.

As the HIV epidemic continues to affect at-risk and vulnerable populations, providers strive to improve prevention programs, in part by seeking new interventions with greater effects. Although interventions with scientific evidence of effectiveness are vital to this effort, many challenges limit access to research products. We examine key challenges and offer a framework for moving research to practice, one in which research steps are linked to practice steps and all these activities take place in a complex and dynamic environment. The Replicating Effective Programs (REP) project of the Centers for Disease Control and Prevention and other technology transfer activities illustrate the operation of this framework for HIV prevention. Further actions to improve technology transfer are called for. These include reducing time from study design to practice; learning from field-based implementations; providing guidance about fidelity to, and tailoring of, science-based interventions; improving linkages among consumers, providers, and researchers; and seeking additional resources.