Use of an inner-city well-baby clinic.

This prospective, longitudinal investigation examined factors that influenced the use of well-baby services among a low-income, minority, high-risk group. The health belief model was used as the theoretical framework. Data were collected from 44 primiparous, black mothers attending an urban maternalchild health care clinic by interviews at the first and sixth months after the birth of their infants. Analysis focused on the cues component of the model and explored the kinds of cues that influenced the mothers to bring their babies to the well-baby clinic. One important finding was that for mothers influenced by health information from radio or television, FYI commercials on television were most often reported. Cecilia E. Dowkinr, Ph.D., R.N. is AJsirlnnl Professor in Community Health Nursing of the Universiry of Michigan School of Nursing, Ann Arbor, Michigon. Noom' E. Ervin, Ph.D., R.N. is Assistant Professor in Public Heolth Nursing ot the College of Nun@ Univenity of Illinois, Chicogo, Illinois. ApprecWn is expressed to the Chicago Deportment of Heolth for their cooper&.on with this reseorch. Address correspondence to Cecilia E. Dawkins, Ph.D., R.N., University of Michigan Shoo1 of Nursing, Community Health Nursing, 400 N o h Ingalk, Room 3187, Ann Arbor, MI 481094486. Telephone (313) 747-0341. As part of a study done to investigate mothers' health beliefs and their use of well-baby services, variables thought to result in their actual attendance to the clinic were explored. This paper examines factors that appear to have motivated 44 mothers to bring their babies to a well-child clinic for their oneand six-month visits. Well-baby services include physical examination, immunizations, growth and development screening, counseling, and referral for appropriate special services. The benefits of these services include early detection of health and related problems (e.g., developmental, behavioral) and fostering of good health practices to promote optimum levels of wellness. Health personnel in well-child and community-oriented facilities devote much attention to the development of good health-maintenance practices among family members. Community health nurses in particular emphasize to new mothers the importance of regular well-baby clinic visits and obtaining immunizations. Nurses find, however, that clients, especially those from poor and minority groups, frequently do not make appointments or fail to keep those made. These kinds of client behaviors contribute to the frustration of community health nurses and the apparent ineffectiveness of nursing interventions. More effective models for nursing interventions could assist with the problem of inadequate health supervision of children. A Health Resources Administration report indicated that nonwhites have lower immunization levels than whites for polio, measles, rubella, and diphtheria-typhoidpertussis (Rudov & Santangelo, 1979). Also, data from the 1982 National Access Survey supported by the Robert Wood Johnson Foundation (1983) revealed that while poor Americans have more physician visits per year than the nonpoor (5.9 versus 4.7), this is partially because of their poorer health status. The survey further stated: