BACKGROUND:
Assessment, feedback, information, and exchange (AFIX) improves medical provider vaccination coverage rates. The Centers for Disease Control and Prevention (CDC) recommends that federally funded immunization programs (grantees) conduct annual AFIX site visits to 25% of clinics participating in Vaccines for Children (VFC).

OBJECTIVE:
Understand how grantees use AFIX funds and determine what factors influence assessment completions.

METHOD:
2000/2001 CDC program funding records were compared with immunization program self-reported data of completed assessments. A Poisson model was estimated to evaluate factors influenced completed assessments.

RESULT:
There was an extremely wide spread in per-assessment spending, i.e. 2000 federal spending ranged from $81 to $174,926. Median funding was $106,551 in 2000 and $266, 387 in 2001, far less than average funding. Numbers of completed assessments increased 30% with a 10% increase in FTEs and 8% when there was a 10% increase in AFIX site-visits combined with VFC site visits. Funding per-child was significant in explaining numbers of completions.

CONCLUSION:
The wide spending range indicates that assessment work practices and funding formulas may need standardization. Grantees should administer AFIX in conjunction with other VFC site visits. Grantee funding increases supporting hiring more FTEs may result in increased assessment completions.

LEARNING OBJECTIVES:
To understand how AFIX funding is used. Learn recommendations to develop guidelines to standardize the assessment process.