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AFIX Resources for Grantees

AFIX Logic Model

This EXAMPLE of a grantee-perspective AFIX logic model [13 KB, 1 page] can be used by grantees for planning and evaluating their AFIX activities. We encourage grantees to update this sample to match the context and attributes specific to their AFIX program. We strongly encourage grantees to gain stakeholder input – for updating as well as utilization of the logic model – because it helps build a shared understanding and agreement about the program and it’s goals and objectives.

For specific questions about AFIX, please contact the AFIX Lead at wgn5@cdc.gov

For specific questions about logic models, please email the Immunization Program Evaluation Workgroup at IPE@cdc.gov or visit the group’s website.

Gaining Buy-In

Buy-in is the enthusiastic support and engagement of, not merely compliance with, the AFIX process. The most logical, best researched and widely documented strategies to improve vaccination practices are unlikely to succeed unless there is buy-in from the providers. Providers are barraged with auditors, consultants, patient advocates, safety committees, licensing agencies and enforcers of local ordinances. You can either compete for attention within this pool of ‘regulators’ or you can be valuable allies in helping the provider accomplish a mutual goal: providing all recommended vaccinations for all eligible children.

The document here describes effective and ineffective ways of gaining practice buy-in and ways to answer some common questions.

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Measuring and Discussing Process vs. Outcomes

Effective AFIX measurements and effective Feedback discussions focus more on processes (missed opportunities, etc.) than outcomes (up-to-date rates). While both are important, real improvement will likely not occur until the Feedback and the measurements focus on the direct and every-day indicators of care. Improving processes will improve both the systems and the outcomes.

This handout provides more about the risks of focusing solely on up-to-date rates or outcomes and the benefits to focusing on processes.

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Feedback

It is best to think of the AFIX collaboration between a provider and grantee site visit staff as a learning experience for both parties. The grantee brings objective knowledge about the VFC/AFIX Program procedures as well as qualitative knowledge, such as how to improve vaccination strategies, to the collaboration. The provider brings objective knowledge about their clientele as well as the business conditions under which they are operating that may pose a challenge to vaccinating.

The idea that AFIX is a learning collaborative very much fits into the concept of a "Quality Circle"

Feedback, as a learning collaboration, should provide:

  • Information that is timely about what was observed or recorded
  • Guidance as to how performance can be improved
  • Specifics rather than broad-ranging comments
  • Examples and models showing what can be improved and how
  • A valuing of provider work
  • Time for providers to act upon advice
  • Benefits of proposed changes
  • Forward-leaning direction about what can be done rather than what was done
  • Engagement of the provider in developing the action plan
  • “Tools” that can be used for implementing the agreed upon action plan

The document here describes effective and ineffective ways of providing Feedback and answers to some common questions.

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