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The study examined experiences of mothers and health care providers with preventive child health care services using qualitative methods at a primary care clinic located in transitional housing for homeless families in an urban community with predominantly Black American residents. Participants were 20 mothers and 4 health care professionals. Three major domains emerged: (a) the infrastructure of the clinic and health care delivery poses barriers to mothers' access and use of services for their children; (b) specialized, biomedical-driven care produces fragmented care delivery not responsive to the comprehensive nature of problems of mothers and their children; and (c) organizational strategies for improving access and use of health care services are directed by health care providers' value orientations. Findings support existence of infrastructural characteristics of the health care system that maintains differential value orientations and power structure, and care delivery processes that are nonresponsive to racially diverse and poor mothers. [ABSTRACT FROM AUTHOR]

Focusing on a joint effort of the Texas Department of Health and the Texas Department of Human Services, this study examined the interagency implementation of maternal and infant health policy in the state. Thompson's typology of implementation[SUP(1)] was integrated with the Montjoy and O'Toole[SUP(2)] model of overhead influence on intraorganizational factors in public policy implementation for analysis. The findings provide some support to the Montjoy and O'Toole model.[SUP(3)] The data suggested Type A [ABSTRACT FROM AUTHOR]