Factors that affect influenza vaccine uptake among staff of long-term care facilities.

A survey of directors and employees of 36 long-term care facilities in Hesse, Germany, revealed that influenza vaccine uptake among staff was less than 30% in 30 and greater than 50% in 6. The study identified policies and practices associated with vaccination uptake at long-term care facilities and factors associated with the decision of staff to get vaccinated.     

Parental knowledge, attitudes, and demand regarding a vaccine to prevent varicella.

BACKGROUND: Maintenance of high immunization rates is challenged by frequent changes to the recommended immunization schedule. This study assessed parent-reported knowledge of, attitudes about, and demand for a new vaccine against varicella. METHODS: Six months following licensure of the varicella vaccine, a cross-sectional study was conducted by mailed survey among a sample of parents of 23- to 35-month-old children. Effective response rate was 65%. RESULTS: Three quarters of parents had heard about the vaccine to prevent varicella. The lay media was the most frequently mentioned source of information. Thirteen percent of parents had already obtained the vaccine for their child, another quarter planned to get it, and one half were undecided. The most frequently cited factor influencing parents who had obtained or intended to obtain the vaccine was their doctor's recommendation. For those undecided or not inclined to get the vaccine, insufficient information about the vaccine was the most frequently listed factor. CONCLUSION: Publicizing a new vaccine through the media may be effective in raising public awareness, but detailed information about the vaccine and the recommendation of providers is still important in a parent's decision about the vaccine for their child.     

Knowledge,attitudes and beliefs related to seasonal influenza vaccine among pregnant women in Thailand

BackgroundIn 2009, Thailand recommended pregnant women be prioritized for influenza vaccination. Vaccine uptake among Thai pregnant women is lower than other high-risk groups.MethodsDuring December 2012–April 2013, we conducted a cross-sectional survey of a convenience sample of Thai pregnant women aged ≥15 years attending antenatal clinics at public hospitals in 8 of 77 provinces. A self-administered questionnaire covered knowledge, attitudes, and beliefs related to influenza vaccination using the Health Belief Model. We examined factors associated with willingness to be vaccinated using log-binomial regression models.ResultsThe survey was completed by 1031 (96%) of 1072 pregnant women approached. A total of 627 (61%) women had heard about influenza vaccine and were included in the analysis, of whom 262 (42%) were willing to be vaccinated, 155 (25%) had received a healthcare provider recommendation for influenza vaccination and 25 (4%) had received the influenza vaccine during the current pregnancy. In unadjusted models, high levels of perceptions of susceptibility (prevalence ratio [PR] 1.5, 95% CI 1.2–2.0), high levels of belief in the benefits of vaccination (PR 2.3, 95% CI 1.7–3.1), moderate (PR 1.7, 95% CI 1.2–2.3) and high (PR 3.4, 95% CI 2.6–4.5) levels of encouragement by others to be vaccinated (i.e., cues to action) were positively associated with willingness to be vaccinated. Moderate (PR 0.5, 95% CI 0.4–0.7) and high levels of (PR 0.5, 95% CI 0.4–0.8) perceived barriers were negatively associated with willingness to be vaccinated. In the final adjusted model, only moderate (PR 1.5, 95% CI 1.1–2.0) and high levels of cues to action (PR 2.7, 95% CI 2.0–3.6) were statistically associated with willingness to be vaccinated.ConclusionCues to action were associated with willingness to be vaccinated and can be used to inform communication strategies during the vaccine campaign to increase influenza vaccination among Thai pregnant women.     

Methodologic issues regarding the use of three observational study designs to assess influenza vaccine effectiveness

BACKGROUND: Influenza causes substantial morbidity and annual vaccination is the most important prevention strategy. Accurately measuring vaccine effectiveness (VE) is difficult. The clinical syndrome most closely associated with influenza virus infection, influenza-like illness (ILI), is not specific. In addition, laboratory confirmation is infrequently done, and available rapid diagnostic tests are imperfect. The objective of this study was to estimate the joint impact of rapid diagnostic test sensitivity and specificity on VE for three types of study designs: a cohort study, a traditional case-control study, and a case-control study that used as controls individuals with ILI who tested negative for influenza virus infection. METHODS: We developed a mathematical model with five input parameters: true VE, attack rates (ARs) of influenza-ILI and non-influenza-ILI and the sensitivity and specificity of the diagnostic test. RESULTS: With imperfect specificity, estimates from all three designs tended to underestimate true VE, but were similar except if fairly extreme inputs were used. Only if test specificity was 95% or more or if influenza attack rates doubled that of background illness did the case-control method slightly overestimate VE. The case-control method usually produced the highest and most accurate estimates, followed by the test-negative design. The bias toward underestimating true VE introduced by low test specificity increased as the AR of influenza- relative to non-influenza-ILI decreases and, to a lesser degree, with lower test sensitivity. CONCLUSIONS: Demonstration of a high influenza VE using tests with imperfect sensitivity and specificity should provide reassurance that the program has been effective in reducing influenza illnesses, assuming adequate control of confounding factors.     

Knowledge, attitudes, and practices of food service staff regarding food hygiene in Shiraz, Iran.

BACKGROUND: The practice of safety measures by the food service staff in hospitals is necessary for the prevention of food-borne outbreaks. Hospitalized patients are more vulnerable to potential hazards, and neglecting these principles can lead to increased morbidity and mortality. METHODS: We assessed the knowledge, attitudes, and practices of food service staff regarding food hygiene in government and private hospitals in Shiraz, Iran. Two questionnaires were designed, one for food service staff and the other for supervisors. Thirty-one hospitals were approached, and the response rate was 99.5%. Four models were developed regarding knowledge, attitudes, and practices, and a multiple logistic regression analysis was performed. Comparison among the government and private hospitals was done. RESULTS: This study showed that personnel had little knowledge regarding the pathogens that cause food-borne diseases and the correct temperature for the storage of hot or cold ready-to-eat foods. Older personnel had better attitudes and practices. Females practiced safety measures less often than did males. Personnel working in hospitals with fewer than 300 beds also had better practices. Most of the personnel had positive attitudes, but disparity between attitude and practice was noted. CONCLUSION: There is a dire need for education and increased awareness among food service staff regarding safe food handling practices.     

Survey of NHS staff attitudes to influenza immunisation

There was a low uptake of influenza vaccination among health care workers in year 1999-2000. The study aimed to identify reasons for low uptake and to use the results to improve uptake during current and future campaigns.     

Changing house staff attitudes toward nurse practitioners during their residency training.

This study examines the hypothesis that increased physician contact with nurse practitioners (NPs) during residency training would ecourage positive house staff attitudes. House staff expectations of and attitudes toward NPs were assessed at three points during the residency. Data indicated a more positive evaluation of NPs by house staff later in the residency program, as shown by: 1) physician expectations and valuation of NPs, 2) attitudes concerning future employment of NPs, and 3) the extent and capacity of NP utilization by residents.     

Assessment of the effectiveness of the 2003-04 influenza vaccine among children and adults--Colorado, 2003

The 2003-04 influenza season was characterized by the early onset of influenza activity, reports of severe illness, particularly in children, and predominant circulation of an influenza A (H3N2) virus strain that was antigenically different from the influenza A (H3N2) vaccine strain. In 2003, a retrospective cohort study among children and a case-control study among adults in Colorado were conducted to provide preliminary data on the effectiveness of the 2003-04 influenza vaccine. This report summarizes the results of those studies, which indicated vaccine effectiveness (VE) among both adults and children, differing from results of a previous study that did not indicate effectiveness among adults.     

Experiences with influenza-like illness and attitudes regarding influenza prevention--United States, 2003-04 influenza season

Despite advances in medical treatment, influenza results in approximately 36,000 deaths each year in the United States. Vaccination has been a mainstay of influenza prevention, with annual vaccination recommended for adults and children at high risk; efforts to interrupt person-to-person transmission are also important. In October 2003, CDC recommended that health-care facilities implement a Universal Respiratory Hygiene Strategy, including providing masks or facial tissues in waiting rooms to persons with respiratory symptoms. To gather information on influenza-like illness (ILI) and attitudes regarding prevention of ILI (including use of vaccine and respiratory hygiene), CDC and 11 Emerging Infections Programs (EIPs) conducted a random-digit-dialed telephone survey of noninstitutionalized U.S. civilian adults in February 2004. This report summarizes the results of that survey, which determined that 43% of adults and 69% of children aged 6 months-17 years with ILI visited a health-care provider for the illness. Eight percent of adults with ILI reported having been asked by a health-care provider to wear a mask; 82% said they would wear a mask if requested. With the limited availability of influenza vaccine this season, the use of masks by persons with cough illnesses in health-care settings, a component of the Universal Respiratory Hygiene Strategy, might be a helpful and acceptable method for decreasing influenza transmission.     

Knowledge,attitudes, and practices regarding drug interactions among community pharmacists

Journal of Public Health - This study aimed to explore the knowledge, attitude, and practice that community pharmacists of Lebanon hold with regard to checking for drug interactions. This...     

Knowledge, attitudes and behavior regarding secondhand smoke among Asian Americans

BACKGROUND: This study seeks to measure exposure to secondhand smoke and to evaluate potential differences in knowledge, attitudes, and tolerance of secondhand smoke among subgroups of Asian Americans in the Delaware Valley region of Pennsylvania and New Jersey. METHODS: A cross-sectional study was conducted among 1374 Asian Americans, which included Chinese, Koreans, Vietnamese, and Cambodians. The sample was selected by using a stratified-cluster proportional sampling technique. Study measures included demographic variables, smoking status, exposure to secondhand smoke, and knowledge, attitudes, and behavior regarding secondhand smoke. Data were analyzed using SPSS. RESULTS: Involuntary exposure to secondhand smoke remains a common public health hazard among Asian Americans, with 38.3% reporting exposure at home and 40.3% at the worksite. Knowledge and tolerance differed significantly by ethnic groups, gender, education, and smoking status. Knowledge level had a significant effect on tolerance behavior. CONCLUSIONS: Findings indicate an urgent need for a smoke-free policy at home, in the work place, and in public areas. Tobacco prevention/intervention and cessation programs for Asian Americans should emphasize the adverse health effects of secondhand smoke and promote a smoke-free environment. Further studies are needed to explore the unexplained differences in tolerance levels regarding secondhand smoke across ethnic groups.     

Assessment of knowledge, attitudes, and practices regarding isolation precautions among Iranian healthcare workers.

We conducted a survey of 1,048 healthcare workers (HCWs) at 8 Iranian hospitals regarding knowledge, attitudes, and practices related to isolation precautions. We found 75% below acceptable safety levels. Routine handwashing before and after glove use was reported by fewer than half of the HCWs.     

Survey on use of and attitudes toward influenza vaccination among emergency department staff in a New York metropolitan hospital.

OBJECTIVE: Recognizing that the potential transmission of influenza virus would be concentrated at a hospital's primary point of entry, we determined rates of staff compliance with the influenza vaccination recommendations of the Advisory Committee on Immunization Practices (ACIP) in the Emergency Department (ED). We describe the basic knowledge concerning influenza transmission and factors influencing vaccination decisions among ED staff. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A large urban teaching hospital. Participants included ED staff, visiting professionals from other departments, and emergency medical service personnel transferring patients to the hospital. RESULTS: Of 230 surveys that were distributed, 200 were completed. One hundred one respondents (51%) were female. The overall influenza vaccination rate was 50%. Having had influenza previously was the most instrumental factor in whether or not a respondent chose vaccination (P<.001). Use of the Employees Health Services Free Vaccine Program (FVP) was a very important factor influencing whether ED staff sought influenza vaccination (P<.0001). Prior knowledge of the ACIP recommendations proved to be not statistically important (P=.03). A significant factor for respondents declining vaccination was the concern that illness could be caused by the vaccine (P<.0001). Variables such as sex of the respondents (P=.6714) and type of job (P=.3628) were not associated with vaccination. CONCLUSION: Despite ACIP recommendations, 50% of respondents did not receive an influenza vaccination. Misconceptions regarding influenza vaccine efficacy, concerns about adverse effects, and fear of contracting illness were significantly associated with noncompliance with vaccination. Variables that were important contributors to compliance with vaccination were prior influenza illness and services rendered by the FVP.     

Physician attitudes regarding cardiovascular risk reduction: the gaps between clinical importance, knowledge, and effectiveness.

Reducing risk factors for patients with vascular disease can reduce the subsequent incidence of cerebro-cardiovascular disease. While physicians have had extensive training in the importance of atherosclerotic vascular disease risk factor modification, evidence suggests that they systematically miss opportunities for clinical prevention during routine practice. The aim of this study was to identify whether physicians felt confident in their knowledge and effectiveness regarding counseling patients to reduce cardiovascular risk and to determine barriers to prevention interventions in the office setting. Surveys were mailed to 509 physicians affiliated with an academic community hospital. Nonrespondents were sent reminders and a second survey. Comparisons were made using chi-square analysis. Two hundred and five surveys were returned (40.3%). Thirty-six percent of physicians felt knowledgeable about weight management techniques, compared to 3% who were confident that they succeeded in their practice (p < 0.001). Similar patterns were found for Tobacco Cessation (62% versus 14%, p = 0.001), Alcohol Reduction (46% versus 7%, p < 0.001), Stress Management (35% versus 5%, p < 0.001), Exercise (53% versus 10%, p < 0.001), Nutrition (36% versus 8%, p < 0.001), Diabetes Management (48% versus 23%, p < 0.001), Blood Pressure Management (57% versus 43%, p < 0.001) and Lipid Management (59% versus 38%, p < 0.001). We identified a significant gap between physician confidence in their knowledge about risk factors and their effectiveness at providing counseling and obtaining results in their office. Most physicians felt that the routine office follow-up visit was an ineffective method for instituting vascular risk factor reduction. Alternate settings for risk factor reduction may be needed for improving atherosclerosis prevention.     

Confounding in evaluating the effectiveness of influenza vaccine

Confounding is a kind of bias which occurs in a research. Confounding is less frequent in randomized controlled trials (RCT) for evaluation of influenza vaccines. However, there are obstacles or difficulties in conducting RCT for evaluation of influenza vaccines, particularly, in the elderly people. Therefore, a retrospective or prospective cohort study has been primarily performed to evaluate effectiveness of influenza vaccine in elderly people. Confounding by indication or other confounding exist in most observational studies. Accordingly, at the stage of designing or analyzing a study, confounding should be controlled with a restriction, matching, stratified or multivariate analysis technique.     

Knowledge, attitudes, and screening practices among older men regarding prostate cancer

OBJECTIVES: This study determined population-based rates of reported prostate cancer screening and assessed prostate cancer-related knowledge, attitudes, and screening practices among men in New York aged 50 years and older. METHODS: Two telephone surveys were conducted. One was included in the 1994 and 1995 statewide Behavioral Risk Factor Surveillance System interviews, and the other was a community-level survey that targeted Black men (African-American Men Survey). Prevalence estimates were computed for each survey, and prostate cancer screening practices were assessed with logistic regression models. RESULTS: Overall, fewer than 10% of the men in each survey perceived their prostate cancer risk to be high; almost 20% perceived no risk of developing the disease. Approximately 60% of the men in each survey reported ever having had a prostate-specific antigen (PSA) test. In both surveys, physician advice was significantly associated with screening with a PSA test or a digital rectal examination. Also, race was significantly associated with screening in the statewide survey. CONCLUSIONS: Many New York men appear to be unaware of risk factors for prostate cancer. However, a substantial percentage reported having been screened for the disease; physician advice may have been a major determining factor in their decision to be tested.