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1.
Background
Knowledge and beliefs about influenza vaccine that differ across racial or ethnic groups may promote racial or ethnic disparities in vaccination.Objective
To identify associations between vaccination behavior and personal beliefs about influenza vaccine by race or ethnicity and education levels among the U.S. elderly population.Methods
Data from a national telephone survey conducted in 2004 were used for this study. Reponses for 3875 adults ≥65 years of age were analyzed using logistic regression methods.Results
Racial and ethnic differences in beliefs were observed. For example, whites were more likely to believe influenza vaccine is very effective in preventing influenza compared to blacks and Hispanics (whites, 60%; blacks, 47%, and Hispanics, 51%, p < 0.01). Among adults who believed the vaccine is very effective, self-reported vaccination was substantially higher across all racial/ethnic groups (whites, 93%; blacks, 76%; Hispanics, 78%) compared to adults who believed the vaccine was only somewhat effective (whites 67%; blacks 61%, Hispanics 61%). Also, vaccination coverage differed by education level and personal beliefs of whites, blacks, and Hispanics.Conclusions
Knowledge and beliefs about influenza vaccine may be important determinants of influenza vaccination among racial/ethnic groups. Strategies to increase coverage should highlight the burden of influenza disease in racial and ethnic populations, the benefits and safety of vaccinations and personal vulnerability to influenza disease if not vaccinated. For greater effectiveness, factors associated with the education levels of some communities may need to be considered when developing or implementing new strategies that target specific racial or ethnic groups. 相似文献2.
Tracy K. Richmond Jennifer L. Spadano-Gasbarro Courtney E. Walls S. Bryn Austin Mary L. Greaney Monica L. Wang Solomon Mezegebu Karen E. Peterson 《Preventive medicine》2013
Background
Prior studies have demonstrated disproportionate clustering of fast food outlets around schools.Purpose
The purpose of this study is to determine if racial/ethnic differences in middle school student self-reported sugar-sweetened beverage (SSB) consumption is explained by differential distributions of food outlets surrounding their schools.Methods
Baseline (2005) data were analyzed from 18,281 middle school students in 47 Massachusetts schools participating in Healthy Choices, an obesity prevention program. Linear mixed effects models were used to examine the association of individual race/ethnicity and daily SSB consumption and the potential mediating effect of the density of food outlets (the number of fast food outlets and convenience stores in a 1500 m buffer area surrounding the school) on this association adjusting for individual and school demographics.Results
More SSB consumption was reported by students of all racial/ethnic minority groups compared to their White peers except Asians. The density of fast food restaurants and convenience stores was not associated with individual SSB consumption (β = 0.001, p = 0.875) nor did it mediate the association of race/ethnicity and SSB consumption.Conclusions
Racial and ethnic differences in SSB consumption among MA middle school students cannot be fully explained by the location of fast food restaurants and convenience stores. 相似文献3.
Objective
Cross-sectional studies have found that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner’s vasectomy than women with higher incomes and whites. However, studies of pregnant and postpartum women report that racial/ethnic minorities, particularly low-income minority women, face greater barriers in obtaining a sterilization than do whites and those with higher incomes. In this paper, we address this apparent contradiction by examining the likelihood a woman gets a sterilization following each delivery, which removes from the comparison any difference in the number of births she has experienced.Study Design
Using the 2006–2010 National Survey of Family Growth, we fit multivariable-adjusted logistic and Cox regression models to estimate odds ratios and hazard ratios for getting a postpartum or interval sterilization, respectively, according to race/ethnicity and insurance status.Results
Women’s chances of obtaining a sterilization varied by both race/ethnicity and insurance. Among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. Privately insured whites were more likely to rely on vasectomy than African Americans and Latinas, but among women with Medicaid-paid deliveries reliance on vasectomy was low for all racial/ethnic groups.Conclusions
Low-income racial/ethnic minority women are less likely to undergo sterilization following delivery compared to low-income whites and privately insured women of similar parities. This could result from unique barriers to obtaining permanent contraception and could expose women to the risk of future unintended pregnancies.Implications
Low-income minorities are less likely to undergo sterilization than low-income whites and privately insured minorities, which may result from barriers to obtaining permanent contraception, and exposes women to unintended pregnancies. 相似文献4.
Background
Rubella remains a common disease in Mainland China and is a major cause of severe birth defects from Congenital Rubella Syndrome (CRS). Rubella-containing vaccines were not included in China's National Expanded Program of Immunization (NEPI) until December 2007. In Shenzhen, women of childbearing age make up a large percentage of its migrant factory worker population. Understanding their immunity to rubella is critical in furthering efforts towards rubella vaccination programs.Objectives
To investigate the seronegativity of rubella antibodies and evaluate potential associates of rubella immunity among female migrant factory workers in Shenzhen, China.Subjects and Methods
: Serum samples were collected from 518 female migrant workers, aged 18–55, working in 44 randomly selected factories in Shenzhen, China during May through June of 2009. Samples were tested for Rubella Immunoglobulin G (IgG) using a commercial Enzyme-linked immunosorbant assay kit. Self-reported vaccination histories and socio-demographic information were also collected.Results
Of 518 female workers, 402 (77.6%) were immune to rubella. Significant differences in seronegativity were dependent on region of origin, being without a job contract, age group, marital status and seronegativity of measles.Conclusions
Seroprevalence of antibodies to rubella in Shenzhen, China amongst female migrant workers is too low to provide immunity in the population. Given the high numbers of women of childbearing age amongst Shenzhen migrant factory workers coming from many provinces across China, local health authorities in Shenzhen should consider combining new rubella immunization programs with existing measles immunization efforts in this population. 相似文献5.
Melissa B. Gilkey Brooke E. Magnus Paul L. Reiter Annie-Laurie McRee Amanda F. Dempsey Noel T. Brewer 《Vaccine》2014
Purpose
The success of national immunization programs depends on the public's confidence in vaccines. We sought to develop a scale for measuring confidence about adolescent vaccination in diverse populations of parents.Methods
Data came from 9623 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on a 13- to 17-year-old child in their households. We used exploratory and confirmatory factor analysis to identify latent constructs underlying parents’ responses to 8 vaccination belief survey items (response scale 0–10) conceptualized using the Health Belief Model. We assessed the scale's psychometric properties overall and across demographic subgroups.Results
Parents’ confidence about adolescent vaccination was generally high. Analyses provided support for three factors assessing benefits of vaccination (mean = 8.5), harms of vaccination (mean = 3.3), and trust in healthcare providers (mean = 9.0). The model showed good fit both overall (comparative fit index = 0.97) and across demographic subgroups, although internal consistency was variable for the three factors. We found lower confidence among several potentially vulnerable subpopulations, including mothers with lower levels of education and parents whose children were of Hispanic ethnicity (both p < 0.05).Conclusions
Our brief, three-factor scale offers an efficient way to measure confidence in adolescent vaccination across demographic subgroups. Given evidence of lower confidence by educational attainment and race/ethnicity, program planners should consider factors such as health literacy and cultural competence when designing interventions to promote adolescent vaccination to ensure these programs are fully accessible. 相似文献6.
Introduction
Arizona had the highest hepatitis A incidence of any U.S. state during 1987–1997. In 1995, the first hepatitis A vaccines became available in the U.S. A series of hepatitis A vaccination policies and recommendations were implemented in 1996–2006. Our objective was to examine the shifting epidemiologic patterns in hepatitis A in Arizona from 1988 to 2007.Methods
Passive surveillance reports to the Arizona Department of Health Services were used to compare hepatitis A rates by age, race/ethnicity and geographic area, before and after widespread vaccination. Reported risk factors and possible sources of infection were compared for two time periods. Age-adjusted incidence during three periods was mapped.Results
Overall hepatitis A incidence in Arizona fell from 58 cases per 100,000 in 1988 to 2 per 100,000 in 2007. The proportion of reported cases among children dropped from 62% in 1994–1995 to 32% in 2006–2007. Racial/ethnic disparities between American Indians and non-Hispanic White populations have been eliminated. The geographic distribution of cases within the state has shifted. Earlier cases were likely to report contact with another hepatitis A case or childcare facilities, while later cases indicated recent international travel.Conclusion
A major shift in the overall burden of hepatitis A and hepatitis A transmission has occurred in Arizona since the widespread implementation of immunization policies and the concomitant rise in vaccination rates in the state. Current transmission has shifted to older age groups and disparities by race/ethnicity are now highest in Hispanic populations. Future strategies to further reduce hepatitis A transmission may require broadening recommendations to include general adult populations without previous vaccination history. 相似文献7.
Norma Mongua-Rodriguez José Luis Díaz-OrtegaLourdes García-García Maricela Piña-PozasElizabeth Ferreira-Guerrero Guadalupe Delgado-SánchezLeticia Ferreyra-Reyes Luis Pablo Cruz-HervertRenata Baez-Saldaña Rogelio Campos-Montero 《Vaccine》2013
Objective
To evaluate the impact of rubella vaccination strategies on the rates of acquired rubella and congenital rubella syndrome in the Americas.Methods
We conducted a systematic review of the literature (MEDLINE, PubMed, EMBASE, Cochrane Library, Artemisa Database, LILACS Database, Evidence Portal, VHL-PAHO Portal, Scielo, and Grey-Literature sources) that was published from 1969–2010. We included studies on rubella incidence and seroprevalence rates that were associated with rubella vaccination. The quality of the studies was evaluated according to international guidelines.Results
A total of 14 studies were identified: 2 clinical trials, 2 cohort studies, 3 transversal studies, 5 ecological studies, and 2 mathematical models. Childhood vaccination reduced the incidence of rubella by 23.6% to 99.6%, increased the occurrence of epidemic cycles in Argentina and in the United States, and shifted the illness to susceptible adults. Vaccination strategies that focused on women and children in Brazil were associated with a 5.5-fold greater incidence of rubella in men leading to new outbreaks and CRS. A combined vaccination strategy with a universal approach that included routine vaccination for boys, girls, women, and men in Mexico and in Costa Rica reduced the incidence of rubella by more than 98% and led to absence of CRS since 2008. A medium and a low risk of bias were found in 3 and 4 articles, respectively.Conclusion
The results of this review demonstrate that the combined vaccination strategy with a universal approach was the most effective strategy as evidenced by a drastic reduction in the number of cases and the interruption of endemic transmission of rubella in the Americas. 相似文献8.
Objective
To describe the epidemiology of congenital rubella infections notified to the Australian Paediatric Surveillance Unit (APSU) from 2004 to 2013 and compare that with previously published APSU data for 1993–2003.Methods
Active national surveillance for congenital rubella infection has been conducted through the APSU since 1993. Monthly reporting by child health clinicians according to pre-defined case criteria triggers requests for clinicians to provide de-identified clinical, epidemiological, and laboratory information. Data were extracted for cases reported between January 2004 and December 2013 and compared with previous years.Results
Five cases of confirmed congenital rubella infection were identified during the reporting period. All five infants had defects consistent with congenital rubella syndrome (CRS). Four of the infants were born in Australia during the study period, and all were born to mothers born overseas. Three of the five mothers had not had rubella vaccination, and in two vaccination status was unknown, although both were from countries without routine rubella immunization programmes. Since 1993, there have been 57 notifications of congenital rubella infection to the APSU; 40 of these infants were born between January 1993 and December 2013, of whom 34 had confirmed CRS.Conclusions
Congenital rubella infection in Australia is predominantly among children born to unimmunized immigrant mothers. Migrant women born in rubella endemic countries without routine immunization remain an important group to target for vaccination. Rubella-susceptible women, especially those in the early stages of pregnancy, should also carefully consider the risks of travelling to rubella endemic countries. 相似文献9.
Policy Points:
- Racial/ethnic differences in the overuse of care (specifically, unneeded care that does not improve patients’ outcomes) have received little scholarly attention.
- Our systematic review of the literature (59 studies) found that the overuse of care is not invariably associated with race/ethnicity, but when it was, a substantial proportion of studies found greater overuse of care among white patients.
- The absence of established subject terms in PubMed for the overuse of care or inappropriate care impedes the ability of researchers or policymakers to synthesize prior scientific or policy efforts.
Context
The literature on disparities in health care has examined the contrast between white patients receiving needed care, compared with racial/ethnic minority patients not receiving needed care. Racial/ethnic differences in the overuse of care, that is, unneeded care that does not improve patients’ outcomes, have received less attention. We systematically reviewed the literature regarding race/ethnicity and the overuse of care.Methods
We searched the Medline database for US studies that included at least 2 racial/ethnic groups and that examined the association between race/ethnicity and the overuse of procedures, diagnostic (care) or therapeutic care. In a recent review, we identified studies of overuse by race/ethnicity, and we also examined reference lists of retrieved articles. We then abstracted and evaluated this information, including the population studied, data source, sample size and assembly, type of care, guideline or appropriateness standard, controls for clinical confounding and financing of care, and findings.Findings
We identified 59 unique studies, of which 11 had a low risk of methodological bias. Studies with multiple outcomes were counted more than once; collectively they assessed 74 different outcomes. Thirty-two studies, 6 with low risks of bias (LRoB), provided evidence that whites received more inappropriate or nonrecommended care than racial/ethnic minorities did. Nine studies (2 LRoB) found evidence of more overuse of care by minorities than by whites. Thirty-three studies (6 LRoB) found no relationship between race/ethnicity and overuse.Conclusions
Although the overuse of care is not invariably associated with race/ethnicity, when it was, a substantial proportion of studies found greater overuse of care among white patients. Clinicians and researchers should try to understand how and why race/ethnicity might be associated with overuse and to intervene to reduce it. 相似文献10.
Shivani R. Khan Allyson G. Hall Rebecca J. Tanner Nicole M. Marlow 《Disability and health journal》2018,11(3):339-344
Background
Individuals living with a disability or are a member of a certain racial/ethnic group may be at heightened risk for not receiving important vaccinations.Objective
This study examined whether race/ethnicity and disability status are associated with the receipt of two vaccines (influenza and pneumococcal) among older adults living in Florida.Methods
Using the 2011–2015 Florida Behavioral Risk Factor Surveillance System, a cross-sectional survey, we ran bivariate and multivariate analyses to determine the associations for race/ethnicity and disability status with receipt of vaccinations among individuals 65 years and older. Interactions between race/ethnicity and disability status were tested in each model.Results
Among our study sample, 68% received the pneumococcal vaccine in their lifetime and 54% of them received influenza vaccine in the past 12 months. Multivariate logistic regression indicated that Non-Hispanic Blacks and Hispanics were less likely to receive both vaccines compared to Non-Hispanic Whites. Older adults with a disability were more likely to receive influenza and pneumococcal vaccines compared to those without. A significant interaction was observed between race/ethnicity and disability status for predicting pneumococcal vaccination receipt.Conclusions
Large proportions of older adults in Florida continue to go without needed vaccinations. Although race/ethnicity and disability status were shown to have some association with receipt of vaccines, having a regular source of care, employment and income also were shown to be important predictors. 相似文献11.
Purpose
Racial/ethnic disparities in rates of low birthweight (LBW) are well established, as are racial/ethnic differences in health outcomes over the life course. Yet, there is little empirical work examining whether the consequences of LBW for subsequent child health vary by race, ethnicity, and national origin.Methods
Using data from the 1998–2016 National Health Interview Survey, we examined whether racial, ethnic, and national differences existed in the association between LBW and subsequent health outcomes, namely being diagnosed with a developmental disability, asthma diagnosis, and poorer general health.Results
Children born with LBW consistently had poorer health relative to children born with normal birthweight. There was no systematic evidence that the linkages between LBW and subsequent health were weaker for one racial/ethnic/national origin group relative to others.Conclusions
LBW was associated with subsequent poorer health. There was no systematic evidence that the link between LBW and subsequent child health were weaker for one racial/ethnic/national origin group relative to others. Together, these findings highlight the importance of reducing race/ethnic disparities in rates of LBW as a way of eradicating inequalities in childhood health. 相似文献12.
Background
Every year, 15 to 20 tetanus cases are reported in France. The latest national figures showed that only 62 % of adults were up-to-date for this vaccination. We tried to determine the factors associated with vaccination coverage and with knowledge of vaccination status.Methods
We analyzed data from the “Santé et Protection sociale” survey (2002). We analyzed the association between factors and tetanus vaccination coverage. We then explored the association between these factors and knowledge of vaccination status.Results
Two demographic variables were only associated with vaccination coverage (higher coverage in male individuals and in individuals living in some regions of the country). Two socioeconomic variables were only associated with knowledge of vaccination status (higher knowledge in people from high income families and in managers/private professionals and in office workers). Coverage and status awareness both decreased with lower education level, in residents of large urban centers and in individuals without private medical insurance, and these two indicators were both associated to age but in an opposite direction.Conclusion
Factors influencing vaccination coverage are rather demographic, whereas socioeconomic factors seem to influence more the knowledge of vaccination status. This distinction should help to target public health actions and adapt information for the least covered and the least informed groups. 相似文献13.
Hong Xu Xiaoli Gao Fang Bo Jing Ma Yan Li Chenlu Fan Likun Jiang Yujie Ma Huiming Luo Zhijie An 《Vaccine》2013
Background
In the 1990s, China introduced rubella vaccine into the private market using BRD-II virus strain, which is different than the globally used RA27/3 strain. In 2007, BRD-II rubella containing vaccine was introduced into the national immunization program and recommended for routine use. However, to our knowledge, there are no field vaccine effectiveness (VE) studies of BRD-II rubella vaccine. In April 2011, a rubella outbreak was detected in two daycare centers in Harbin city, China. We conducted an investigation to determine VE of BRD-II rubella vaccine.Methods
Rubella cases were either laboratory-confirmed or epidemiologically linked to laboratory-confirmed cases. We collected demographic characteristics, migrant status, and history of rubella and measles vaccination from all children in the two daycare centers.Results
The first case of rubella was on 22 November, 2010. Among the 143 children in the two daycare centers, 22 acquired rubella, for an overall attack rate (AR) of 15.4% (22/143). The AR in higher-grade classes (21.7%) was higher than in lower grade classes (3.9%). The AR among migrant children (47.8%) was higher than among local children (9.2%). Rubella vaccine coverage was 17% (24/143), while measles vaccine coverage was 100%. The AR among rubella-vaccinated children was 0% (0/24), and the AR among rubella-unvaccinated children was 18.5% (22/119), for a VE of 100% (P value = 0.025, 95% CI: 35–100%). Rubella vaccine coverage among children born before 2007 was 10.2% (10/98), and was lower than that for children born in 2007 or after (31.1% (14/45), RR = 0.33, 95%CI: 0.16–0.68). Emergency vaccination was conducted on 11 and 12 April 2011, and the outbreak stopped in one week later.Conclusions
Domestic BRD-II strain rubella vaccine showed high vaccine effectiveness against rubella. Rubella vaccine coverage through routine immunization was insufficient. Consideration should be given for measuring rubella vaccine coverage to determine the need for catch-up vaccination in China. 相似文献14.
Michaela Riddell Nicolas Senn C. John Clements Linda Hobday Benjamin Cowie Jonah Kurubi Ali Kevin Peter Siba John C. Reeder Chris Morgan 《Vaccine》2012
Aim
To determine the age specific immunity profile for rubella from three discrete study populations in Papua New Guinea, and to inform policy regarding the possible introduction of rubella vaccine.Background
In 2005, the Western Pacific Region (WPR), of which Papua New Guinea (PNG) is a member state, declared the goal of regional measles elimination by 2012. Recently, WPR has incorporated an accelerated control goal for rubella and congenital rubella syndrome (CRS). PNG currently recommends two doses of measles vaccination at 6 and 9 months of age with a monovalent measles vaccine, which does not include rubella vaccine.Methods
Convenience samples were collected from 1326 eligible participants in PNG and assessed for rubella immunity using the Dade Behring Enzygnost™ Anti-Rubella-Virus enzyme immunoassay. Nearly 34% were collected during an age stratified prospective survey of febrile patients in Madang Province; approximately 49% were collected from women of childbearing age in East Sepik and Milne Bay Provinces. Remaining specimens were collected from 6 to 7-month-old infants in Port Moresby prior to receiving the first dose of measles vaccine.Findings
Of all samples tested, 65.2% (95% confidence interval (CI): 62.6–67.8) had evidence of immunity to rubella infection. Of women more than 15 years of age, 91.6% (95% CI: 89.4–93.5) were immune. The force of infection was highest between 5 and 19 years of age.Conclusions
Although a population-based sample was not used, our multi-centre study of the population immunity profile suggests that immunity against rubella is extremely high in most women of childbearing age, but women who become pregnant at an early age may be at high risk of rubella infection during pregnancy and potential delivery of an infant with CRS. Routine measles vaccine coverage, a proxy for measles-rubella vaccine coverage, as measured in recently published studies, is well below the WHO target of 80% coverage. Introduction of a child or infant dose of rubella vaccine requires caution and further study. 相似文献15.
Objectives
Zoster vaccine is recommended for prevention of herpes zoster among adults aged 60 years and older. We examined the zoster vaccination rates during 2007–2011 and assessed association with age, sex, race/ethnicity, neighborhood income and education attainment in eligible adults at Kaiser Permanente Southern California, a managed care organization in the US.Methods
We calculated annual zoster vaccination rate among members ≥60 years without documented contraindications. Multivariable logistic regression was performed to examine factors associated with zoster vaccine uptake in an open cohort of 819,466 adults.Results
The zoster vaccination rates increased annually in all groups and the overall rate reached 21.7% in 2011 (P-trend < 0.001). Coverage was highest among individuals aged 65–74 years, who were female and non-Hispanic White. In the adjusted analysis, odds of vaccination decreased by age. Females (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.17–1.20) and those who lived in neighborhoods with higher education attainment were more likely to be vaccinated (>75% vs. <50% adults with some college education: OR = 1.76, 95% CI = 1.73–1.80). Compared to Whites, non-Hispanic Blacks and Hispanics were less likely to receive the vaccine (non-Hispanic Blacks: OR = 0.56, 95% CI = 0.55–0.58; Hispanics: OR = 0.59, 95% CI = 0.58–0.60).Conclusion
The zoster vaccine coverage is higher in this insured population than previously reported in the US general population, but it remains low. Significant racial/ethnic disparity was observed and worsened even among individuals with relatively equal access to zoster vaccination. 相似文献16.
Background
A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals.Methods
Thematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009.Results
The number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state.Conclusions
The responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.17.
Tiro JA Pruitt SL Bruce CM Persaud D Lau M Vernon SW Morrow J Skinner CS 《Vaccine》2012,30(13):2368-2375
Background
Adolescent HPV vaccination in minority and low income populations with high cervical cancer incidence and mortality could reduce disparities. Safety-net primary care clinics are a key delivery site for improving vaccination rates in these populations.Purpose
To examine prevalence of HPV initiation (≥1 dose), completion (receipt of dose 3 within 12 months of initiation), and receipt of 3 doses in four safety-net clinics as well as individual-, household-, and clinic-level correlates of initiation.Methods
We used multilevel modeling to investigate HPV initiation among 700 adolescent females who sought primary care in four safety-net clinics in Dallas, Texas from March 2007 to December 2009. Data were abstracted from patients’ paper and electronic medical records.Results
HPV vaccine uptake varied significantly by clinic. Across clinics, initiation was 36.6% and completion was 39.7% among those who initiated. In the total study population, only 15.7% received all three doses. In multivariate, two-level logistic regression analyses, initiation was associated with receipt of other adolescent vaccines, influenza vaccination in the year prior to data abstraction, being sexually active, and having more chart documentation (presence of health maintenance questionnaire and/or immunization record). There was no association between initiation and age, race/ethnicity, or insurance status.Conclusions
In four urban safety-net clinics, HPV initiation rates paralleled 2008 national rates. The correlation of HPV initiation with other adolescent vaccines underscores the importance of reviewing vaccination status at every health care visit. HPV vaccine uptake in safety-net clinics should continue to be monitored to understand impact on cervical cancer disparities. 相似文献18.
Introduction
Home health aides (HAs) receive limited training and reach many older patient populations highly susceptible to influenza virus. We sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.Methods
We analyzed data from the 2007 U.S. National Home Health Aide Survey, a nationally representative sample of HAs reporting on occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n = 3377).Results
Seasonal flu vaccine receipt was low among all types of HAs (43.9%). After adjustment for socio-demographic indicators (i.e. age, gender, race and health insurance), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to licensed nursing assistants (adjusted odds ratio, AOR = 0.42, 95% CI [0.20–0.85]; 0.41, [0.17–0.99]; 0.50, [0.26–0.97], and 0.53, [0.26–0.99], respectively).Conclusion
Targeted effective vaccination campaigns are needed to improve vaccination rates among home health aides. 相似文献19.
Tracey Poole Felicity Goodyear-Smith Helen Petousis-Harris Natalie Desmond Daniel Exeter Leah Pointon Ranmalie Jayasinha 《Vaccine》2012
Background
The New Zealand HPV publicly funded immunisation programme commenced in September 2008. Delivery through a school based programme was anticipated to result in higher coverage rates and reduced inequalities compared to vaccination delivered through other settings. The programme provided for on-going vaccination of girls in year 8 with an initial catch-up programme through general practices for young women born after 1 January 1990 until the end of 2010.Objective
To assess the uptake of the funded HPV vaccine through school based vaccination programmes in secondary schools and general practices in 2009, and the factors associated with coverage by database matching.Methods
Retrospective quantitative analysis of secondary anonymised data School-Based Vaccination Service and National Immunisation Register databases of female students from secondary schools in Auckland District Health Board catchment area. Data included student and school demographic and other variables. Binary logistic regression was used to estimate odds ratios and significance for univariables. Multivariable logistic regression estimated strength of association between individual factors and initiation and completion, adjusted for all other factors.Results
The programme achieved overall coverage of 71.5%, with Pacific girls highest at 88% and Maori at 78%. Girls higher socioeconomic status were more likely be vaccinated in general practice.Conclusion
School-based vaccination service targeted at ethic sub-populations provided equity for the Maori and Pacific student who achieved high levels of vaccination. 相似文献20.