Effects of Maternal and Provider Characteristics on Up-to-Date Immunization Status of Children Aged 19 to 35 Months

Kim, Sam S.; Frimpong, Jemima A.; Rivers, Patrick A.; Kronenfeld, Jennie Jacobs

doi:10.2105/ajph.2005.076661

Cited by 61 publications

(52 citation statements)

References 28 publications

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“…White participants had 14%-21% lower coverage in comparison with Black and Hispanic participants. These findings are similar to characteristics of unvaccinated children found in US studies, with unvaccinated children more likely to be White, male, or have a college-educated parent [29][30][31][32].…”

Section: Discussionsupporting

confidence: 84%

Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness Case-control Study

et al. 2016

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Vaccination program evaluation includes assessment of vaccine uptake and direct vaccine effectiveness (VE). Often examined separately, we propose a design to estimate rotavirus vaccination coverage using controls from a rotavirus VE test-negative case-control study and to examine coverage following implementation of the Quebec, Canada, rotavirus vaccination program. We present our assumptions for using these data as a proxy for coverage in the general population, explore effects of diagnostic accuracy on coverage estimates via simulations, and validate estimates with an external source. We found 79.0% (95% confidence interval, 74.3%, 83.0%) ≥2-dose rotavirus coverage among participants eligible for publicly funded vaccination. No differences were detected between study and external coverage estimates. Simulations revealed minimal bias in estimates with high diagnostic sensitivity and specificity. We conclude that controls from a VE case-control study may be a valuable resource of coverage information when reasonable assumptions can be made for estimate generalizability; high rotavirus coverage demonstrates success of the Quebec program.

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Section: Discussionsupporting

confidence: 84%

Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness Case-control Study

et al. 2016

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“…Previous studies that examined factors associated with vaccine uptake found both positive and negative associations with education level and income 21, 22, 23, 24. In this study, we found that many reasons for unwillingness to receive vaccine were similar in higher and lower education groups; however, the qualitative responses of some participants may suggest that while those with lower education levels have specific beliefs or reasons for not wanting vaccine, those with higher education levels have non‐specific preferences not to get vaccinated.…”

Section: Discussionmentioning

confidence: 93%

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Wong

Cohen

Norris

et al. 2016

Influenza Resp Viruses

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BackgroundUnderstanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies. We aimed to characterize knowledge, attitudes, and practices surrounding influenza illness and vaccination in two South African communities and explore reasons for vaccine hesitancy.MethodsHousehold primary caregivers in Soweto and Klerksdorp townships were interviewed about knowledge of influenza and intention to receive an influenza vaccine using a structured questionnaire. Factors associated with unwillingness to receive vaccine were explored using multivariable regression.ResultsWe interviewed representatives of 973 households in Soweto and 1,442 in Klerksdorp. Most respondents in Soweto (692, 71%) and Klerksdorp (1247, 87%) thought weather or cold caused influenza. While most would get a free influenza vaccine, those unwilling to receive vaccine had concerns about efficacy (Soweto: 19%; Klerksdorp: 19%) and safety (Soweto: 17%; Klerksdorp: 10%). In Soweto, females (aRR 2·0, 95% CI 1·3–3·2) and those with higher household income (aRR 1·8, 95% CI 1·2–2·7) were less willing to receive vaccine. In Klerksdorp, more educated respondents (aRR 1·6, 95% CI 1·1–2·4) were less willing to receive vaccine; households reporting an HIV‐positive member were more willing to receive vaccine (aRR 0·3, 95% CI 0·1–0·8).ConclusionsAlthough findings suggest most community participants were amenable to influenza vaccination, knowledge gaps were present. Emphasizing the importance of influenza as a health problem and addressing vaccine safety and efficacy concerns may improve uptake. Populations less amenable to vaccination, including those with higher education and income, may benefit from targeted messaging efforts.

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“…35 In the available administrative data, the best approximation of English proficiency was language spoken at home and interpreter need. Four risk factors with supporting evidence were not available in the database: low parent educational attainment, 12,19,23 single-parent household, 12,19,24,25 adolescent exposure to intimate partner violence, 27 and discontinuous insurance coverage. [29][30][31] Risk factors involving parents were based on biologic parents, regardless of whether they lived in the child's household.…”

Section: Identification Of Social Complexity Risk Factorsmentioning

confidence: 99%

“…We could not identify all social complexity risk factors associated with use patterns in prior studies. 12,19,[23][24][25]27,[29][30][31] To be included in the initial cohort, children had to have an identifiable biologic parent and at least 1 month of Medicaid coverage during the study period, resulting in the exclusion of 13% of otherwise eligible children. In assessing the child's exposure to social risk in the context of their family and environment, we were limited to biologic parents.…”

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confidence: 99%

Using State Administrative Data to Identify Social Complexity Risk Factors for Children

Arthur¹,

Lucenko

Sharkova

et al. 2018

Ann Fam Med

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PURPOSE Screening for social determinants of health is challenging but critically important for optimizing child health outcomes. We aimed to test the feasibility of using an integrated state agency administrative database to identify social complexity risk factors and examined their relationship to emergency department (ED) use. METHODSWe conducted a retrospective cohort study among children younger than 18 years with Washington State Medicaid insurance coverage (N = 505,367). We linked child and parent administrative data for this cohort to identify a set of social complexity risk factors, such as poverty and parent mental illness, that have either a known or hypothesized association with suboptimal health care use. Using multivariate analyses, we examined associations of each risk factor and of number of risk factors with the rate of ED use. RESULTSNine of 11 identifiable social complexity risk factors were associated with a higher rate of ED use. Additionally, the rate increased as the number of risk factors increased from 0 to 5 or more, reaching approximately twice the rate when 5 or more risk factors were present in children aged younger than 5 years (incidence rate ratio = 1.92; 95% CI, 1.85-2.00) and in children aged 5 to 17 years (incidence rate ratio = 2.06; 95% CI, 1.99-2.14).CONCLUSIONS State administrative data can be used to identify social complexity risk factors associated with higher rates of ED use among Medicaid-insured children. State agencies could give primary care medical homes a social risk flag or score to facilitate targeted screening and identification of needed resources, potentially preventing future unnecessary ED use in this vulnerable population of children. 2018;16:62-69. https://doi.org/10.1370/afm.2134. Ann Fam Med INTRODUCTIONI n light of the strong evidence that exposure to social adversity in childhood is linked to poor child and adult health outcomes, 1-4 systematic strategies are needed to identify children at risk in order to provide appropriate referrals and services. Adverse childhood experiences, originally described by Felitti et al, 4 include family-related risk factors such as mental illness of a household member and exposure to abuse or neglect. There is a compelling case for identifying and addressing adverse childhood experiences and other social determinants of health at the family level because supporting parents is often the starting point for supporting children. 5Pediatric primary care interventions have successfully identified children with adverse childhood experiences or other social determinants of health, typically through parent report on a questionnaire. Subsequent intervention usually involves providing referrals to a social worker or appropriate community, hospital, or government programs, such as the Supplemental Nutrition Assistance Program, housing programs, utility bill assistance programs, transportation assistance, childcare providers, legal services, shelter arrangements, tax preparation support, or help in completing benefits forms ...

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Effects of Maternal and Provider Characteristics on Up-to-Date Immunization Status of Children Aged 19 to 35 Months

Cited by 61 publications

References 28 publications

Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness Case-control Study

Two Birds With One Stone: Estimating Population Vaccination Coverage From a Test-negative Vaccine Effectiveness Case-control Study

Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Using State Administrative Data to Identify Social Complexity Risk Factors for Children

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