Interventions to Improve Adolescent Vaccination What May Work and What Still Needs to Be Tested

This article is being published concurrently in the American Journal of Preventive Medicine and Vaccine. The articles are identical except for stylistic changes in keeping with each journalʼs style. Either of these versions may be used in citing this article. See: Dempsey, A. F., & Zimet, G. D. (2015). Interventions to Improve Adolescent Vaccination: What May Work and What Still Needs to Be Tested. Vaccine, 33, Supplement 4, D106–D113. http://doi.org/10.1016/j.vaccine.2015.09.032Since the development of the “adolescent platform” of vaccination in 1997, hundreds of studies have been conducted, identifying barriers to and facilitators of adolescent vaccination. More recent research has focused on developing and evaluating interventions to increase uptake of adolescent vaccines. This review describes a selection of recent intervention studies for increasing adolescent vaccination, divided into three categories: those with promising results that may warrant more widespread implementation, those with mixed results requiring more research, and those with proven effectiveness in other domains that have not yet been tested with regard to adolescent vaccination

Validation of the Vaccination Confidence Scale: A Brief Measure to Identify Parents at Risk for Refusing Adolescent Vaccines

Objective To validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. Methods We analyzed weighted data from 9018 parents who completed the 2010 National Immunization Survey–Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and human papillomavirus vaccines. For each vaccine, separate logistic regression models assessed associations between parents\u27 mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses for the scale\u27s 4-item short form. Results One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific vaccines ranging from 21% for human papillomavirus to 2% for Tdap. Using the full 8-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium (odds ratio, 2.08; 95% confidence interval, 1.75–2.47) or low (odds ratio, 4.61; 95% confidence interval, 3.51–6.05) versus high. For the 4-item short form, scores were also consistently associated with vaccine refusal and vaccination status. Vaccination confidence was inconsistently associated with vaccine delay. Conclusions The Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. The scale\u27s short form appears to offer comparable performance

Use of the Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS) in Young Adult Women

Background Validated measures that can accurate describe young adults’ HPV vaccination attitudes and how these relate to vaccination intention and receipt are needed for developing interventions to improve low HPV vaccination levels. The Carolina HPV Immunization Attitudes Scale (CHIAS) is a validated measure of these outcomes that was originally designed for parents. Objective To assess the performance of the CHIAS among young adult women using an exploratory factor analysis. Methods A convenience sample of 139 young adult women (age 18–26 years) were given the CHIAS measure at baseline. Factor analysis was used to determine attitudinal factor groupings and the association of these factors with HPV vaccination intention. A 6-month follow up assessment examined the stability of the CHIAS over time and the association of baseline vaccine factors with vaccine receipt. Results Five factors loaded on to the CHIAS in young adults - “Barriers,” “Harms,” “Effectiveness,” “Risk Denial” and “Uncertainty,” - which was similar to the factor loadings of CHIAS for parents. “Harms” was the factor most consistently associated with vaccination intention at all time points assessed. Only 5 women had received or made an appointment to receive the vaccine at the 6-month follow-up. Conclusions In terms of categorizing HPV vaccination attitudes, the CHIAS appears to have similar performance among young adults as in parents. However, additional studies are needed to assess the utility of the CHIAS for predicting HPV vaccine receipt among the young adult population

TeamSTEPPS: Radiologic Sciences Students’ Perspective

Purpose: Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) provides participants with a simulated interprofessional education experience. TeamSTEPPS focuses on skills that support teamwork performance and communication principles with the goal of improving quality and patient safety. Background: Thomas Jefferson University is a leader in providing its students with interprofessional training and education opportunities. Students in the Department of Radiologic Sciences, Jefferson School of Health Professions (JSHP), participate in interprofessional education sessions with other health professional disciplines including nursing and bioscience technology. For the past two years, radiologic sciences students have participated in the TeamSTEPPS program. The simulated case scenarios provided an opportunity for multiple medical and healthcare professional disciplines to participate. Description of program: Student representatives from various medical and health professional programs at Thomas Jefferson University participated in TeamSTEPPS in the Spring of 2013 and the Spring of 2014. During the TeamSTEPPS program, students participated in the simulated case scenarios and provided feedback in the debriefing session. Results: Feedback from the radiologic sciences students was positive and insightful. Radiologic science students were proud to be a valued member of the team. In a literature review of radiologic science participation in interprofessional education activities, there appears to be a want and need for radiologic science inclusion in both interprofessional education and the interprofessional healthcare delivery. Conclusion: Radiologic sciences students express a want and need for continued participation in interprofessional education and training opportunities including TeamSTEPPS. Relevance to Interprofessional Education and Practice: Interprofessional education and training provides healthcare professionals with effective collaborative working skills and knowledge to improve patient outcomes, patient safety, teamwork and communication among healthcare professionals. At the conclusion of this session participants will be able to: 1. Discuss the importance of interprofessional education and training. 2. Identify the role radiologic science professionals have in the interprofessional team

How Volunteerism Enhances Workplace Skills

The idea of fostering learning through service is surprisingly controversial. Employers should plan carefull

Lead me to train better: transformational leadership’s moderation of the negative relationship between athlete personality and training behaviors

High-quality training environments are essential for athletic peak performance. However, recent research highlighted that athletes' personality characteristics could undermine effective training. The current set of studies aimed to examine whether specific transformational leadership characteristics displayed by the coach would moderate the potential negative impacts of two personality traits (i.e., extraversion and neuroticism) on training behaviours. In study 1, ninety-nine university athletes completed questionnaires assessing personality, transformational leadership, and training behaviours. In study 2, eighty-four high-level athletes completed the same personality and transformational leadership questionnaires. However, in study 2 the head coaches assessed athletes’ training behaviours. Both studies showed that coach high-performance expectations moderated the extraversion-distractibility relationship. Further, both studies also demonstrated that the relationship between neuroticism and coping with adversity was moderated by coach’s inspirational motivation. Our findings highlight that extraversion and neuroticism can negatively relate to training behaviours, but such effects can be moderated by certain transformational leadership behaviours.N/

Lead me to train better: Transformational leadership moderates the negative relationship between athlete personality and training behaviours.

High-quality training environments are essential for athletic peak performance. However, recent research highlighted that athletes' personality characteristics could undermine effective training. The current set of studies aimed to examine whether specific transformational leadership characteristics displayed by the coach would moderate the potential negative impacts of two personality traits (i.e., extraversion and neuroticism) on training behaviours. In study 1, ninety-nine university athletes completed questionnaires assessing personality, transformational leadership, and training behaviours. In study 2, eighty-four high-level athletes completed the same personality and transformational leadership questionnaires. However, in study 2 the head coaches assessed athletes’ training behaviours. Both studies showed that coach high-performance expectations moderated the extraversion-distractibility relationship. Further, both studies also demonstrated that the relationship between neuroticism and coping with adversity was moderated by coach’s inspirational motivation. Our findings highlight that extraversion and neuroticism can negatively relate to training behaviours, but such effects can be moderated by certain transformational leadership behaviours

Hopewell Newsletter- June 2010

1. Small Scale Geoarchaeological Investigations of Earthen Wall Construction at the Hopeton Earthworks (33RO 26) Several geoarchaeological and geophysical investigations have been conducted at the Hopeton Earthworks (33RO26) and met with good success (Figure 1). As such, soil cores excavated in the summer of 2007 were studied using a two-pronged methodology of soil profile characterization and magnetic susceptibility testing. These techniques were employed to closely examine three sections of earthen wall at different locations at Hopeton as a means of understanding the soil composition of the walls and assessing possible uniformity in wall construction across the site. The following focuses solely on the geoarchaeological study of the selected locations. 2. The Role of Geophysics at Hopewell Culture National Historical Park Hopewell Culture National Historical Park is best known for its earthwork complexes built by the Hopewell during the Middle Woodland period. The park was originally established in 1923 to preserve the Mound City site after its use as a World War I training camp. In the past two decades, the park has added four additional earthworks—Hopeton Earthworks, Hopewell Mound Group, Seip Earthworks, and High Bank Works—and recently had its boundaries increased to include Spruce Hill. The recent growth in land located within the park has provided opportunities for archaeological research, most of which used some sort of geophysical technique. 3. Recent Investigations at the Mound City Group Ohio Hopewell earthworks have been studied extensively, both in historic and in modern times. Mound excavations during historic and modern times have revealed much about the construction and use of mound space. More recent research at Hopewell sites in Ohio has focused on non-mound areas both within and adjacent to the earthworks. This article focuses on current research conducted outside of the enclosure at the Mound City Group. 4. Clues to the Relationship of the Riverbank Site (33RO1059) to other Ohio Hopewell Sites Through Instrumental Neutron Activation Analysis on Pottery Excavations were conducted at the Riverbank Site (33RO1059), located by the Hopewell Site (33RO27), in 2004 and 2006 to gather data from the site before it is eroded away by the Paint Creek and to improve understanding of the role of small sites located near large Hopewell earthworks. Instrumental Neutron Activation Analysis (INAA) was conducted on pottery from the Riverbank Site to help clarify its relationship with other nearby sites. Fifteen sherds from the site were sent to the University of Missouri Research Reactor (MURR) for INAA, and the results were compared to the larger database of Hopewell ceramics. Based on the results, which show that the fifteen sherds formed a unique trace element compositional group, the site likely represents a shortterm occupation, possibly for a pilgrimage to the Hopewell Site, and the ceramics were likely either locally constructed for use at the site or constructed elsewhere to carry items on the way to Hopewell. 5. Feature Finds from the Riverbank Site, 33RO1059 Located just south and east of the Hopewell site’s Square Enclosure by about 225 meters is the Riverbank site, 33RO1059, which represents multiple occupations spanning the Archaic through historic periods, and includes a significant Middle Woodland component. Particularly noteworthy are two impressive pit features that were encountered in 2006 during a data recovery project undertaken by the Midwest Archeological Center. These pits, Features 7 and 8, would have been contemporaneous with Hopewell activities at the nearby earthwork complex, and the material culture recovered from them provides an intriguing glimpse of activities outside of the earthwork walls. 6. The Initial Phase of the Magnetic Investigations of the Mound City Group (32RO 32) at the Hopewell Culture National Historical Park, Ross County, Ohio The Mound City Group (Site 32RO32) covers approximately 13 acres. It contained at least 23 mounds when Squier and Davis made the first study of the mound complex in 1846. In the summer of 2009, the Midwest Archeological Center conducted the initial phase of a magnetic survey of the entire site. The magnetic survey in the southern portion of the site covered 11,200 m2 or 2.77 acres. The magnetic data indicated the presence of numerous magnetic anomalies associated with the Hopewell occupation and with the World War I training facility of Camp Sherman

HPV Vaccine Hesitancy: Findings From a Statewide Survey of Health Care Providers

Healthcare provider recommendations are critical for human papillomavirus (HPV) vaccine uptake. We sought to describe providers' HPV vaccine recommendation practices and explore their perceptions of parental hesitancy

Development of an electronic health message system to support recovery after stroke: Inspiring Virtual Enabled Resources following Vascular Events (iVERVE)

Purpose: Worldwide, stroke is a leading cause of disease burden. Many survivors have unmet needs after discharge from hospital. Electronic communication technology to support post-discharge care has not been used for patients with stroke. In this paper, we describe the development of a novel electronic messaging system designed for survivors of stroke to support their goals of recovery and secondary prevention after hospital discharge. Participants and methods: This was a formative evaluation study. The design was informed by a literature search, existing data from survivors of stroke, and behavior change theories. We established two working groups; one for developing the electronic infrastructure and the other (comprising researchers, clinical experts and consumer representatives) for establishing the patient-centered program. Following agreement on the categories for the goal-setting menu, we drafted relevant messages to support and educate patients. These messages were then independently reviewed by multiple topic experts. Concurrently, we established an online database to capture participant characteristics and then integrated this database with a purpose-built messaging system. We conducted alpha testing of the approach using the first 60 messages. Results: The initial goal-setting menu comprised 26 subcategories. Following expert review, another 8 goal subcategories were added to the secondary prevention category: managing cholesterol; smoking; physical activity; alcohol consumption; weight management; medication management; access to health professionals, and self-care. Initially, 455 health messages were created by members of working group 2. Following refinement and mapping to different goals by the project team, 980 health messages across the health goals and 69 general motivational messages were formulated. Seventeen independent reviewers assessed the messages and suggested adding 73 messages and removing 16 (2%). Overall, 1,233 messages (18 administrative, 69 general motivation and 1,146 health-related) were created. Conclusion: This novel electronic self-management support system is ready to be pilot tested in a randomized controlled trial in patients with stroke