Cervical Cancer Free North Carolina: Evaluation of Two Adolescent HPV Vaccine Interventions: The School Health Center Study and the AFIX (Assessment, Feedback, Incentives, and Exchange) Program in North Carolina

Background: Each year in North Carolina (NC), more than 370 women are diagnosed with cervical cancer (CCFNC, 2003). It is estimated that 70% of cervical cancer cases are caused by the human papillomavirus (HPV). Although cervical cancer can be prevented through the human papillomavirus vaccination, rates among adolescents in NC remain low (CCFNC, 2011). Methods: To improve adolescent HPV vaccination rates across NC, we assisted with the evaluation of two adolescent vaccination interventions including the Rockingham County School Health Center Program and the Assessment, Feedback, eXchange, and Incentives (AFIX) Program. For the School Health Center Program, we completed 48 phone interviews with parents and guardians of adolescents attending Rockingham County high schools regarding their satisfaction with the SHC program. For the AFIX Project, we analyzed baseline and follow up data for 91 NC immunization providers to determine the efficacy of the AFIX intervention. Results and Discussion: The results for both projects were not finalized before the submission of this assignment.Master of Public Healt

The Spoken Word Project: Using Poetry in Community Dialogue and Mobilization for HIV Prevention

Spoken word, a form of performance poetry, is a promising approach to HIV/AIDS awareness and prevention, as it has the potential to encourage dialogue among and within communities and address concerns regarding the social stigma present in rural communities. The purpose of this study is to describe the development and implementation of the Spoken Word Project (SWP), an HIV/AIDS pilot intervention in rural North Carolina designed to improve HIV-related attitudes and self-efficacy and decrease stigma through the use of performance poetry. Spoken word is a collaborative effort between residents of two rural counties in North Carolina and Project GRACE (Growing, Reaching, Advocating for Change and Empowerment), a community-based participatory research collaboration aimed at reducing health disparities in African American communities. The project included 15 adult and youth participants. Results indicated that spoken word has the ability to build upon local resources, generate community reflection, and engage a broad spectrum of performers and audiences. Our findings also showed that the effect of stigma and limited community conversations about HIV in rural communities can be abated through the use of spoken word

Organizational correlates of adolescent immunization: Findings of a state-wide study of primary care clinics in North Carolina

To analyze organization-level correlates of immunization coverage among adolescents served by high-volume primary care providers in North Carolina

Organizational correlates of adolescent immunization: Findings of a state-wide study of primary care clinics in North Carolina

OBJECTIVE: To analyze organization-level correlates of immunization coverage among adolescents served by high-volume primary care providers in North Carolina. METHOD: We randomly selected 91 clinics with at least 200 active records for patients ages 11–18 in the North Carolina Immunization Registry. For the 105,121 adolescents served by these clinics, we obtained immunization status for 6 vaccines, including human papillomavirus (HPV) vaccine (females only); meningococcal conjugate; and tetanus, diphtheria, and pertussis booster (Tdap). RESULTS: Clinics specializing in pediatrics had higher coverage for meningococcal vaccine (OR = 1.79, 95% CI: 1.25–2.55), Tdap vaccine (OR = 1.22, 95% CI: 1.00–1.50), and childhood vaccines. However, pediatric clinics had lower coverage for HPV vaccine initiation (OR = 0.70, 95% CI: 0.52–0.94). Other correlates, which varied by vaccine, included policies related to vaccine documentation and the age at which clinics recommended vaccines. CONCLUSION: Overall, adolescents were more likely to receive vaccines, except HPV vaccine, if they attended a pediatric clinic with supportive clinical policies