Childhood vaccination practices and parental hesitancy barriers in rural and urban primary care settings

Nationally and in Montana, children living in rural areas have unique barriers to vaccine access and lower vaccination rates compared to children in urban areas. However, there has been minimal prior research on rural-focused strategies for increasing vaccination rates. Our objective was to compare rural and urban Montana primary care providers’ (PCPs’) practices in promoting childhood vaccination and their perceptions regarding barriers to and strategies for promoting vaccination. We conducted a mail and online survey of rural and urban Montana PCPs. In October-December 2021, the survey was pilot tested by PCPs across Montana. In January-April 2022, we sent out four survey mailings to all eligible PCPs, 4-6 weeks apart. The last mailing contained a hand-addressed, larger, and different-colored envelope than was previously used. The survey included modules on routine vaccinations in children 0-2 years old and COVID-19 vaccination in children 5-17 years old. We completed descriptive analyses and used chi-square statistical tests to compare responses from rural and urban PCPs. The participation rate was 36% (n=298). Urban PCPs (90-94%, depending on vaccine) stocked routinely recommended vaccines more frequently than rural PCPs (71-84%), but stocked the COVID-19 vaccine less often (urban: 44%, rural: 71%, pp=0.01) and concerns that vaccination will weaken their child’s immune system (29% vs. 6%, pp=0.01). This study’s results illuminated potential interventions to increase rural vaccination rates, such as increasing the number of providers stocking all recommended vaccines, identifying strategies to address parents’ concerns, and collaborating with health departments on public vaccine communication campaigns

Trial to Improve Inter-professional Practice Behaviors at a Student-Run, Free Clinic

The Indiana University Student Outreach Clinic (IUSOC) is a student-run, free clinic on the east side of Indianapolis. Students from eleven different disciplines (pharmacy, social work, occupational therapy, physical therapy, law, dentistry, global health, optometry, public health, nursing and medicine), covering three institutions (Indiana University, Butler University, and the University of Indianapolis), volunteer at the IUSOC. This study is a randomized-controlled intervention designed to improve inter-professional practice knowledge and behaviors within the IUSOC. On intervention clinic days, all clinic volunteers will gather in a huddle before seeing patients for a structured didactic information session. The session will highlight the importance of screening patients for comorbid conditions and subsequently referring patients to the appropriate clinic partners through inter-professional consultations. Clinic volunteers will receive a knowledge sheet that lists the top roles of each partner organization, in addition to a description of the screening tool, to be utilized on intervention days. The information session, knowledge sheet handout, and screening tool will not be employed on clinic control days. The primary aim is to assess the efficacy of the intervention by tracking and comparing the number of consults made during control and intervention days. The secondary aims are to investigate the impact of the intervention on collaboration and relationships among the professions represented at the clinic, to assess professional students’ knowledge of services provided by partner organizations, and to assess volunteer satisfaction of inter-professional relationships. We propose the intervention will increase the number of partner-to-partner consults and improve the measures listed above. Students will be surveyed using the Interprofessional Socialization and Valuing Scale, along with other survey tools developed by IUSOC research scientists. The project aims enhance inter-professional practice behaviors in students, as well as offer insight into the roles of healthcare professional and explore attitudes regarding teamwork in a healthcare setting. Learning Objectives: Describe how IPE measures in a student-run, free clinic setting may be structured to improve teamwork among volunteers. Knowledge regarding how an innovative screening and knowledge protocol may lead to increased inter-professional practice behaviors among student volunteers. Explore personal attitudes and values regarding teamwork in a healthcare setting

Prevalence of Dyslipidemia and Related Risk Factors Among Adults in Armenia

This study provides insight into the previously unreported prevalence of dyslipidemia in a region with high CVD mortality

HIV Awareness in the Former Soviet Union: An Assessment of HIV Knowledge Among Varied University Disciplines in Armenia

Globally, 36.7 million people are HIV-positive, the majority of whom are living in low- and middle-income countries, with 2.1 million new cases in 2015 alone

Preventative Healthcare in Post-Soviet Armenia: Providing Education and Screenings to Expand Awareness of Noncommunicable Diseases

Non-communicable diseases (NCDs) account for over 75% of annual deaths globally. Cardiovascular disease, cancer, diabetes, and respiratory disease are the most common NCDs which, while typically unique to the developed world, are growing in prominence in post-Soviet nations. In Armenia, mortality from preventable NCDs is over 90%. Global Health Armenia (GHA) concluded a collaborative multidisciplinary project providing education in NCD prevention and free health screenings, along with encouraging participants to follow up with their community physicians

Training and Technical Assistance to Enhance Capacity Building Between Prevention Research Centers and Their Partners

IntroductionThe Centers for Disease Control and Prevention has administered the Prevention Research Centers Program since 1986. We quantified the number and reach of training programs across all centers, determined whether the centers' outcomes varied by characteristics of the academic institution, and explored potential benefits of training and technical assistance for academic researchers and community partners. We characterized how these activities enhanced capacity building within Prevention Research Centers and the community.MethodsThe program office collected quantitative information on training across all 33 centers via its Internet-based system from April through December 2007. Qualitative data were collected from April through May 2007. We selected 9 centers each for 2 separate, semistructured, telephone interviews, 1 on training and 1 on technical assistance.ResultsAcross 24 centers, 4,777 people were trained in 99 training programs in fiscal year 2007 (October 1, 2006-September 30, 2007). Nearly 30% of people trained were community members or agency representatives. Training and technical assistance activities provided opportunities to enhance community partners’ capacity in areas such as conducting needs assessments and writing grants and to improve the centers’ capacity for cultural competency.ConclusionBoth qualitative and quantitative data demonstrated that training and technical assistance activities can foster capacity building and provide a reciprocal venue to support researchers’ and the community’s research interests. Future evaluation could assess community and public health partners’ perception of centers’ training programs and technical assistance

Is Childhood Socioeconomic Status Related to Coronary Heart Disease? Evidence From the Health and Retirement Study (1992-2012)

Objective: We investigated the association between childhood socioeconomic status (SES) and coronary heart disease (CHD) in older Americans. Method: We used Health and Retirement Study data from 1992 to 2012 to examine a nationally representative sample of Americans aged ≥50 years ( N = 30,623). We modeled CHD as a function of childhood and adult SES using maternal and paternal educational level as a proxy for childhood SES. Results: Respondents reporting low childhood SES were significantly more likely to have CHD than respondents reporting high childhood SES. Respondents reporting both low childhood and adult SES were 2.34 times more likely to have CHD than respondents reporting both high childhood and adult SES. People with low childhood SES and high adult SES were 1.60 times more likely than people with high childhood SES and high adult SES to report CHD in the fully adjusted model. High childhood SES and low adult SES increased the likelihood of CHD by 13%, compared with high SES both as a child and adult. Conclusion: Childhood SES is significantly associated with increased risk of CHD in later life among older adult Americans

Is Antibiotic Prophylaxis Necessary in Small (≤20% TBSA) Burn Excisions? A Retrospective Study

Background:. This study investigates the effect of prophylactic perioperative antibiotic use on patients with small burns [≤20% total body surface area (TBSA)] on rates of infection, graft loss, or readmission. Methods:. A retrospective chart review was conducted on patients admitted to our institution’s burn center between January 2020 and July 2021. Patients were included if they had a 20% or less TBSA burn with 1 or more operating room visit for burn excision and were excluded if a preoperative infection was present. Data were gathered regarding patient demographics, burn mechanism, burn characteristics, and outcome measures including infection, graft loss, and readmission. Statistical analysis was conducted by Mann–Whitney U and Fisher exact tests, and P values reported at two-sided significance of less than 0.05. Results:. There were no significant differences in age, body mass index, TBSA, percent third-degree burn, or comorbidities between patients who received (n = 29) or did not receive (n = 47) prophylactic perioperative antibiotics. There was a nonsignificant trend toward higher length of stay in the prophylactic antibiotic group, possibly driven by a nonsignificant trend toward higher rates of flame injuries in this group. There was no difference in infection (P = 0.544), graft loss (P = 0.494), or 30-day readmission (P = 0.584) between the two groups. Conclusion:. This study finds no significant difference in postoperative infection, graft loss, or 30-day readmission in two similar patient cohorts who received or did not receive prophylactic perioperative antibiotics for acute excision of small (≤20% TBSA) burns