Predictors of universal influenza vaccination uptake in grades 1 and 2 Toronto school children: Effective vaccination strategies should not end with at risk children

IntroductionInfluenza and influenza-like illness (ILI) create considerable burden on healthcare resources each winter. Children with pre-existing conditions such as asthma, diabetes mellitus and cerebral palsy are among those at greatest risk of clinical deterioration from influenza/ILI. The Antibiotics for at Risk CHildren with InfluEnza (ARCHIE) trial aims to determine whether early oral treatment with the antibiotic co-amoxiclav reduces the likelihood of reconsultation due to clinical deterioration in these ‘at risk’ children.Methods and analysisThe ARCHIE trial is a double-blind, parallel, randomised, placebo-controlled trial. ‘At risk’ children aged 6 months to 12 years inclusive who present within the first 5 days of an ILI episode will be randomised to receive a 5-day course of oral co-amoxiclav 400/57 twice daily or placebo. Randomisation will use a non-deterministic minimisation algorithm to balance age and seasonal influenza vaccination status.To detect respiratory virus infections, a nasal swab will be obtained from each participant before commencing study medication. To identify carriage of potential bacterial respiratory pathogens, we will also obtain a throat swab where possible.The primary outcome is reconsultation in any healthcare setting due to clinical deterioration within 28 days of randomisation. We will analyse this outcome using log-binomial regression model adjusted for region, age and seasonal influenza vaccination status.Secondary outcomes include duration of fever, duration of symptoms and adverse events. Continuous outcomes will be compared using regression analysis (or equivalent non-parametric method for non-normal data) adjusting for minimisation variables. Binary outcomes will be compared using χ2/Fisher’s exact test and log-binomial regression.EthicsThe ARCHIE trial has been reviewed and approved by the North West-Liverpool East Research Ethics Committee, Health Research Authority and Medicines and Healthcare Products Regulatory Agency. Our findings will be published in peer-reviewed journals and disseminated via our study website (www.archiestudy.com) and links with relevant charities.Trial registration numbersISRCTN70714783; Pre-results.

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Group Interventions in Schools: Promoting Mental Health for At-Risk Children and Youth: Book review

PsycEXTRA Dataset ◽

10.1037/e514072010-012 ◽

2009 ◽

Author(s):

Arthur M. Horne

Keyword(s):

Mental Health ◽

At Risk ◽

Children And Youth ◽

Group Interventions ◽

At Risk Children

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Un Kilo de Ayuda

10.1093/oso/9780199366088.003.0013 ◽

2018 ◽

Author(s):

Mary Kay Gugerty ◽

Dean Karlan

Keyword(s):

At Risk ◽

Impact Evaluation ◽

Health Problems ◽

Health Data ◽

Outcome Data ◽

Monitoring Data ◽

Program Monitoring ◽

At Risk Children ◽

The World ◽

The Right

This case explores two common challenges facing organizations around the world: how to collect the right amount of data, and how to credibly use outcome data collected during program monitoring. Health promoters at Un Kilo de Ayuda (UKA) in Mexico use regularly collected health data on more than 50,000 children to structure their work, track their progress, and identify at-risk children in time to treat health problems. In this case, readers will assess the tradeoffs between actionability and responsibility that UKA faces in determining how much data to collect. They will also examine the challenges of monitoring data on a program’s outcomes instead of outputs, particularly when it comes to asserting a program’s impact on those outcomes. Finally, readers will propose ways to generate credible data on one of the organization’s programs when plans for an impact evaluation fall through.

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Protecting Against Delinquency in Early Adolescence With Nonverbal Intelligence and Neighborhood Social Capital

The Journal of Early Adolescence ◽

10.1177/02724316211020362 ◽

2021 ◽

pp. 027243162110203

Author(s):

Glenn D. Walters

Keyword(s):

At Risk ◽

Social Capital ◽

Protective Factors ◽

Conduct Problems ◽

Nonverbal Intelligence ◽

Neighborhood Social Capital ◽

At Risk Children ◽

The Matrix ◽

Childhood Conduct Problems ◽

Matrix Reasoning

The goal of this study was to test nonverbal intelligence and neighborhood social capital as protective factors against future delinquency in early adolescent youth placed at risk by virtue of their involvement in childhood conduct problems. Analyzing longitudinal data from 3,028 youth (1,565 boys, 1,463 girls) in one cohort of the Longitudinal Study of Australian Children (LSAC) and 3,682 youth (1,896 boys, 1,786 girls) in a second cohort of the LSAC, nonverbal intelligence, as measured by the Matrix Reasoning subscale of the WISC-IV, displayed a consistent moderating effect on the conduct problems–future delinquency relationship. According to these results, conduct problems were slightly but significantly less likely to lead to delinquency when nonverbal intelligence was high than when it was low or moderate. By shielding at-risk children from future delinquency, protective factors like high nonverbal intelligence may provide a means by which delinquency can be prevented or reduced.

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Coverage and Timing of Influenza Vaccination Among Privately Insured Pregnant Women in the United States, 2010-2018

Public Health Reports ◽

10.1177/00333549211026779 ◽

2021 ◽

pp. 003335492110267

Author(s):

Kai Hong ◽

Megan C. Lindley ◽

Fangjun Zhou

Keyword(s):

Influenza Vaccination ◽

Pregnant Women ◽

Vaccination Coverage ◽

Influenza Season ◽

The United States ◽

Metropolitan Statistical Area ◽

Provider Education ◽

Vaccination Uptake ◽

Increased Risk ◽

Privately Insured

Objective Pregnant women are at increased risk of serious complications from influenza and are recommended to receive an influenza vaccination during pregnancy. The objective of this study was to assess trends, timing patterns, and associated factors of influenza vaccination among pregnant women. Methods We used 2010-2018 MarketScan data on 1 286 749 pregnant women aged 15-49 who were privately insured to examine trends and timing patterns of influenza vaccination coverage. We examined descriptive statistics and identified factors associated with vaccination uptake by using multivariate log-binomial and Cox proportional hazard models. Results In-plan influenza vaccination coverage before delivery increased from 22.0% during the 2010-2011 influenza season to 33.2% during the 2017-2018 influenza season. About two-thirds of vaccinated women received the vaccine in September or October during each influenza season. For women who delivered in September through May, influenza vaccination coverage increased rapidly at the beginning of influenza season and flattened after October. For women who delivered in June through August, influenza vaccination coverage increased gradually until February and flattened thereafter. Most vaccinated women who delivered before January received the vaccine in the third trimester. Increased likelihood of being vaccinated was associated with age 31-40, living in a metropolitan statistical area, living outside the South, enrollment in a consumer-driven or high-deductible health plan, being spouses or dependents of policy holders, and delivery in November through January. Conclusions Despite increases during the past several years, vaccination uptake is still suboptimal, particularly after October. Health care provider education on timing of vaccination and recommendations throughout influenza seasons are needed to improve influenza vaccination coverage among pregnant women.

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080 MEASUREMENT OF ANTICIPATORY POSTURAL ADJUSTMENTS (APA) DURING SELF-PACED MOVEMENTS IN PRE-SCHOOL CHILDREN AT RISK FOR POOR DEVELOPMENTAL OUTCOME

Parkinsonism & Related Disorders ◽

10.1016/s1353-8020(10)70081-x ◽

2010 ◽

Vol 16 ◽

pp. S24

Author(s):

R.L. Freedland ◽

D. Ferrario

Keyword(s):

At Risk ◽

School Children ◽

Anticipatory Postural Adjustments ◽

Developmental Outcome ◽

Children At Risk ◽

Postural Adjustments

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Influenza vaccination during the coronavirus pandemic: intention to vaccinate among the at-risk population in the Central Catalonia Health Region (VAGCOVID)

BMC Family Practice ◽

10.1186/s12875-021-01434-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Anna Bonet-Esteve ◽

Raquel Muñoz-Miralles ◽

Carla Gonzalez-Claramunt ◽

Ana M Rufas ◽

Xavier Pelegrin Cruz ◽

...

Keyword(s):

At Risk ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Perceived Risk ◽

Seasonal Influenza ◽

Public Health Issue ◽

Risk Population ◽

Previous Season ◽

The Individual

Abstract Background Influenza is a major public health issue, with the primary preventive measure being an annual influenza vaccination. Nevertheless, vaccination coverage among the at-risk population is low. Our understanding of the behaviour of the influenza virus during the SARS-CoV-2 coronavirus pandemic is limited, meaning influenza vaccination is still recommended for individuals at risk for severe complications due to influenza infection. The aim of the study is to determine the intention to vaccinate against seasonal influenza among the at-risk population in the 2020-21 campaign during the SARS-CoV-2 pandemic and to analyse the factors which influence such intention. Methods Cross-sectional telephone survey of adults (aged over 18) with risk factors in central Catalonia where the need for the Seasonal Influenza Vaccine (SIV) was recommended. Results A total of 434 participants responded to the survey, 43.3% of whom intended to be vaccinated against influenza for the 2020-2021 influenza season, 40.8% had no intention to be vaccinated and 15.9% were uncertain or did not express their opinion. The intention to get vaccinated against influenza is associated with having dependents, the individual’s perception of the risk of being infected with influenza and the perceived risk of transmission to dependents. It is also associated with age, whether the individual had received influenza vaccine the previous season or any other season before. The best predictors of the intention to vaccinate are the individual’s perception of the risk of catching influenza and whether the individual had been vaccinated in the previous season. Conclusions Intention to vaccinate can be a good predictor of individual behaviour in relation to vaccination. During the current SARS-CoV-2 pandemic many individuals are hesitant to influenza vaccination. In order to improve influenza vaccination coverage in people included in risk groups, it is necessary to promote educational actions, especially among those who express doubts.

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