scholarly journals SHINGLES VACCINE UPTAKE AMONG OLDER ADULTS: IDENTIFYING EARLY, LATE, AND NON-ADOPTERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Hyewon Kang ◽  
Eileen Crimmins ◽  
Jennifer A Ailshire
Keyword(s):  
Health Care Access ◽  
Vaccine Uptake ◽  
Factors Affecting ◽  
Early Adopters ◽  
Individual Level ◽  
Vaccination Rates ◽  
Highly Educated ◽  
Effective Strategies ◽  
Care Access ◽  
Early Late

Abstract Although a shingles vaccine (Zostavax) has been available since 2006, vaccination uptake has been slow. As a newly approved shingles vaccine (Shingrix) became available in 2018, understanding factors affecting acceptance and timing of the original vaccine would be useful in establishing effective strategies for greater immunization. Using the Health and Retirement study, we examined individual-level and area-level characteristics of early and late vaccine adopters, and those who were not vaccinated between 2006 and 2016. Early adopters were those who got vaccinated during the four year window after the approval of the vaccine; late vaccine adopters were those who got vaccinated from 2010 to 2016. Early adopters (13.5%) and late adopters (18.5%) comprised 32% of the sample, leaving two-thirds unvaccinated. Regression results suggest that those who received the vaccine were more likely to be socioeconomically advantaged, covered by insurance, socially active, healthy, to use other preventive vaccines, and to live in a region with more vaccinated people. Early adopters were more likely to be highly educated, affluent, and more conscientious compared to late adopters. Utilization of influenza vaccine and living in the region with the highest level of vaccination were found to be significant factors predicting early vaccine uptake. Our findings highlight the importance of outreach efforts and health care access in increasing vaccination rates.

scholarly journals Factors influencing health-care access of female commercial sex workers in India: an in-depth review

2017 ◽  
Vol 4 (4) ◽  
pp. 886 ◽  
Author(s):  
Rudrajit Paul ◽  
Meera Suresh ◽  
Jayati Mondal
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Sex Workers ◽  
Healthcare Access ◽  
Care Facility ◽  
Health Care Facility ◽  
Commercial Sex ◽  
Commercial Sex Workers ◽  
Factors Affecting ◽  
Care Access

Commercial sex workers (CSW) are a vulnerable section of the society with diverse health problems. However, different surveys have consistently shown limited healthcare access by this group. There are a lot of factors, related both to the health care facility and the potential users, which influence this access. In this review, we have analysed some of the factors affecting healthcare access of female CSWs in India. The analysis has been done according to a standard conceptual framework. Certain remedial measures have also been proposed at the end. 

scholarly journals Health Care Access and Utilization for American Indian Elders: A Concept-Mapping Study

2019 ◽  
Vol 76 (1) ◽  
pp. 141-151 ◽  
Author(s):  
David H Sommerfeld ◽  
Elise Trott Jaramillo ◽  
Erik Lujan ◽  
Emily Haozous ◽  
Cathleen E Willging
Keyword(s):  
Health Care ◽  
American Indian ◽  
Concept Mapping ◽  
Health Care Providers ◽  
Health Care Access ◽  
National Policy ◽  
Health Care Use ◽  
Care Providers ◽  
Factors Affecting ◽  
Care Access

Abstract Objectives Inequities in access to and utilization of health care greatly influence the health and quality of life of American Indian elders (AIEs). This study explores the importance and perceived prevalence of factors affecting health care use within this population and assesses the changeability of these factors to produce a list of action items that are timely and relevant to improving health care access and utilization. Method Concept mapping was conducted with AIEs (n = 65) and professional stakeholders (n = 50), including tribal leaders, administrators of public-sector health systems, outreach workers, and health care providers. Data were analyzed using multidimensional scaling and cluster analyses. Results The final concept-map model comprised nine thematic clusters related to factors affecting elder health care: Difficulties Obtaining and Using Insurance; Insecurity from Lack of Knowledge; Limited Availability of Services; Scheduling Challenges; Provider Issues and Relationships; Family and Emotional Challenges; Health-Related Self-Efficacy and Knowledge; Accessibility and Transportation Barriers; and Tribal/National Policy. Discussion Findings suggest that improvements in access to and utilization of health care among AIEs will require actions across multiple domains, including health system navigation services, workforce improvements, and tribal, state, and federal policy. A multilevel socioecological approach is necessary to organize and undertake these actions.

Does health plan type influence receipt of an annual influenza vaccination?

2019 ◽  
Vol 74 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Ian W Watson ◽  
Sanda Cristina Oancea
Keyword(s):  
Health Plan ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Behavioral Risk ◽  
Logistic Regression Models ◽  
Vaccination Rates ◽  
Care Access ◽  
Flu Vaccination ◽  
The Usa

BackgroundThe influenza virus caused 48.8 million people to fall ill and 79 400 deaths during the 2017–2018 influenza season, yet less than 50% of US adults receive an annual flu vaccination (AFV). Having health insurance coverage influences whether individuals receive an AFV. The current study aims to determine if an association exists between an individual’s health plan type (HPT) and their receipt of an AFV.MethodsData from the 2017 Behavioral Risk Factor Surveillance System and the optional ‘Health Care Access’ module were used for this study. The final study sample size was 35 684. Multivariable weighted and adjusted logistic regression models were conducted to investigate the association between HPT and AFV.ResultsMedicare coverage was significantly associated with an increase in AFV for both men (adjusted OR (AOR) 1.62 (95% CI 1.28 to 2.06)) and women (AOR 1.28 (95% CI 1.00 to 1.53)). For men, other sources of coverage were also significantly positively associated with AFV (AOR 1.67 (95% CI 1.27 to 2.19)), while for women obtaining coverage on their own was significantly negatively associated with AFV (AOR 0.75 (95% CI 0.59 to 0.97)).ConclusionThese findings are of interest to health policy makers as these show there are HPTs which are effective at improving vaccination rates. Adopting methods used by these HPTs could help the USA reach its Healthy People 2020 AFV coverage goal of 70%.

State–Level Sexism and Gender Disparities in Health Care Access and Quality in the United States

2021 ◽  
pp. 002214652110581
Author(s):  
Kristen Schorpp Rapp ◽  
Vanessa V. Volpe ◽  
Tabitha L. Hale ◽  
Dominique F. Quartararo
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Access ◽  
Political Representation ◽  
State Level ◽  
The United States ◽  
Gender Disparities ◽  
Individual Level ◽  
Care Access ◽  
Access And Quality

In this investigation, we examined the associations between state-level structural sexism—a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system—and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014–2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.

scholarly journals Behavioral nudges increase COVID-19 vaccinations: Two randomized controlled trials

2021 ◽  
Author(s):  
Hengchen Dai ◽  
Silvia Saccardo ◽  
Maria A Han ◽  
Lily Roh ◽  
Naveen Raja ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Behavioral Science ◽  
Age Groups ◽  
Text Messages ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Controlled Trials ◽  
Vaccination Rates ◽  
Effective Strategies ◽  
Randomized Controlled

AbstractFighting the COVID-19 pandemic requires quick and effective strategies to maximize vaccine uptake. We present two sequential randomized controlled trials (RCTs) that tackle this challenge with behavioral science insights. We deliver text-based nudges to UCLA Health patients one day (first RCT; N=113,229) and eight days (second RCT; N=90,662) after they receive notifications of vaccine eligibility. In the first RCT, text messages designed to make vaccination salient and easy to schedule boost appointment and vaccination rates by 86% and 26%, respectively. Nudges that make patients feel endowed with the vaccine heighten these effects, but addressing vaccine hesitancy via a video-based information intervention does not yield benefits beyond simple text. These results hold across ethnicity and age groups. By contrast, online experiments (N=2,003) soliciting hypothetical responses to the same messages reveal the opposite patterns, underscoring the importance of pilot-testing behavioral nudges in the real world before scaling them up. In the second RCT, we further find that receiving a second reminder boosts appointment and vaccination rates by 52% and 16%, respectively. Our findings suggest that text-based nudges can substantially increase and accelerate COVID-19 vaccinations at almost zero marginal cost, highlighting the promising role of behavioral science in addressing a critical component of the COVID-19 pandemic response.

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