scholarly journals COVID-19 Vaccine Acceptability and Inequity in the United States: Results from a nationally representative survey

2021 ◽  
Author(s):  
Dustin Gibson ◽  
Smisha Agarwal ◽  
Ankita Meghani ◽  
Rupali J. Limaye ◽  
Alain Labrique
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Online Survey ◽  
The United States ◽  
Demographic Characteristics ◽  
Third Party ◽  
Sample Population ◽  
Nationally Representative ◽  
To Receive ◽  
Racial Ethnic

AbstractBackgroundAt the time of this survey, September 1st, there were roughly 6 million COVID-19 cases and 176,771 deaths in the United States and no federally approved vaccine. The objective of this study was to explore the willingness to accept a COVID-19 vaccine in the United States and describe variability in this acceptability by key racial, ethnic and socio-demographic characteristics.MethodsThis was a cross-sectional digital survey that sampled participants from a nationally-representative panel maintained by a third party, Dynata. Dynata randomly sampled their database and emailed web-based surveys to United States residents ensuring the sample was matched to US Census estimates for age, race, gender, income, and Census region. Participants were asked how willing or unwilling they would be to: 1) receive a COVID-19 vaccine as soon as it was made publicly available, and 2) receive the influenza vaccine for the upcoming influenza season. Participants could respond with extremely willing, willing, unwilling, or extremely unwilling. For those who reported being unwilling to receive a COVID-19 vaccine, reasons for this hesitancy were captured. All participants were asked about where they obtain vaccine-related information, and which sources they trust most. Univariable and multivariable logistic regressions were conducted to examine the association of all demographic characteristics with willingness to receive COVID-19 vaccine.FindingsFrom September 1st to September 7, 2020, 1592 respondents completed the online survey. Overall, weighted analyses found that only 58.9% of the sample population were either willing or extremely willing to receive a COVID-19 vaccine as soon as it was made publicly available. In comparison, 67.7% of the respondents were willing or extremely willing to take the influenza vaccine. By gender, 66.1% of males and 51.5% of females were willing to receive a COVID-19 vaccine. Males were significantly more willing to receive a COVID-19 vaccine (adjusted odds ratio (OR)=1.98, 95% CI: 1.56, 2.53; p<0.001) than females. Blacks were the least willing racial/ethnic group (48.8%) Blacks, (aOR=0.59, 95%CI: 0.43, 0.80; p<0.001) were significantly less willing, than whites, to receive a COVID-19 vaccine. There were numerous reasons provided for being unwilling to receive a COVID-19 vaccine. The most common reason was concern about the vaccine’s safety (36.9%), followed by concerns over its efficacy (19.1%).InterpretationIn conclusion, we found that a substantial proportion (41%) of United States residents are unwilling to receive a COVID-19 vaccine as soon as one is made publicly available. We found that vaccine acceptance differs by sub-populations. In addition to sub-group differences in willingness to receive the vaccine, respondents provided a variety of reasons for being unwilling to receive the vaccine, driven by various sources of vaccine information (and misinformation). This compounds the challenge of delivering a safe and efficacious COVID-19 vaccine at a population level to achieve herd immunity. A multi-pronged and targeted communications and outreach effort is likely needed to achieve a high level of immunization coverage.

scholarly journals Treatment Sequencing in Advanced BRAF-Mutant Melanoma Patients: Current Practice in the United States

2017 ◽  
Vol 34 (1) ◽  
pp. 17-23
Author(s):  
Céline Audibert ◽  
Mark Stuntz ◽  
Daniel Glass
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Targeted Therapy ◽  
Online Survey ◽  
The United States ◽  
Community Based ◽  
Academic Center ◽  
Melanoma Patients ◽  
To Receive ◽  
Braf Mutant

Background: Treatment of advanced BRAF-mutant melanoma has changed dramatically in the past 3 years thanks to the approval of new immunotherapy and targeted therapy agents. Objectives: The goal of our survey was to investigate when immunotherapy and targeted therapy are used in the management of advanced melanoma patients and whether differences exist between the types of setting. Methods: Oncologists from academic centers, community-based centers, and private clinics were invited to participate in an online survey. Survey questions addressed the proportion of BRAF-mutant patients per treatment line, proportion of patients on targeted therapy and immunotherapy available in the United States, and reasons for prescribing each drug class. Results: A total of 101 physicians completed the survey, of which 47 worked in a private clinic, 33 in an academic center, and 21 in a community-based center. Academic center participants tended to see more severe patients ( P < .001) and had more patients in second-line treatment than participants from other setting types. In addition, academic center physicians had more patients in clinical trials ( P < .001), and they prescribed the ipilimumab and nivolumab combination more frequently. In terms of sequencing, all participants used targeted therapy for severe or rapidly progressing patients and immunotherapy for those who were less severe or slowly progressing. Conclusions: The findings illustrate the differences in treatment approach per type of setting, with patients in academic centers more likely to receive recently approved products or to be enrolled in clinical trials than those in community-based settings.

A Preliminary Overview of Music Therapy Reimbursement Practice in the United States

2020 ◽  
Author(s):  
Kimberly Sena Moore ◽  
Laurie Peebles
Keyword(s):  
United States ◽  
Music Therapy ◽  
Online Survey ◽  
Private Insurance ◽  
International Classification Of Diseases ◽  
The United States ◽  
Third Party ◽  
Music Therapists ◽  
Baseline Information ◽  
Therapy Services

Abstract Music therapy services are currently being reimbursed through state and private insurance funding streams, yet to date, there is no known systematic exploration on music therapy reimbursement practices. Such information would be helpful to include when communicating with third-party payers and can assist in tracking reimbursement trends. Thus, we sought to provide baseline information on how music therapy services are currently being reimbursed in the United States, with a focus on approved treatment parameters, referral sources, Current Procedural Terminology (CPT) codes used, and types of music interventions and music therapy experiences implemented. Board-certified music therapists in private practice who had successfully obtained reimbursement for music therapy services between 2012 and 2018 completed a 28-item online survey. In total, 7 respondents provided information on 55 unique reimbursement cases from 5 different states, most of which were based on Medicaid waiver programs. We conducted descriptive analyses to summarize music therapy reimbursement practices. Most of the clients were referred by doctors or physician’s assistants. The most common CPT code utilized was 97530 (Therapeutic Activities, one-on-one, each 15 minutes), and most of the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes were based on specific diagnoses rather than general clinical needs. In most of the cases, reimbursement of music therapy was ongoing, and services incorporated a variety of music therapy methods, with few specific music interventions identified. Most notably, reimbursement practice varied by state; thus, we recommend the creation and dissemination of state-specific surveys.

scholarly journals A Demographic Analysis of Racial/Ethnic Minority Enrollment Into HVTN Preventive Early Phase HIV Vaccine Clinical Trials Conducted in the United States, 2002-2016

2018 ◽  
Vol 134 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Katherine Foy Huamani ◽  
Barbara Metch ◽  
Gail Broder ◽  
Michele Andrasik
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Phase 1 ◽  
The United States ◽  
Demographic Characteristics ◽  
Hiv Vaccine ◽  
Ethnic Minority Groups ◽  
Racial Ethnic

Objectives: Racial/ethnic minority communities in the United States are overrepresented among new HIV diagnoses, yet their inclusion in preventive HIV vaccine clinical trials is inadequate. An analysis of enrollment demographic characteristics from US preventive HIV vaccine clinical trials from 1988 through 2002 showed that enrollment of racial/ethnic minority groups increased. We analyzed enrollment in preventive HIV vaccine clinical trials from 2002 through 2016 and compared our data with data from the previous study, described demographic characteristics of trial participants, and assessed how well this distribution reflected the racial/ethnic distribution of new HIV diagnoses in the United States. Methods: We examined data on demographic characteristics from 43 Phase 1 and Phase 2A preventive HIV vaccine clinical trials conducted in the United States and compared the results with those of the previous study. We also compared racial/ethnic distributions from 2011 through 2015 with Centers for Disease Control and Prevention data on the number of new HIV diagnoses during the same period. Results: Of 3469 participants, 1134 (32.7%) identified as a racial/ethnic minority, a 94% increase from the previous period (634/3731; 17.0%). Percentage annual enrollment of all racial/ethnic minority participants fluctuated from 17% to 53% from mid-2002 to 2016. Percentages of new HIV diagnoses among the general population were 1.9 to 2.9 times the percentage enrollment of black participants and 1.3 to 6.6 times the percentage enrollment of Hispanic/Latino participants in clinical trials for the same period. Conclusions: Although enrollment of racial/ethnic minority groups into HIV vaccine clinical trials has increased, it is not proportional to the number of new HIV diagnoses among these groups. To enhance recruitment of racial/ethnic minority groups, the HIV Vaccine Trials Network has prioritized community partnerships and invested resources into staff training.

Radon Testing Status in Schools by Radon Zone and School Location and Demographic Characteristics: United States, 2014

2018 ◽  
Vol 35 (6) ◽  
pp. 442-448 ◽  
Author(s):  
Sherry Everett Jones ◽  
Stephanie Foster ◽  
Andrew S. Berens
Keyword(s):  
United States ◽  
Indoor Radon ◽  
The United States ◽  
Demographic Characteristics ◽  
Short Term ◽  
Naturally Occurring ◽  
Nationally Representative ◽  
Using Data ◽  
Radon Testing ◽  
Radon Survey

Radon is a naturally occurring, radioactive, colorless, odorless gas, and the second leading cause of lung cancer. The 1990–1991 National School Radon Survey estimated that more than 70,000 schoolrooms nationwide had “high short-term radon levels.” Using data from a nationally representative survey of schools in the United States ( N = 568; response rate = 69%), we examined the location and demographic characteristics of U.S. schools that had ever been tested for radon and whether having been tested varied by radon zone, which predicts average indoor radon levels in U.S. counties. Overall, 46.0% (95% confidence interval [39.8%, 52.4%]) of schools reported that they had ever been tested for radon. Testing significantly varied by region, percentage of minority students, and radon zone. These findings highlight the need for improved awareness of radon testing in schools, as testing is the only way to identify when remediation is needed.

scholarly journals Caught in the Crossfire: How Contradictory Information and Norms on Social Media Influence Young Women’s Intentions to Receive HPV Vaccination in the United States and China

2020 ◽  
Vol 11 ◽  
Author(s):  
Shuya Pan ◽  
Di Zhang ◽  
Jingwen Zhang
Keyword(s):  
United States ◽  
Social Media ◽  
Social Norms ◽  
Online Survey ◽  
Hpv Vaccination ◽  
Positive Association ◽  
The United States ◽  
Hpv Vaccines ◽  
Contradictory Information ◽  
To Receive

This study uses online survey data from the United States and China to examine how contradictory information and social norms regarding HPV vaccines obtained through social media are related to young women’s attitudes and intentions surrounding HPV vaccination. The results show that exposure to contradictory information on social media had a greater negative association with intentions to receive HPV vaccination among the United States participants than among the Chinese participants, while social norms supporting HPV vaccines had a stronger positive association with intentions to receive HPV vaccination among the Chinese participants than among the United States participants. These findings extend the literature on social media communication regarding HPV vaccination and contribute to our knowledge of cultural contexts that influence intentions to receive HPV vaccination.

scholarly journals Neighborhood Disparities in the Availability, Advertising, Promotion, and Youth Appeal of Little Cigars and Cigarillos, United States, 2015

2020 ◽  
Vol 22 (12) ◽  
pp. 2170-2177 ◽  
Author(s):  
Amanda Y Kong ◽  
Tara L Queen ◽  
Shelley D Golden ◽  
Kurt M Ribisl
Keyword(s):  
United States ◽  
The United States ◽  
National Study ◽  
Lower Income ◽  
Point Of Sale ◽  
Black Residents ◽  
The Face ◽  
Marketing Data ◽  
Nationally Representative ◽  
Racial Ethnic

Abstract Introduction Between 2012 and 2016, sales of cigars increased by 29% in the United States. In small local studies, greater little cigar and cigarillo (LCC) availability and marketing has been documented in neighborhoods with a greater proportion of Hispanic or Latino and black residents, and near schools. This national study of cigarette retailers assesses whether LCC availability and marketing at the point of sale is associated with neighborhood racial, ethnic, income, and percent youth demographics. Methods In 2015, we collected LCC availability and marketing data through retailer audits of a nationally representative sample of 2128 cigarette retailers. Using 2011–2015 American Community Survey census tract estimates, we modeled associations of neighborhood demographics (in quartiles) with availability of LCC-flavored products, and presence of exterior advertisements, youth marketing, and promotions. Results Nearly 90% of retailers sold LCCs, 83.0% sold flavored LCCs, and 30.9% had youth marketing. Controlling for retailer type and other neighborhood characteristics, neighborhoods with the highest proportion of black residents had significantly higher odds of flavored LCC availability (adjusted odds ratio [AOR] = 2.24, 95% confidence interval [CI] = 1.52, 3.30); exterior advertisements (AOR = 2.84, 95% CI = 1.94, 4.16); price promotions (AOR = 1.62; 95% CI = 1.07–2.45), and youth appeal (AOR = 1.49, 95% CI 1.08–2.08) compared to the lowest. Disparities in flavored LCC availability, exterior advertising, and youth appeal were also present for lower income neighborhoods. Conclusion Neighborhoods with a greater proportion of black or lower income residents have greater flavored LCCs availability and LCC marketing. Without stronger LCC regulation, residents of these neighborhoods may be at a greater risk of LCC use. Implications LCCs are harmful combustible tobacco products that are less regulated than cigarettes (eg, lower taxation, cheaper outlay due to small package sizes, availability of flavors), which makes them an affordable and appealing product to youth. This study documents greater availability, advertising, and marketing of LCCs in neighborhoods with a higher proportion of black or lower-income residents, potentially putting these populations at a greater risk of using or switching to these products in the face of increasing cigarette regulations. These findings underscore the need for local, state, and federal LCC regulatory action.

Cross-Cohort Evidence of Disparities in Service Receipt for Speech or Language Impairments

2017 ◽  
Vol 84 (1) ◽  
pp. 27-41 ◽  
Author(s):  
Paul L. Morgan ◽  
George Farkas ◽  
Marianne M. Hillemeier ◽  
Hui Li ◽  
Wik Hung Pun ◽  
...  
Keyword(s):  
United States ◽  
Special Education ◽  
The United States ◽  
Language Impairments ◽  
Odds Ratios ◽  
White Children ◽  
English Speaking ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
To Receive

We examined the extent to which disparities in the receipt of special education services for speech or language impairments (SLIs) on the basis of race, ethnicity, or language use by kindergarten—when the delivery of these services might be expected to be most effective—have changed over a 12-year period in the United States. Logistic regression modeling of 2 nationally representative cohorts ( N = 16,800 and 12,080) indicated that children who are Black (covariate-adjusted odds ratios = 0.39 and 0.54) or from non-English-speaking households (covariate-adjusted odds ratios = 0.57 and 0.50) continue to be less likely to receive services for SLIs. Hispanic children are now less likely to receive these services (covariate adjusted odds ratio = 0.54) than otherwise similar non-Hispanic White children. Disparities in special education service receipt for SLIs attributable to race, ethnicity, and language presently occur in the United States and are not explained by many potential confounds.

scholarly journals Selective exposure and the authoritarian dynamic: Evidence from Canada and the United States

2020 ◽  
Vol 8 (1) ◽  
pp. 151-172
Author(s):  
Robert A. Hinckley ◽  
Allison Harell
Keyword(s):  
United States ◽  
Free Speech ◽  
Attitude Change ◽  
Online Survey ◽  
Civil Liberties ◽  
The United States ◽  
Selective Exposure ◽  
Political Messages ◽  
Exposure Experiment ◽  
To Receive

This study explores to what extent selective exposure to political messages can produce political (in)tolerance among authoritarians and non-authoritarians. Drawing on a selection-exposure experiment embedded within an online survey conducted in the United States (N = 1978) and Canada (N = 1673), we explore how authoritarians and non-authoritarians react to framing around civil liberties controversies. Participants were randomly assigned to receive a message about a controversial group. In the forced-choice condition, participants were randomly assigned a political or non-political message. In a second condition, participants were given a choice of which message to read more about. The results show that authoritarians who are politically knowledgeable generally avoid messages that promote free speech by consuming non-political information. While messages about the dangers of free speech have the potential to produce more intolerance among authoritarians, we found that this effect was limited to those who are the least likely to consume them when given a choice. By contrast, we found that messages about the risk posed by free speech produced intolerance among non-authoritarians for whom threat-related cognitions were already chronically accessible. The effects of pro-civil liberties messages were limited to unthreatened non-authoritarians. Hence, we conclude that in the contemporary information environment selective exposure can increase polarization around a civil liberties controversy by producing attitude change but this occurs mainly among non-authoritarians.

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