HPV Vaccine Initiation and Completion Among Native Hawaiian and Pacific Islander Adults, United States, 2014

2021 ◽  
pp. 101053952110274
Author(s):  
Sameer Vali Gopalani ◽  
Amanda E. Janitz ◽  
Sydney A. Martinez ◽  
Janis E. Campbell ◽  
Sixia Chen
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Vaccination Coverage ◽  
Hpv Vaccine ◽  
Regression Models ◽  
Insurance Coverage ◽  
Hpv Vaccination ◽  
Pacific Islander ◽  
Logistic Regression Models ◽  
Vaccine Initiation

Native Hawaiian and Pacific Islander (NHPI) adults bear a disproportionate burden of certain human papillomavirus (HPV)-associated cancers. In 2015, data from the National Health Interview Survey (NHIS) showed vaccination coverage among adults by racial and ethnic groups; however, coverage data for NHPI adults were unavailable. In this study, we estimated the initiation and completion of HPV vaccination and assessed the factors associated with vaccination among NHPI adults aged 18 to 26 years in the United States. We analyzed public data files from the 2014 NHPI NHIS (n = 1204). We specified sampling design parameters and fitted weighted logistic regression models to calculate the odds of HPV vaccine initiation. We developed a directed acyclic graph to identify a minimally sufficient set for adjustment and adjusted for insurance coverage (for education and ethnicity) and doctor visit (for insurance coverage, earnings, ethnicity, and sex). Overall, 24.9% and 11.5% of NHPI adults had initiated and completed the HPV vaccination series, respectively. Weighted logistic regression models elucidated that the odds of HPV vaccine initiation were higher for females (weighted odds ratio = 5.4; 95% confidence interval = 2.8-10.4) compared with males. Low vaccination coverage found among NHPI adults provides an opportunity for targeted programs to reduce the burden of HPV-associated cancers.

Correlates of Perceived HIV Prevalence and Associations With HIV Testing Behavior Among Men Who Have Sex With Men in the United States

2014 ◽  
Vol 10 (2) ◽  
pp. 90-99 ◽  
Author(s):  
Darcy White ◽  
Rob Stephenson
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Hiv Testing ◽  
Regression Models ◽  
Binary Logistic Regression ◽  
The United States ◽  
Hiv Prevalence ◽  
Logistic Regression Models ◽  
Sex With Men ◽  
Hiv Testing Behavior

As the rate of HIV infection continues to rise among men who have sex with men (MSM) in the United States, a focus of current prevention efforts is to encourage frequent HIV testing. Although levels of lifetime testing are high, low levels of routine testing among MSM are concerning. Using data from an online sample of 768 MSM, this article explores how perceptions of HIV prevalence are associated with HIV testing behavior. Ordinal logistic regression models were fitted to examine correlates of perceived prevalence, and binary logistic regression models were fitted to assess associations between perceived prevalence and HIV testing. The results indicate that perceptions of higher prevalence among more proximal reference groups such as friends and sex partners are associated with greater odds of HIV testing. Perceptions of HIV prevalence were nonuniform across the sample; these variations point to groups to target with strategic messaging and interventions to increase HIV testing among MSM.

scholarly journals COVID-19 Vaccine Acceptance Among Healthcare Workers in a United States Medical Center

2021 ◽  
Author(s):  
Michelle H. Moniz ◽  
Courtney Townsel ◽  
Abram L. Wagner ◽  
Brian J. Zikmund-Fisher ◽  
Sarah Hawley ◽  
...  
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
Healthcare Workers ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Vaccine Acceptance ◽  
Logistic Regression Models ◽  
Occupational Characteristics ◽  
To Receive

ABSTRACTBackgroundThe Centers for Disease Control and Prevention prioritized healthcare personnel for the first phase of COVID-19 vaccination in the United States to keep critical healthcare infrastructure open and functioning, but vaccine hesitancy may limit vaccine uptake.ObjectiveTo evaluate vaccine intentions among healthcare workers eligible for COVID-19 vaccination and explore differences by sociodemographic and occupational characteristics.DesignFrom February 1-15, 2021, we conducted a cross-sectional, opt-in online survey at a Midwest U.S. academic healthcare center that began vaccinating employees in December 2020.ParticipantsThe entire employee workforce of the study site was eligible.Main MeasuresCOVID-19 vaccination intention, categorized as Received/Scheduled/ASAP, Not Now, and Not Ever. Logistic regression models to assess the relationship between demographic and occupational characteristics and intention to receive COVID-19 vaccination.Key ResultsMost participants (n=11,387, of 39,259 individual and group email accounts invited) had received or were scheduled to receive the COVID-19 vaccine (n=9081, 79.8%) or planned to receive it as soon as possible (n=546, 4.8%), while fewer were hesitant (Not Now, n=954, 8.4%; Not Ever, n=369, 3.2%). In multivariable logistic regression models predicting vaccine intention, physicians (aOR 22.2, 9.1-54.3), trainees (aOR 5.9, 3.0-11.4), and nurse practitioners/nurse midwives/physician assistants (aOR 1.9, 1.2-3.0) were significantly more likely to demonstrate vaccine acceptance, compared to nurses, whereas other clinical staff were significantly less likely (aOR 0.8, 0.6-0.9). Prior infection with COVID-19, gender, race/ethnicity, and age were all significantly associated with vaccine intention. Overall, 29.6% reported at least one concern about COVID-19 vaccination.ConclusionsIn a large, diverse sample of healthcare workers, over 11% delayed COVID-19 vaccination when it was available to them, with notable variation in vaccine hesitancy across professional roles and demographic groups. Our findings suggest immediate opportunities to empathetically engage those with COVID-19 vaccine concerns and optimize vaccine coverage across our healthcare system.

scholarly journals Serious Psychological Distress and Emergency Room Use among Adults with Multimorbidity in the United States

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Khalid Alhussain ◽  
Abdulkarim M. Meraya ◽  
Usha Sambamoorthi
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Psychological Distress ◽  
Emergency Room ◽  
Regression Models ◽  
The United States ◽  
Serious Psychological Distress ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression

Objectives. (1) To examine the association between serious psychological distress (SPD) and emergency room (ER) use in the past 12 months among adults with multimorbidity in the United States (US) and (2) to investigate the association between SPD and the reasons for ER use. Methods. The current study used a cross-sectional design with retrospective data from the 2015 National Health Interview Survey. Logistic regression models were used to assess the association between SPD and ER use among adults with multimorbidity. Among ER users, adjusted logistic regression models were conducted to examine the association between SPD and the reasons for the ER use. Results. After controlling for other variables, adults with multimorbidity and SPD were more likely to use ER than those with multimorbidity and no SPD (AOR = 1.61, 95% CI = 1.26, 2.04). Among ER users, there were no significant associations between SPD and the reasons for ER use after controlling for other variables. Conclusion. Adults with multimorbidity and SPD were more likely to use ER as compared to those with multimorbidity and no SPD. Among adults with multimorbidity, routine screening for SPD may be needed to reduce the ER use.

scholarly journals Youth Access to School Salad Bars in the United States—2011 to 2014

2016 ◽  
Vol 32 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Brenna K. VanFrank ◽  
Stephen Onufrak ◽  
Diane M. Harris
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Logistic Regression Models ◽  
Multivariable Logistic Regression ◽  
Let's Move ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Over Time

Purpose: To examine differences in students’ access to school salad bars across sociodemographic groups and changes in availability over time. Design: Nonexperimental. Setting: Nationally representative 2011 and 2014 YouthStyles surveys. Participants: A total of 833 (2011) and 994 (2014) US youth aged 12 to 17 years. Measures: Youth-reported availability of school salad bars. Analysis: Multivariable logistic regression models were used to assess differences in school salad bar availability by sociodemographics and changes in availability from 2011 to 2014. Results: Youth-reported salad bar availability differed by age in 2011 and race/ethnicity in 2014, but not by sex, income, metropolitan residence, or region in either year. Salad bars were reported by 62% of youth in 2011 and 67% in 2014; the increase was not statistically significant ( P = .07). Significant increases from 2011 to 2014 were noted among youth aged 12 to 14 years (56%-69%; P < .01), youth of non-Hispanic other races (60%-85%; P < .01), and youth in the Midwest (58%-72%; P = .01). Conclusion: These results suggest that youth-reported access to school salad bars does not differ significantly across most sociodemographic groups. Although overall salad bar availability did not increase significantly from 2011 to 2014, some increases were observed among subgroups. Continued efforts to promote school salad bars through initiatives such as Let’s Move Salad Bars to Schools could help increase access for the nearly one-third of US youth reporting no access.

scholarly journals Sociodemographic Characteristics and Health Status of Mindfulness Users in the United States

Mindfulness ◽  
2020 ◽  
Vol 11 (12) ◽  
pp. 2725-2729 ◽  
Author(s):  
Otto Simonsson ◽  
Maryanne Martin ◽  
Stephen Fisher
Keyword(s):  
United States ◽  
Mental Illness ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Access Barriers ◽  
Physical Pain ◽  
Unequal Distribution ◽  
Logistic Regression Models ◽  
Barriers To Healthcare

Abstract Objectives The aims of the present study are to provide population estimates for the prevalence of mindfulness use in the United States and to identify which groups are more likely to self-report mindfulness use. Methods Using data from the 2017 National Health Interview Survey (NHIS), the current study analyzed 26,742 responses from adults in the United States and estimated patterns in the likelihood of self-reported mindfulness use across groups using logistic regression models. Results The results suggest that 5% of adults in the United States in 2017 had used mindfulness over the prior year, which is significantly more than the finding that 2% of adults in the United States had used mindfulness during the 12 months prior to the 2012 NHIS interview. The logistic regression models show that self-reported mindfulness use was less likely among married adults and more likely among women, sexual minorities, young and middle-aged adults, white adults, employed adults, adults without minor children in the family, adults from the West of the United States, adults with access barriers to healthcare, adults with cost barriers to healthcare, adults with mental illness, and adults with physical pain. Most notably, mindfulness use was reported by substantial numbers of respondents with access barriers to healthcare (10%), cost barriers to healthcare (9%), mental illness (15%), or physical pain (7%). Conclusions The results of the present study suggest an unequal distribution of mindfulness use across groups in the United States.

scholarly journals Rise in Use of Digital Mental Health Tools and Technologies in the United States During the COVID-19 Pandemic: Survey Study (Preprint)

2021 ◽  
Author(s):  
Dara H Sorkin ◽  
Emily A Janio ◽  
Elizabeth V Eikey ◽  
Margaret Schneider ◽  
Katelyn Davis ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Logistic Regression ◽  
Regression Models ◽  
The United States ◽  
Clinical Depression ◽  
Depression And Anxiety ◽  
Logistic Regression Models ◽  
Symptoms Of Depression ◽  
Time Point

BACKGROUND Accompanying the rising rates of reported mental distress during the COVID-19 pandemic has been a reported increase in the use of digital technologies to manage health generally, and mental health more specifically. OBJECTIVE The objective of this study was to systematically examine whether there was a COVID-19 pandemic–related increase in the self-reported use of digital mental health tools and other technologies to manage mental health. METHODS We analyzed results from a survey of 5907 individuals in the United States using Amazon Mechanical Turk (MTurk); the survey was administered during 4 week-long periods in 2020 and survey respondents were from all 50 states and Washington DC. The first set of analyses employed two different logistic regression models to estimate the likelihood of having symptoms indicative of clinical depression and anxiety, respectively, as a function of the rate of COVID-19 cases per 10 people and survey time point. The second set employed seven different logistic regression models to estimate the likelihood of using seven different types of digital mental health tools and other technologies to manage one’s mental health, as a function of symptoms indicative of clinical depression and anxiety, rate of COVID-19 cases per 10 people, and survey time point. These models also examined potential interactions between symptoms of clinical depression and anxiety, respectively, and rate of COVID-19 cases. All models controlled for respondent sociodemographic characteristics and state fixed effects. RESULTS Higher COVID-19 case rates were associated with a significantly greater likelihood of reporting symptoms of depression (odds ratio [OR] 2.06, 95% CI 1.27-3.35), but not anxiety (OR 1.21, 95% CI 0.77-1.88). Survey time point, a proxy for time, was associated with a greater likelihood of reporting clinically meaningful symptoms of depression and anxiety (OR 1.19, 95% CI 1.12-1.27 and OR 1.12, 95% CI 1.05-1.19, respectively). Reported symptoms of depression and anxiety were associated with a greater likelihood of using each type of technology. Higher COVID-19 case rates were associated with a significantly greater likelihood of using mental health forums, websites, or apps (OR 2.70, 95% CI 1.49-4.88), and other health forums, websites, or apps (OR 2.60, 95% CI 1.55-4.34). Time was associated with increased odds of reported use of mental health forums, websites, or apps (OR 1.20, 95% CI 1.11-1.30), phone-based or text-based crisis lines (OR 1.20, 95% CI 1.10-1.31), and online, computer, or console gaming/video gaming (OR 1.12, 95% CI 1.05-1.19). Interactions between COVID-19 case rate and mental health symptoms were not significantly associated with any of the technology types. CONCLUSIONS Findings suggested increased use of digital mental health tools and other technologies over time during the early stages of the COVID-19 pandemic. As such, additional effort is urgently needed to consider the quality of these products, either by ensuring users have access to evidence-based and evidence-informed technologies and/or by providing them with the skills to make informed decisions around their potential efficacy.

scholarly journals Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial

2018 ◽  
pp. 135-145
Author(s):  
Noel T. Brewer ◽  
Megan E. Hall ◽  
Teri L. Malo ◽  
Melissa B. Gilkey ◽  
Beth Quinn ◽  
...  
Keyword(s):  
North Carolina ◽  
Vaccination Coverage ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Immunization Registry ◽  
The North ◽  
Vaccine Initiation ◽  
Parallel Group ◽  
Effectiveness Of Training ◽  
Training Control

OBJECTIVE Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. Thus, we sought to determine the effectiveness of training providers to improve their recommendations using either presumptive “announcements” or participatory “conversations.” METHODS In 2015, we conducted a parallel-group randomized clinical trial with 30 pediatric and family medicine clinics in central North Carolina. We randomized clinics to receive no training (control), announcement training, or conversation training. Announcements are brief statements that assume parents are ready to vaccinate, whereas conversations engage parents in open-ended discussions. A physician led the 1-hour, in-clinic training. The North Carolina Immunization Registry provided data on the primary trial outcome: 6-month coverage change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years. RESULTS The immunization registry attributed 17 173 adolescents aged 11 or 12 to the 29 clinics still open at 6-months posttraining. Six-month increases in HPV vaccination coverage were larger for patients in clinics that received announcement training versus those in control clinics (5.4% difference, 95% confidence interval: 1.1%–9.7%). Stratified analyses showed increases for both girls (4.6% difference) and boys (6.2% difference). Patients in clinics receiving conversation training did not differ from those in control clinics with respect to changes in HPV vaccination coverage. Neither training was effective for changing coverage for other vaccination outcomes or for adolescents aged 13 through 17 (n = 37 796). CONCLUSIONS Training providers to use announcements resulted in a clinically meaningful increase in HPV vaccine initiation among young adolescents.

scholarly journals Vision Impairment, Poor Diet, and Food Insecurity in the United States

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 30-30
Author(s):  
Ajay Kolli ◽  
Rebecca Mozaffarian ◽  
Erica Kenney
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Food Security ◽  
Food Insecurity ◽  
Diet Quality ◽  
Regression Models ◽  
The United States ◽  
Vision Impairment ◽  
Logistic Regression Models ◽  
Poor Diet

Abstract Objectives To test the hypotheses that poor diet and food insecurity are associated with both measured and self-reported vision impairment (VI). Methods We analyzed data from adults age ≥50 years in the National Health and Nutrition Examination Survey (NHANES) between 1999–2008 in the United States (US). To assess diet quality, Healthy Eating Index 2015 scores (HEI-2015) were applied to participants’ 24-hour recall dietary intake. Participants were categorized as having full, marginal, low, or very low food security using the US Food Security Survey Module. Presenting VI (PVI) was defined as presenting distance visual acuity worse than 20/40 in the better-seeing eye. Self-reported VI (SRVI) was defined as vision reported as fair, poor, or very poor. Accounting for NHANES’ complex survey design, separate logistic regression models were constructed to assess the associations between HEI-2015 quintile and PVI, HEI-2015 quintile and SRVI, food insecurity category and PVI, and food insecurity category and SRVI. Models were adjusted for age, gender, race, education, income, cigarette use, alcohol use, body mass index, and physical activity. Results Of the 10078 adults in this analysis, mean age was 63.4 years, 54% were women, and 80% were white. Mean HEI-2015 score (from 0–100) was 52.5. The prevalence of full food security was 89.9%, that of PVI was 7.2%, and that of SRVI was 20.1%. In adjusted logistic regression models, those with HEI-2015 scores in the lowest quintile (poor diet) had significantly higher odds of SRVI (OR: 1.29; 95% confidence interval [CI]: 1.04–1.61), but not PVI (OR: 1.13; CI: 0.86–1.49) compared to those in the fifth quintile. Compared to full food security, marginal (OR: 1.31; CI: 0.97–1.76), low (OR: 1.61; CI: 1.17–2.23), and very low (OR: 2.71; CI: 1.75, 4.20) food security was associated with increased odds of PVI. Similarly, marginal (OR: 1.58; CI: 1.23–2.02), low (OR: 1.46; CI: 1.11–2.92), and very low (OR: 1.85; CI: 1.41, 2.41) food security were associated with increased odds of SRVI compared to full security. Conclusions In this nationally representative sample of US adults age 50 years and older, poorer overall diet quality was associated with greater prevalence of SRVI. In a dose-response pattern, increasingly severe food insecurity was associated with greater prevalence of both PVI and SRVI. Funding Sources None

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