The Immunity Community: A Community Engagement Strategy for Reducing Vaccine Hesitancy

Parental concerns about vaccine safety have grown in the United States and abroad, resulting in delayed or skipped immunizations (often called “vaccine hesitancy”). To address vaccine hesitancy in Washington State, a public–private partnership of health organizations implemented and evaluated a 3-year community intervention, called the “Immunity Community.” The intervention mobilized parents who value immunization and provided them with tools to engage in positive dialogue about immunizations in their communities. The evaluation used qualitative and quantitative methods, including focus groups, interviews, and pre and post online surveys of parents, to assess perceptions about and reactions to the intervention, assess facilitators and barriers to success, and track outcomes including parental knowledge and attitudes. The program successfully engaged parent volunteers to be immunization advocates. Surveys of parents in the intervention communities showed statistically significant improvements in vaccine-related attitudes: The percentage concerned about other parents not vaccinating their children increased from 81.2% to 88.6%, and the percentage reporting themselves as “vaccine-hesitant” decreased from 22.6% to 14.0%. There were not statistically significant changes in parental behaviors. This study demonstrates the promise of using parent advocates as part of a community-based approach to reduce vaccine hesitancy.

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Clinical decision support alert malfunctions: analysis and empirically derived taxonomy

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocx106 ◽

2017 ◽

Vol 25 (5) ◽

pp. 496-506 ◽

Cited By ~ 21

Author(s):

Adam Wright ◽

Angela Ai ◽

Joan Ash ◽

Jane F Wiesen ◽

Thu-Trang T Hickman ◽

...

Keyword(s):

Decision Support ◽

Electronic Health Record ◽

Medical Informatics ◽

Clinical Decision Support ◽

Quantitative Methods ◽

Clinical Decision ◽

The United States ◽

Health Record ◽

Qualitative And Quantitative Methods ◽

Electronic Health

Abstract Objective To develop an empirically derived taxonomy of clinical decision support (CDS) alert malfunctions. Materials and Methods We identified CDS alert malfunctions using a mix of qualitative and quantitative methods: (1) site visits with interviews of chief medical informatics officers, CDS developers, clinical leaders, and CDS end users; (2) surveys of chief medical informatics officers; (3) analysis of CDS firing rates; and (4) analysis of CDS overrides. We used a multi-round, manual, iterative card sort to develop a multi-axial, empirically derived taxonomy of CDS malfunctions. Results We analyzed 68 CDS alert malfunction cases from 14 sites across the United States with diverse electronic health record systems. Four primary axes emerged: the cause of the malfunction, its mode of discovery, when it began, and how it affected rule firing. Build errors, conceptualization errors, and the introduction of new concepts or terms were the most frequent causes. User reports were the predominant mode of discovery. Many malfunctions within our database caused rules to fire for patients for whom they should not have (false positives), but the reverse (false negatives) was also common. Discussion Across organizations and electronic health record systems, similar malfunction patterns recurred. Challenges included updates to code sets and values, software issues at the time of system upgrades, difficulties with migration of CDS content between computing environments, and the challenge of correctly conceptualizing and building CDS. Conclusion CDS alert malfunctions are frequent. The empirically derived taxonomy formalizes the common recurring issues that cause these malfunctions, helping CDS developers anticipate and prevent CDS malfunctions before they occur or detect and resolve them expediently.

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COVID-19 vaccine hesitancy in underserved communities of North Carolina

PLoS ONE ◽

10.1371/journal.pone.0248542 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0248542

Author(s):

Irene A. Doherty ◽

William Pilkington ◽

Laurin Brown ◽

Victoria Billings ◽

Undi Hoffler ◽

...

Keyword(s):

North Carolina ◽

Health Care Providers ◽

Vaccine Safety ◽

The United States ◽

Vaccine Hesitancy ◽

Care Providers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Underserved Communities ◽

Safety Concerns

Background In the United States, underserved communities including Blacks and Latinx are disproportionately affected by COVID-19. This study sought to estimate the prevalence of COVID-19 vaccine hesitancy, describe attitudes related to vaccination, and identify correlates among historically marginalized populations across 9 counties in North Carolina. Methods We conducted a cross-sectional survey distributed at free COVID-19 testing events in underserved rural and urban communities from August 27 –December 15, 2020. Vaccine hesitancy was defined as the response of “no” or “don’t know/not sure” to whether the participant would get the COVID-19 vaccine as soon as it became available. Results The sample comprised 948 participants including 27.7% Whites, 59.6% Blacks, 12.7% Latinx, and 63% female. 32% earned <$20K annually, 60% owned a computer and ~80% had internet access at home. The prevalence of vaccine hesitancy was 68.9% including 62.7%, 74%, and 59.5% among Whites, Blacks, and Latinx, respectively. Between September and December, the largest decline in vaccine hesitancy occurred among Whites (27.5 percentage points), followed by Latinx (17.6) and only 12.0 points among Blacks. 51.2% of respondents reported vaccine safety concerns, 23.7% wanted others to get vaccinated first, and 63.1% would trust health care providers about the COVID-19 vaccine. Factors associated with hesitancy in multivariable logistic regression included being female (OR = 1.90 95%CI [1.36, 2.64]), being Black (OR = 1.68 1.16, 2.45]), calendar month (OR = 0.76 [0.63, 0.92]), safety concerns (OR = 4.28 [3.06, 5.97]), and government distrust (OR = 3.57 [2.26, 5.63]). Conclusions This study engaged the community to directly reach underserved minority populations at highest risk of COVID-19 that permitted assessment of vaccine hesitancy (which was much higher than national estimates), driven in part by distrust, and safety concerns.

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Social and Political Drivers of the Reorientation of U.S. Trade Policy: The Case of U.S. Withdrawal from the Trans-Pacific Partnership

Social Currents ◽

10.1177/2329496519825512 ◽

2019 ◽

Vol 6 (3) ◽

pp. 199-218 ◽

Cited By ~ 1

Author(s):

Jesse Liss

Keyword(s):

United States ◽

Trade Policy ◽

Multinational Corporations ◽

Quantitative Methods ◽

Political Power ◽

Political Influence ◽

The United States ◽

Qualitative And Quantitative Methods ◽

Stakeholder Groups ◽

Sociological Explanation

Previous sociological studies demonstrated that U.S. multinational corporations (MNCs) had durable political power to motivate U.S. trade policy. However, why did the United States switch from a “free trade” to an “America First” trade agenda? Economists and political scientists argue that protectionist voters elected the protectionist candidate—Trump. An alternative sociological explanation is that U.S. MNCs lost political power to competing stakeholder groups. The article uses qualitative and quantitative methods to test these competing theories using the case study of the U.S. withdrawal from the Trans-Pacific Partnership (TPP). The article argues that both theories are necessary, and neither are sufficient. The United States withdrew from the TPP because increasing negative effects of trade and investment in the United States reshaped trade politics, especially on the republican side; however, power relations between stakeholder groups had to shift as well. U.S. MNCs lost political influence over trade policy to new domestic manufacturing organizations and their networks with labor and fair trade coalitions.

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What Barriers Exist in the Minds of Vaccine-Hesitant Parents, and How Can We Address Them?

Family Medicine ◽

10.22454/fammed.2020.432940 ◽

2020 ◽

Vol 52 (9) ◽

pp. 626-630

Author(s):

Andrew R. Kerrigan ◽

Imane Aitnouri ◽

Jessica Mar ◽

Wayne Altman

Keyword(s):

Vaccine Safety ◽

The United States ◽

Descriptive Statistics ◽

Vaccine Hesitancy ◽

Vaccination Rates ◽

Risks And Benefits ◽

Vaccine Schedule ◽

Study Population ◽

Risk Of Disease ◽

Sexual Concerns

Background and Objectives: Despite substantial health benefits and prolific research efforts to demonstrate safety and increase uptake, vaccine hesitancy has increased dramatically. This study aimed to systematically analyze available literature on vaccine hesitancy in the United States and determine the rationale behind vaccine-hesitant parents and potential interventions. Methods: We conducted a literature search and identified 232 articles; we included 90 after screening. We pulled information from each article using standardized questions for “type of study,” “population,” “specific vaccine,” “reasons for hesitancy,” “hesitancy prevalence,” “attempt at change,” “results of intervention,” and “future interventions.” We created recurrent themes from the data and analyzed these themes via descriptive statistics. Results: Vaccine safety was the most commonly identified reason for vaccine hesitancy amongst studies (50%), followed by not enough information (30%), side effects (26%), low risk of disease (26%), social norms (22%), vaccine schedule (21%), not recommended by doctor (21%), efficacy (18%), cost/access (13%), sexual concerns (12%) and distrust of establishment (7%). Only 20% of papers documented an intervention, and <50% of these reported increased vaccination rates or intent. More research was the most commonly identified next step (49%). Conclusions: Despite large amounts of research on vaccination rates, patients are still reporting not enough information and safety as the most common reasons for vaccine hesitancy. Interventions were few and without promising results. More research was the most suggested intervention. Such research must address concerns of the vaccine-hesitant community, comparing risks and benefits of each vaccination in a longitudinal, coherent, and transparently unbiased fashion.

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Vaccine Hesitancy in the Time of COVID-19: Attitudes and Intentions of Teens and Parents Regarding the COVID-19 Vaccine

Vaccines ◽

10.3390/vaccines10010004 ◽

2021 ◽

Vol 10 (1) ◽

pp. 4

Author(s):

Amy B. Middleman ◽

Judy Klein ◽

Jane Quinn

Keyword(s):

Vaccine Coverage ◽

Vaccine Safety ◽

Negative Influence ◽

Demographic Variables ◽

Vaccine Hesitancy ◽

Vaccination Rates ◽

Time Points ◽

Parental Concerns ◽

The Us ◽

Coverage Rates

To assess attitudes and intentions related to the COVID-19 vaccine during the pandemic, we surveyed adolescents aged 13–18 years and the parents of 13–18-year-olds using national research panels on three occasions or “waves”: before the COVID-19 vaccine was available, after it was available for adults, and after it was available for ages ≥12 years. Data on experiences with COVID-19, the importance of adolescent vaccines, and intentions regarding COVID-19 vaccination were analyzed across time points. We found that parental concerns about vaccine safety significantly increased from Wave 1 to 2. Social media had a negative influence on parents’ and adolescents’ opinions about vaccine safety. Demographic variables were associated with vaccination rates reported in Wave 3, consistent with known inequities related to vaccine access. Parents (70%) were supportive of concomitant COVID-19 vaccination with other adolescent vaccines for teens. It is important to address variables associated with vaccine hesitancy to increase COVID-19 vaccine coverage rates in the US.

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Lessons Learned about Evaluation in the United States and Some Possible Implications for Europe

European Journal of Psychological Assessment ◽

10.1027/1015-5759.14.2.97 ◽

1998 ◽

Vol 14 (2) ◽

pp. 97-115 ◽

Cited By ~ 8

Author(s):

Thomas D. Cook ◽

Werner W. Wittmann

Keyword(s):

United States ◽

Quantitative Methods ◽

Organizational Context ◽

Social Scientist ◽

The United States ◽

Lessons Learned ◽

Qualitative And Quantitative Methods ◽

Political Interests ◽

History Of ◽

Applied Social Science

The history of program evaluation in the United States over the last 25 years is used to abstract themes that may be of importance to the development of evaluation in Europe. The themes relate to (1) the organizational context of evaluation, particularly as regards the tension between the different roles of the social scientist and the auditor; (2) the dependence of evaluation on politics, which entails that research findings be selectively used, and that evaluation questions serve some political interests more than others unless active steps are taken to make evaluations broadly accountable and their results widely disseminated; (3) the reality that most understandings of evaluation emphasize describing what programs have actually achieved, whereas some program planners want it to refer to the ex-ante task of analyzing what the results of a future program might be if it were to be implemented; (4) the mutually supportive roles that both qualitative and quantitative methods have to play in evaluation once the trap is avoided of assuming the supremacy of either one of these method types over the other; and (5) the limited value that can usually be assigned to the results of individual evaluations when compared to what careful literature reviews can accomplish. We argue that a flourishing evaluation culture requires strong methods, strong theory about the nature of evaluation and its links to use, plus continuous updates of what evaluations have discovered in different substantive areas. Today, North American evaluation is perhaps best characterized as applied social-science methods - and this may be too narrow a conception for evaluation to continue flourishing.

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Diabetes Care Among Rural Americans

Annual Review of Nursing Research ◽

10.1891/0739-6686.26.1.3 ◽

2008 ◽

Vol 26 (1) ◽

pp. 3-39 ◽

Cited By ~ 4

Author(s):

Sharon Williams Utz

Keyword(s):

United States ◽

Low Socioeconomic Status ◽

Diabetes Care ◽

Quantitative Methods ◽

Minority Group ◽

The United States ◽

Urban Centers ◽

Qualitative And Quantitative Methods ◽

Program Evaluations ◽

Complex Chronic Illness

The prevalence of diabetes in the United States is higher among those living in rural/nonmetropolitan statistical areas than in urban centers. Managing this complex chronic illness is complicated by factors such as limited access to care, low socioeconomic status, aging, and membership in a racial or ethnic minority group. A review of the literature was conducted focusing on research about rural Americans with diabetes by searching databases of CINAHL, PubMed, and MEDLINE, and selecting articles in English that were published between 2000 and 2007. Search terms included: nursing, research, rural, rural nursing, rural health services/programs, and diabetes care. Additional search strategies included journal hand searching and networking. Twenty-six research reports were found and included qualitative and quantitative methods and program evaluations. All regions of the United States were represented except the Northwest. The vast majority of research reports were of descriptive studies (n = 16), with program evaluation reports (n = 7) and studies testing an intervention (n = 3) also represented. The quality of each study is examined and summarized.

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Hearing the Silence: Children’s Voices on Violence

Advances in Social Work ◽

10.18060/40 ◽

2018 ◽

Vol 4 (1) ◽

pp. 20-33 ◽

Cited By ~ 1

Author(s):

Kathryn S. Collins

Keyword(s):

Quantitative Methods ◽

The United States ◽

Future Research ◽

Child Survivors ◽

Qualitative And Quantitative ◽

Qualitative And Quantitative Methods ◽

Victim Services ◽

Children’S Voices ◽

Victimization Research ◽

Court Process

Each year more than five million children in the United States are exposed to traumatizing events in their communities. This paper presents a discussion of multiple areas in violence and victimization research that needs to be continued as well as provides suggestions on how to un-silence child survivors through bridging the gaps between research and practice. It reviews the overarching problem of violence in the U.S. at the domestic and global levels and the effects of victimization. Suggestions on how to study possible mediators and moderators of victimization and individual and family adjustment, including: 1) The ecological perspective; 2) Court process and verdict; and 3)Utilization of victim services, are explored. Finally, a rationale and examples of combining qualitative and quantitative methods in future research that uses children’s attributions of violence as a mediator are presented.

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'Judgemental Category' is the Major Concept in Ntozake Shange's “For Colored Girls Who Have Considered Suicide/When the Rainbow is Enuf”

International Journal of Engineering and Advanced Technology - Regular Issue ◽

10.35940/ijeat.a1136.109119 ◽

2019 ◽

Vol 9 (1) ◽

pp. 256-264

Keyword(s):

Black Women ◽

Quantitative Methods ◽

The United States ◽

The Other ◽

Data Sets ◽

Qualitative And Quantitative ◽

Qualitative And Quantitative Methods ◽

Linguistic Resources ◽

Black American Women

This paper aims to explore the frequencies of using the Attitudinal resources in Shange‟s Postmodern American drama “For Colored Girls Who Have Considered Suicide/When the Rainbow is Enuf”. The purpose of that investigation is to make a comparative analysis among all three types of Attitude categories which are: Appreciation, Judgment, and Affect. In order to accomplish the role of being the spokesperson of black American women in the United States of America by delivering the real agony and oppression that those people faced because of their class, gender, and race. The playwright has presented and cantered on seven black women who encountered some form of neglect, harassment, and abuse; either emotionally, sexually, or physically. The analysing process has presented that the playwright had utilized many linguistic resources; „Judgement‟. This category is considered as one of the major Attitudinal systems in the discourse-semantic appraisal mode within Systemic Functional Linguistics (SFL) for interpersonal meanings. Judgement is connected with the evaluation of black women‟s characters as well as their behaviours in this literary text. This article intends to discover the reason behind the heavy use of that category compared with the other two types of Attitudinal system. The paper has adopted qualitative and quantitative methods to conduct the objectives of the Attitudinal resources in the selected data sets. This paper has concluded that in the Attitude category, Judgement turned to be the most presentation system comparing with the other Attitudinal types which are Affect and Appreciation. Moreover, within the scope of Judgement „Propriety‟ and „Tenacity‟ have exceeded other judgmental subtypes.

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Love My Body: Pilot Study to Understand Reproductive Health Vulnerabilities in Adolescent Girls

Journal of Medical Internet Research ◽

10.2196/16336 ◽

2020 ◽

Vol 22 (3) ◽

pp. e16336 ◽

Cited By ~ 1

Author(s):

Golfo Tzilos Wernette ◽

Kristina Countryman ◽

Kristie Khatibi ◽

Erin Riley ◽

Rob Stephenson

Keyword(s):

Pilot Study ◽

Alcohol Use ◽

Sexual Health ◽

Adolescent Girls ◽

Quantitative Methods ◽

Target Population ◽

The United States ◽

Sexual Risk Taking ◽

Sexually Transmitted ◽

Qualitative And Quantitative Methods

Background Sexually transmitted infections (STIs) are on the rise in the United States, and adolescent girls (15-19 years old) are more susceptible to acquiring STIs than their male peers. The co-occurrence of alcohol use and sexual risk taking contribute significantly to STI acquisition. Mobile health (mHealth) interventions are ideally suited for our target population and have demonstrated increases in STI testing in young people, as well as reductions in alcohol use. Objective This pilot study used both qualitative and quantitative methods to explore the views of adolescent girls (age range 15-19 years old; 74.6%, 279/374 white) on the desired qualities and content of an mHealth app for sexual health. Methods We conducted nine 60-min in-depth interviews (IDIs) to gather information and identify themes of sexual health and alcohol use, and we tested the feasibility of using a two-week social media campaign to collect survey information regarding sexual health risk in adolescent girls. Results We iteratively coded IDIs and identified major themes around pressure of alcohol use, lack of STI knowledge, male pressure to not use condoms, and pregnancy as a worse outcome than STIs. Results from the web-based survey on risky health behaviors, which was completed by 367 participants, support the use of a sexual health app designed for girls. Conclusions Future work will integrate these themes to inform the development of a culturally sensitive mHealth app to prevent STIs among adolescent girls.

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