scholarly journals Differences in Regional Patterns of Influenza Activity Across Surveillance Systems in the United States: Comparative Evaluation

10.2196/13403 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e13403 ◽  
Author(s):  
Kristin Baltrusaitis ◽  
Alessandro Vespignani ◽  
Roni Rosenfeld ◽  
Josh Gray ◽  
Dorrie Raymond ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Influenza Season ◽  
The United States ◽  
Surveillance Data ◽  
Data Sources ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Influenza Activity ◽  
Data Source

Background The Centers for Disease Control and Prevention (CDC) tracks influenza-like illness (ILI) using information on patient visits to health care providers through the Outpatient Influenza-like Illness Surveillance Network (ILINet). As participation in this system is voluntary, the composition, coverage, and consistency of health care reports vary from state to state, leading to different measures of ILI activity between regions. The degree to which these measures reflect actual differences in influenza activity or systematic differences in the methods used to collect and aggregate the data is unclear. Objective The objective of our study was to qualitatively and quantitatively compare national and region-specific ILI activity in the United States across 4 surveillance data sources—CDC ILINet, Flu Near You (FNY), athenahealth, and HealthTweets.org—to determine whether these data sources, commonly used as input in influenza modeling efforts, show geographical patterns that are similar to those observed in CDC ILINet’s data. We also compared the yearly percentage of FNY participants who sought health care for ILI symptoms across geographical areas. Methods We compared the national and regional 2018-2019 ILI activity baselines, calculated using noninfluenza weeks from previous years, for each surveillance data source. We also compared measures of ILI activity across geographical areas during 3 influenza seasons, 2015-2016, 2016-2017, and 2017-2018. Geographical differences in weekly ILI activity within each data source were also assessed using relative mean differences and time series heatmaps. National and regional age-adjusted health care–seeking percentages were calculated for each influenza season by dividing the number of FNY participants who sought medical care for ILI symptoms by the total number of ILI reports within an influenza season. Pearson correlations were used to assess the association between the health care–seeking percentages and baselines for each surveillance data source. Results We observed consistent differences in ILI activity across geographical areas for CDC ILINet and athenahealth data. ILI activity for FNY displayed little variation across geographical areas, whereas differences in ILI activity for HealthTweets.org were associated with the total number of tweets within a geographical area. The percentage of FNY participants who sought health care for ILI symptoms differed slightly across geographical areas, and these percentages were positively correlated with CDC ILINet and athenahealth baselines. Conclusions Our findings suggest that differences in ILI activity across geographical areas as reported by a given surveillance system may not accurately reflect true differences in the prevalence of ILI. Instead, these differences may reflect systematic collection and aggregation biases that are particular to each system and consistent across influenza seasons. These findings are potentially relevant in the real-time analysis of the influenza season and in the definition of unbiased forecast models.

scholarly journals Is there really more flu in the south? Surveillance systems show differences in influenza activity across regions. (Preprint)

2019 ◽  
Author(s):  
Kristin Baltrusaitis ◽  
Alessandro Vespignani ◽  
Roni Rosenfeld ◽  
Josh Gray ◽  
Dorrie Raymond ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Season ◽  
The United States ◽  
Data Sources ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Care Providers ◽  
Influenza Like Illness ◽  
Influenza Activity ◽  
Data Source

BACKGROUND The Centers for Disease Control and Prevention (CDC) track influenza-like illness (ILI) using information on patient visits to health care providers through the Outpatient Influenza-like Illness Surveillance Network (ILINet). Because participation in this system is voluntary, the composition, coverage, and consistency of healthcare reports varies from state to state, leading to different measures of ILI activity between regions. The degree to which these measures reflect actual differences in influenza activity or systematic differences in the methods used to collect and aggregate the data is unclear. OBJECTIVE We qualitatively and quantitatively compare national and region-specific ILI activity in the United States (US) across four data sources: CDC ILINet, Flu Near You (FNY), athenahealth, and HealthTweets.org to determine whether these data sources, commonly used as input in influenza modeling efforts, show geographical patterns that are similar to those observed in CDC ILINet’s data. We also compare the yearly percent of FNY participants who sought health-care for ILI symptoms across geographical areas. METHODS We compare the national and regional 2018 ILI activity baselines, calculated using non-influenza weeks from previous years, for each surveillance data source. We also compare measures of ILI activity across geographical areas during three influenza seasons, 2015-2016, 2016-2017, and 2017-2018. Geographical differences in weekly ILI activity within each data source are assessed using relative mean differences and time series heatmaps. National and regional age-adjusted health-care seeking percents are calculated for each influenza season by dividing the number of FNY participants who sought medical care for ILI symptoms by the total number of ILI reports within an influenza season. RESULTS We observe consistent differences in ILI activity across geographical areas for CDC ILINet and athenahealth data. ILI activity for FNY displayed little variation across geographical areas, while differences in ILI activity for HealthTweets.org appear to be associated with the total number of Tweets within a geographical area. The percent of FNY participants seeking health-care for ILI symptoms differs slightly across geographical areas. Specifically, regions with higher health-care seeking percentages correspond to regions with higher CDC ILINet and athenahealth ILI activity. CONCLUSIONS Our findings suggest that differences in ILI activity across geographical areas as reported by a given surveillance system may not accurately reflect true differences in the prevalence of ILI. Instead, these differences may reflect systematic collection and/or aggregation biases that are particular to each system and consistent across influenza seasons. These findings are potentially relevant in the real-time analysis of the influenza season and in the definition of unbiased forecast models.

Bother Related to Bladder Control and Health Care Seeking Behavior in Adults in the United States

2009 ◽  
Vol 181 (6) ◽  
pp. 2591-2598 ◽  
Author(s):  
Joshua S. Benner ◽  
Russell Becker ◽  
Kristina Fanning ◽  
Zhanna Jumadilova ◽  
Tamara Bavendam ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
The United States ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Bladder Control ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Health Care Seeking Behavior

Yoga as Entrée to Complementary and Alternative Medicine and Medically Pluralistic Practices

2012 ◽  
Vol 71 (4) ◽  
pp. 348-357 ◽  
Author(s):  
Jacqueline Sivén ◽  
Joanna Mishtal
Keyword(s):  
Health Care ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
The United States ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Structured Interviews ◽  
Complementary And Alternative ◽  
Yoga Practitioners

Yoga is increasingly ubiquitous in the United States and globally. The growth of yoga's popularity alongside Indian healing philosophies, including Ayurvedic medicine, makes yoga an important influence on conceptualization of health in holistic terms. Because of these philosophies, the growing use of yoga has implications for how healthcare is sought and utilized. Yoga practitioners are likely to engage in pluralistic health care-seeking practices, yet, the underlying perspectives that drive yoga practitioners to engage in particular health practices are poorly understood in anthropological and public health literature. This study examined perspectives on health care-seeking among long-term yoga practitioners in a yoga community in Florida. Based on semi-structured interviews conducted in 2010 with 26 adults in a Florida yoga center who have practiced yoga at least once per week for at least one year, the study found that long-term yoga practitioners utilized yoga and other systems of complementary and alternative medicine (CAM) to address health needs that were not met by biomedicine. Moreover, once individuals embarked on long-term yoga practice, they expanded their health care-seeking practices to other CAMs. This study contributes to understanding of the pluralization of health care-seeking practices, highlights concerns with the biomedical health system, and contributes to current debates on health care reform.

scholarly journals “When the pain is so acute or if I think that I’m going to die”: Health care seeking behaviors and experiences of transgender and gender diverse people in an urban area

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246883
Author(s):  
Mandi L. Pratt-Chapman ◽  
Jeanne Murphy ◽  
Dana Hines ◽  
Ruta Brazinskaite ◽  
Allison R. Warren ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Care Coordination ◽  
The United States ◽  
Health Care Seeking ◽  
Provider Communication ◽  
Care Seeking ◽  
Gender Diverse ◽  
And Gender ◽  
Health Care Seeking Behaviors

Introduction Approximately 1.4 million transgender and gender diverse (TGD) adults in the United States have unique health and health care needs, including anatomy-driven cancer screening. This study explored the general healthcare experiences of TGD people in the Washington, DC area, and cancer screening experiences in particular. Methods Twenty-one TGD people were recruited through word of mouth and Lesbian Gay Bisexual Transgender Queer (LGBTQ)-specific community events. Participant interviews were conducted and recorded via WebEx (n = 20; one interview failed to record). Interviews were transcribed using Rev.com. Two coders conducted line-by-line coding for emergent themes in NVivo 12, developed a codebook by consensus, and refined the codebook throughout the coding process. Member checking was conducted to ensure credibility of findings. Results Three major themes served as parent nodes: health-care seeking behaviors, quality care, and TGD-specific health care experiences. Within these parent nodes there were 14 child nodes and 4 grand-child nodes. Subthemes for health care seeking behaviors included coverage and costs of care, convenience, trust/mistrust of provider, and provider recommendations for screening. Subthemes for quality of care included professionalism, clinical competence in transgender care, care coordination, provider communication, and patient self-advocacy. Overall, transgender men were less satisfied with care than transgender women. Conclusions Results suggest a need for improved provider communication skills, including clear explanations of procedures and recommendations for appropriate screenings to TGD patients. Results also suggest a need for improved clinical knowledge and cultural competency. Respondents also wanted better care coordination and insurance navigation. Overall, these findings can inform health care improvements for TGD people.

scholarly journals Inventory of Data Sources for Estimating Health Care Costs in the United States

Medical Care ◽  
2009 ◽  
Vol 47 (Supplement) ◽  
pp. S127-S142 ◽  
Author(s):  
Jennifer L. Lund ◽  
K Robin Yabroff ◽  
Yoko Ibuka ◽  
Louise B. Russell ◽  
Paul G. Barnett ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Costs ◽  
The United States ◽  
Data Sources ◽  
Care Costs

The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants

2021 ◽  
pp. 104973232199204
Author(s):  
Rebecca M. Crocker
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Access ◽  
Mexican Immigrants ◽  
The United States ◽  
Care Utilization ◽  
Care Seeking ◽  
Care Access ◽  
The Impact

Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population’s care-seeking experiences before migration. In this article, I use a life-course approach to explore binational isolation from health care and the ways in which early-life experiences pattern Mexicans’ care-seeking practices in the United States. This ethnographic research project took place in Tucson, Arizona, between 2013 and 2014 and used semistructured interviews with service providers and first-generation Mexican immigrants. The majority of participants faced significant barriers to medical care in Mexico, which resulted in low rates of care utilization and heavy reliance on lay modalities. Immigrants faced an even broader array of barriers to care in the United States, and their lack of prior health care access further discouraged care utilization and compromised their medical care experiences after migration.

scholarly journals Insights From Twitter Conversations on Lupus and Reproductive Health: Protocol for a Content Analysis (Preprint)

2019 ◽  
Author(s):  
Oleg Stens ◽  
Michael H Weisman ◽  
Julia Simard ◽  
Katja Reuter
Keyword(s):  
United States ◽  
Health Care ◽  
Content Analysis ◽  
Reproductive Health ◽  
The United States ◽  
Reproductive Age ◽  
Social Media Analytics ◽  
Translational Science ◽  
Health Issues ◽  
Data Source

BACKGROUND Systemic lupus erythematosus (SLE) is the most common form of lupus. It is a chronic autoimmune disease that predominantly affects women of reproductive age, impacting contraception, fertility, and pregnancy. Although clinic-based studies have contributed to an increased understanding of reproductive health care needs of patients with SLE, misinformation abounds and perspectives on reproductive health issues among patients with lupus remain poorly understood. Social networks such as Twitter may serve as a data source for exploring how lupus patients communicate about their health issues, thus adding a dimension to enrich our understanding of communication regarding reproductive health in this unique patient population. OBJECTIVE The objective of this study is to conduct a content analysis of Twitter data published by users in English in the United States from September 1, 2017, to October 31, 2018, in order to examine people’s perspectives on reproductive health among patients with lupus. METHODS This study will analyze user-generated posts that include keywords related to lupus and reproductive health from Twitter. To access public Twitter user data, we will use Symplur Signals, a health care social media analytics platform. Text classifiers will be used to identify topics in posts. Posts will be classified manually into the a priori and emergent categories. Based on the information available in a user’s Twitter profile (ie, username, description, and profile image), we will further attempt to characterize the user who generated the post. We will use descriptive statistics to analyze the data and identify the most prevalent topics in the Twitter content among patients with lupus. RESULTS This study has been funded by the National Center for Advancing Translational Science (NCATS) through their Clinical and Translational Science Awards program. The Institutional Review Board at the University of Southern California approved the study (HS-18-00912). Data extraction and cleaning are complete. We obtained 47,715 Twitter posts containing terms related to “lupus” from users in the United States, published in English between September 1, 2017, and October 31, 2018. We will include 40,885 posts in the analysis, which will be completed in fall 2020. This study was supported by funds from the has been funded by the National Center for Advancing Translational Science (NCATS) through their Clinical and Translational Science Awards program. CONCLUSIONS The findings from this study will provide pilot data on the use of Twitter among patients with lupus. Our findings will shed light on whether Twitter is a promising data source for learning about reproductive health issues expressed among patients with lupus. The data will also help to determine whether Twitter can serve as a potential outreach platform for raising awareness of lupus and reproductive health and for implementing relevant health interventions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15623

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