scholarly journals Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India

Vaccines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Nijika Shrivastwa ◽  
Abram Wagner ◽  
Matthew Boulton
Keyword(s):  
Vaccination Coverage ◽  
State Level ◽  
Childhood Vaccination ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Institutional Settings ◽  
Childhood Immunizations ◽  
Indian Census ◽  
Facility Survey

There is little research on state-level differences in child health outcomes in India. The aim of this study was to identify state-level characteristics that relate to childhood immunizations. Most state-level characteristics came from the 2011 Indian Census. Individual-level data and other state-level characteristics were obtained from the 2007–2008 District Level Household and Facility Survey. Predictors of full vaccination were assessed with logistic regression models. Among 86,882 children 12–36 months, 53.2% were fully vaccinated. Children living in bigger households (≥7 members), born in non-institutional settings, and female had lower odds of complete vaccination. Individuals living in states in the mid-range of poverty had lower odds of full vaccination compared to those in lower or higher poverty states (3rd vs. 1st quintile: odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.30, 0.42). Greater average population per primary health center was associated with decreased odds of full vaccination (5th vs. 1st quintile: OR: 0.37, 95% CI: 0.30, 0.47). Vaccination coverage in India can be explained by a complex interplay of individual- and state-level factors. Solutions to increasing vaccination must be multisectoral and acknowledge the cultural and socio-economic diversity that influences an individual child’s vaccination coverage along with within-state disparities.

scholarly journals 87. Impact of State of Residence on Adult Vaccination Uptake: A Multilevel Modeling Approach

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S175-S175
Author(s):  
Shannon Hunter ◽  
Diana Garbinsky ◽  
Elizabeth M La ◽  
Sara Poston ◽  
Cosmina Hogea
Keyword(s):  
Multilevel Modeling ◽  
Vaccination Coverage ◽  
Multilevel Models ◽  
State Level ◽  
Childhood Vaccination ◽  
Material Support ◽  
Adult Vaccination ◽  
Direct Compensation ◽  
Cluster Variation ◽  
Coverage Rates

Abstract Background Previous studies on adult vaccination coverage found inter-state variability that persists after adjusting for individual demographic factors. Assessing the impact of state-level factors may help improve uptake strategies. This study aimed to: • Update previous estimates of state-level, model-adjusted coverage rates for influenza; pneumococcal; tetanus, diphtheria, and acellular pertussis (Tdap); and herpes zoster (HZ) vaccines (individually and in compliance with all age-appropriate recommended vaccinations) • Evaluate effects of individual and state-level factors on adult vaccination coverage using a multilevel modeling framework. Methods Behavioral Risk Factor Surveillance System (BRFSS) survey data (2015–2017) were retrospectively analyzed. Multivariable logistic regression models estimated state vaccination coverage and compliance using predicted marginal proportions. BRFSS data were then combined with external state-level data to estimate multilevel models evaluating effects of state-level factors on coverage. Weighted odds ratios and measures of cluster variation were estimated. Results Adult vaccination coverage and compliance varied by state, even after adjusting for individual characteristics, with coverage ranging as follows: • Influenza (2017): 35.1–48.1% • Pneumococcal (2017): 68.2–80.8% • Tdap (2016): 21.9–46.5% • HZ (2017): 30.5–50.9% Few state-level variables were retained in final multilevel models, and measures of cluster variation suggested substantial residual variation unexplained by individual and state-level variables. Key state-level variables positively associated with vaccination included health insurance coverage rates (influenza/HZ), pharmacists’ vaccination authority (HZ), presence of childhood vaccination exemptions (pneumococcal/Tdap), and adult immunization information system participation (Tdap/HZ). Conclusion Adult vaccination coverage and compliance continue to show substantial variation by state even after adjusting for individual and state-level characteristics associated with vaccination. Further research is needed to assess additional state or local factors impacting vaccination disparities. Funding GlaxoSmithKline Biologicals SA (study identifier: HO-18-19794) Disclosures Shannon Hunter, MS, GSK (Other Financial or Material Support, Ms. Hunter is an employee of RTI Health Solutions, who received consultancy fees from GSK for conduct of the study. Ms. Hunter received no direct compensation from the Sponsor.) Diana Garbinsky, MS, GSK (Other Financial or Material Support, The study was conducted by RTI Health Solutions, which received consultancy fees from GSK. I am a salaried employee at RTI Health Solutions and received no direct compensation from GSK for the conduct of this study..) Elizabeth M. La, PhD, RTI Health Solutions (Employee) Sara Poston, PharmD, The GlaxoSmithKline group of companies (Employee, Shareholder) Cosmina Hogea, PhD, GlaxoSmithKline (Employee, Shareholder)

scholarly journals Social distancing during the COVID-19 pandemic: quantifying the practice in Michigan – a “hotspot state” early in the pandemic – using a volunteer-based online survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea E. Cassidy-Bushrow ◽  
Mohammed Baseer ◽  
Karen Kippen ◽  
Albert M. Levin ◽  
Jia Li ◽  
...  
Keyword(s):  
Online Survey ◽  
State Level ◽  
The United States ◽  
Older Individuals ◽  
Executive Orders ◽  
Social Distancing ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Factors Associated ◽  
Potential Factors

Abstract Background Public Health policies related to social distancing efforts during the COVID-19 pandemic helped slow the infection rate. However, individual-level factors associated with social distancing are largely unknown. We sought to examine social distancing during the COVID-19 pandemic in Michigan, an infection “hotspot” state in the United States early in the pandemic. Methods Two surveys were distributed to Michigan residents via email lists and social media following COVID-19 related state mandates in March; 45,691 adults responded to the first survey and 8512 to the second. Staying home ≥ 3 out of 5 previous days defined having more social distancing. Logistic regression models were used to examine potential factors associated with more social distancing. Results Most respondents were women (86% in Survey 1, 87% in Survey 2). In Survey 1, 63% reported more social distancing, increasing to 78% in Survey 2. Female sex and having someone (or self) sick in the home were consistently associated with higher social distancing, while increasing age was positively associated in Survey 1 but negatively associated in Survey 2. Most respondents felt social distancing policies were important (88% in Survey 1; 91% in Survey 2). Conclusions Michiganders responding to the surveys were both practicing and supportive of social distancing. State-level executive orders positively impacted behaviors early in the COVID-19 pandemic in Michigan. Additional supports are needed to help vulnerable populations practice social distancing, including older individuals.

scholarly journals Associations Between State Intimate Partner Violence-Related Firearm Policies and Injuries Among Women and Men Who Experience Intimate Partner Violence

2020 ◽  
Author(s):  
Tiara C. Willie ◽  
Trace Kershaw ◽  
Rachel Perler ◽  
Amy Caplon ◽  
Marina Katague ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
State Level ◽  
Health Impact ◽  
Intimate Partner ◽  
Climate Index ◽  
Lower Odds ◽  
Individual Level ◽  
Level Data ◽  
Firearm Policy

Abstract Background: Comprehensive state firearm policies related to intimate partner violence (IPV) may have a significant public health impact on non-lethal IPV-related injuries. Research indicates that more restrictive firearm policies may reduce risk for intimate partner homicide, however it is unclear whether firearm policies prevent or reduce the risk of non-lethal IPV-related injuries. This study sought to examine associations between state-level policies and injuries among U.S. IPV survivors.Methods: Individual-level data were drawn from the National Intimate Partner and Sexual Violence Survey, a nationally-representative study of noninstitutionalized adults. State-level data were drawn from a firearm policy compendium. Multivariable regressions were used to test associations of an IPV firearm policy climate index, as well as individual policies, with non-fatal IPV-related injuries (N=6,565). Results: On average, states had 2 IPV-related firearm policies (range 0 to 6). Overall, IPV-related firearm policy climate was associated with lower odds of experiencing injuries (aOR[95% CI]= .95[.91, .98]). Three specific policies were associated with IPV-related injuries. Individuals who reported IPV and live in states that required firearm surrender of persons convicted of IPV-related misdemeanors (aOR[95% CI]=.78 [.64, .95]), prohibited firearms to persons subject to IPV-related protective orders (aOR[95% CI]=.82[.68, .97]) and convicted of stalking (aOR[95% CI]=.77[.64, .92]) had lower odds of experiencing injuries than individuals living in states without these policies. Conclusions: Restrictive state firearm policies regarding IPV may provide unique opportunities to protect IPV survivors from injuries.

scholarly journals Social Distancing During the COVID-19 Pandemic: Quantifying the Practice in Michigan – a “Hotspot State” Early in the Pandemic – Using a Volunteer-Based Online Survey

2020 ◽  
Author(s):  
Andrea E. Cassidy-Bushrow ◽  
Mohammed Baseer ◽  
Karen Kippen ◽  
Albert M. Levin ◽  
Jia Li ◽  
...  
Keyword(s):  
Online Survey ◽  
State Level ◽  
The United States ◽  
Older Individuals ◽  
Executive Orders ◽  
Social Distancing ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Factors Associated ◽  
Potential Factors

Abstract Background: Public Health policies related to social distancing efforts during the COVID-19 pandemic helped slow the infection rate. However, individual-level factors associated with social distancing are largely unknown. We sought to examine social distancing during the COVID-19 pandemic in Michigan, an infection “hotspot” state in the United States early in the pandemic.Methods: Two surveys were distributed to Michigan residents via email lists and social media following COVID-19 related state mandates in March; 45,691 adults responded to the first survey and 8,512 to the second. Staying home ≥ 3 out of 5 previous days defined having more social distancing. Logistic regression models were used to examine potential factors associated with more social distancing.Results: Most respondents were women (86% in Survey 1, 87% in Survey 2). In Survey 1, 63% reported more social distancing, increasing to 78% in Survey 2. Female sex and having someone (or self) sick in the home were consistently associated with higher social distancing, while increasing age was positively associated in Survey 1 but negatively associated in Survey 2. Most respondents felt social distancing policies were important (88% in Survey 1; 91% in Survey 2). Conclusions: Michiganders responding to the surveys were both practicing and supportive of social distancing. State-level executive orders positively impacted behaviors early in the COVID-19 pandemic in Michigan. Additional supports are needed to help vulnerable populations practice social distancing, including older individuals.

scholarly journals Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: A multilevel mixed-effects analysis

2022 ◽  
Author(s):  
Satyajit Kundu ◽  
Subarna Kundu ◽  
Abdul-Aziz Seidu ◽  
Joshua Okyere ◽  
Susmita Ghosh ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Urban Areas ◽  
Immunization Coverage ◽  
Binary Logistic Regression ◽  
Wealth Index ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
Change Rate ◽  
Logistic Regression Models ◽  
Over Time

Abstract There is a dearth of information on childhood vaccination coverage in Bangladesh. Thus, this study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh. Bangladesh's Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data on vaccination coverage for children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed. The overall prevalence (weighted) of full vaccination among children aged 12-35 months was 86.17% in 2011 and 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of immunization coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%). To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.

scholarly journals The Association between Quitline Characteristics and Smoking Cessation by Educational Attainment, Income, Race/Ethnicity, and Sex

2021 ◽  
Vol 18 (6) ◽  
pp. 3297
Author(s):  
David C. Colston ◽  
Bethany J. Simard ◽  
Yanmei Xie ◽  
Marshall Chandler McLeod ◽  
Michael R. Elliott ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
State Level ◽  
The United States ◽  
Potential Effect ◽  
Effect Modification ◽  
Logistic Regression Models ◽  
Individual Level ◽  
The North ◽  
Race Ethnicity ◽  
The Individual

Little research examines how tobacco quitlines affect disparities in smoking cessation in the United States. Our study utilized data from the Tobacco Use Supplement to the Current Population Survey (2010, 2011, 2012, 2015, 2018) (TUS-CPS) and state-level quitline data from the North American Quitline Consortium and National Quitline Data Warehouse. We ran multilevel logistic regression models assessing a state-run quitline’s budget, reach, number of counseling sessions offered per caller, and hours of operation on 90-day smoking cessation. Multiplicative interactions between all exposures and sex, race/ethnicity, income, and education were tested to understand potential effect modification. We found no evidence that budget, reach, number of counseling sessions, or hours available for counseling were associated with cessation in the main effects analyses. However, when looking at effect modification by sex, we found that higher budgets were associated with greater cessation in males relative to females. Further, higher budgets and offering more sessions had a stronger association with cessation among individuals with lower education, while available counseling hours were more strongly associated with cessation among those with higher education. No quitline characteristics examined were associated with smoking cessation. We found evidence for effect modification by sex and education. Despite proven efficacy at the individual-level, current resource allocation to quitlines may not be sufficient to improve rates of cessation.

scholarly journals Childhood vaccination coverage in Australia: an equity perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arzu Arat ◽  
Hannah C. Moore ◽  
Sharon Goldfeld ◽  
Viveca Östberg ◽  
Vicky Sheppeard ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Economic Status ◽  
Childhood Vaccination ◽  
High Coverage ◽  
Socio Economic Status ◽  
Policy Interventions ◽  
South Wales ◽  
Social Inequities ◽  
Future Policy ◽  
Aboriginal Children

Abstract Background This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states. Results Vaccination coverage was 3–4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). Conclusion Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.

scholarly journals Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qun Miao ◽  
Sandra Dunn ◽  
Shi Wu Wen ◽  
Jane Lougheed ◽  
Jessica Reszel ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Household Income ◽  
Congenital Heart ◽  
Population Based ◽  
Income Poverty ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Chd Risk

Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

scholarly journals Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults

SLEEP ◽  
2021 ◽  
Author(s):  
G L Dunietz ◽  
R D Chervin ◽  
J F Burke ◽  
A S Conceicao ◽  
T J Braley
Keyword(s):  
Older Adults ◽  
Statistical Significance ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Not Otherwise Specified ◽  
Dementia Risk ◽  
Obstructive Sleep ◽  
Study Participants

Abstract Study Objectives To examine associations between PAP therapy, adherence and incident diagnoses of Alzheimer’s disease (AD), mild cognitive impairment (MCI), and dementia not-otherwise-specified (DNOS) in older adults. Methods This retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65+, with an OSA diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes [AD(n=1,057), DNOS(n=378), and MCI(n=443)] that were newly-identified between 2011-2013. PAP treatment was defined as presence of ≥1 durable medical equipment (HCPCS) code for PAP supplies. PAP adherence was defined as ≥2 HCPCS codes for PAP equipment, separated by≥1 month. Logistic regression models, adjusted for demographic and health characteristics, were used to estimate associations between PAP treatment or adherence and new AD, DNOS, and MCI diagnoses. Results In this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75y. The majority (78%) of beneficiaries with OSA were prescribed PAP (treated), and 74% showed evidence of adherent PAP use. In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (OR=0.78, 95% CI:0.69-0.89; and OR=0.69, 95% CI:0.55-0.85). Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR=0.82, 95% CI:0.66-1.02). PAP adherence was associated with lower odds of incident diagnoses of AD (OR=0.65, 95% CI:0.56-0.76). Conclusions PAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults. Results suggest that treatment of OSA may reduce risk of subsequent dementia.

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.

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