scholarly journals Tennessee's 3-Star Report: Using Available Data Systems to Reduce Missed Opportunities to Vaccinate Preteens

2016 ◽  
Vol 8s2 ◽  
pp. BII.S40207 ◽  
Author(s):  
Kelly L. Moore ◽  
Melissa K. Fankhauser ◽  
Pamela C. Hull
Keyword(s):  
Hpv Vaccination ◽  
Local Health ◽  
Data Systems ◽  
Local Health Departments ◽  
Missed Opportunities ◽  
Vaccination Rates ◽  
Tdap Vaccine ◽  
Billing Management ◽  
Using Data ◽  
To Receive

All preteens should receive tetanus–diphtheria–pertussis vaccine (Tdap), quadrivalent meningococcal vaccine (Men-ACWY), and the human papillomavirus (HPV) cancer vaccine series. In Tennessee, HPV vaccination rates have stagnated at low levels for a decade. Three fundamental strategies to reduce missed opportunities for immunization include administering all recommended vaccines at the same visit, making strong recommendations for vaccines, and auditing and feedback. In Tennessee, during each summer, a surge of preteens visit local health departments (LHDs) to receive a required Tdap vaccine before entering seventh grade, presenting an opportunity to administer Men-ACWY and HPV. The Tennessee Immunization Program (TIP) coined the term “3-Star visit” for such encounters and developed a monthly report to track them using data from the Patient Tracking Billing Management Information System (PTBMIS) used by LHDs across Tennessee. Implementation of this quality improvement report has correlated with a substantial increase in 3-Star visits from 2013 to 2016, particularly during the summer months.

Parent-Reported Reasons for Nonreceipt of Recommended Adolescent Vaccinations, National Immunization Survey—Teen, 2009

2011 ◽  
Vol 50 (12) ◽  
pp. 1116-1124 ◽  
Author(s):  
Christina Dorell ◽  
David Yankey ◽  
Sheryl Strasser
Keyword(s):  
Healthcare Provider ◽  
Disease Risk ◽  
Parental Knowledge ◽  
Parent Communication ◽  
National Immunization ◽  
Tdap Vaccine ◽  
Using Data ◽  
To Receive ◽  
Lack Of Knowledge ◽  
National Immunization Survey

Objectives: To identify parent-reported reasons for non-receipt of adolescent vaccinations by provider recommendation status. Methods: Parental reasons for non-receipt of adolescent vaccines were analyzed among adolescents 13-17 years using data from the 2009 National Immunization Survey-Teen (n=20,066). Results: Among unvaccinated adolescents, 87.9% (Td/Tdap), 90.9% (MenACWY), and 66.0% (HPV) of parents reported that they did not receive a healthcare provider recommendation for their adolescent to receive the vaccine. Among those without a provider recommendation, the most common reasons for not receiving the vaccines were ‘vaccine not recommended’ [Td/Tdap, MenACWY] and ‘not needed’ [HPV]. Among those with a recommendation, the most common parental reasons were ‘lack of knowledge’ [Td/Tdap], ‘vaccine not needed’ [MenACWY], and ‘lack of knowledge’ [HPV]. Conclusions: Non-receipt of provider recommendations was a main parent-reported reason for not getting vaccinated. Increasing parental knowledge and vaccination coverage through increased provider-parent communication about disease risk and vaccine benefits is needed.

scholarly journals Exploring Costing Methods for Environmental Health Services in North Carolina

2016 ◽  
Vol 132 (1) ◽  
pp. 37-40
Author(s):  
Simone R. Singh ◽  
Nancy L. Winterbauer ◽  
Ashley Tucker ◽  
Lisa Macon Harrison
Keyword(s):  
North Carolina ◽  
Health Services ◽  
Environmental Health ◽  
Economies Of Scale ◽  
Bivariate Analysis ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Site Water ◽  
Using Data

All local health departments in North Carolina are mandated to provide a defined set of environmental health services, yet few have the tools to understand the costs incurred in delivering these services. The objectives of this study were to (1) derive cost estimates for 2 commonly provided environmental health services—food and lodging inspections and on-site water services—and (2) explore factors that drive variations in costs, focusing on the roles of economies of scale and scope. Using data from 15 local health departments in North Carolina, we found that costs varied substantially. A bivariate analysis found evidence of economies of scale: higher volumes of services were associated with lower costs per service. Providing a greater scope of services, however, was not consistently associated with reduced costs. In-depth cost data provide public health officials with key information when deciding how to best serve their communities.

scholarly journals Collaborating to offer HPV vaccinations in jails: results from a pre-implementation study in four states

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Emerson ◽  
Molly Allison ◽  
Lisa Saldana ◽  
Patricia J. Kelly ◽  
Megha Ramaswamy
Keyword(s):  
Young Adults ◽  
Hpv Vaccination ◽  
Health Department ◽  
Local Health Department ◽  
Correctional Facilities ◽  
Local Health ◽  
Implementation Study ◽  
Chi Square ◽  
Shared Interest ◽  
Using Data

Abstract Background Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with jail and local health department (LHD) interest in partnering to offer HPV vaccinations to young adults in jail. Methods Consolidated framework for implementation research (CFIR)-guided surveys were conducted with jail administrators in Iowa, Kansas, Missouri, and Nebraska, September 2017–October 2018. Jail survey data were analyzed using chi square distribution and relative risk regression. Using data from sister surveys conducted with LHD administrators in the same counties (results previously reported), we identified characteristics of counties in which both the jail and LHD indicated interest in collaborating to offer HPV vaccinations in the jail. Results Jail survey response was 192/347 (55.3%). Surveys with LHDs yielded 237/344 (68.9%) responses. Eleven communities were identified where both the jail and LHD expressed interest. Only “any vaccines provided in jail” predicted shared interest (RR: 5.36; CI: 2.52–11.40; p < .01). For jail administrators, offering other vaccines was 3 times (CI:1.49–6.01; p < .01) and employing a nurse 1.65 times more likely (CI: 1.20–2.28; p < .01) to predict interest in collaborating to offer HPV vaccination. Open-ended responses indicated that managing linkages and stakeholder investment were areas of emphasis where collaborations to provide vaccinations in the jails had been previously implemented. Conclusions Interest in jail-LHD partnerships to provide HPV vaccinations in jails exists in the Midwest but will require building-out existing programs and linkages and identifying and strengthening shared values, goals, and benefits at all levels.

Missed Opportunities for Human Papillomavirus Vaccination by Parental Nativity, Minnesota, 2015-2018

2021 ◽  
pp. 003335492110272
Author(s):  
Emily A. Groene ◽  
Keith J. Horvath ◽  
Nicholas Yared ◽  
Inari Mohammed ◽  
Miriam Muscoplat ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
The United States ◽  
Human Papillomavirus Vaccination ◽  
Missed Opportunities ◽  
Lower Odds ◽  
Vaccine Initiation ◽  
The Caribbean ◽  
Using Data

Objectives Human papillomavirus (HPV) vaccination coverage in the United States is far below coverage for other routine adolescent vaccines. We examined whether missed opportunities for HPV vaccination among adolescents differ by parental nativity (country of origin) in Minnesota. Methods We retrospectively analyzed birth record and immunization information data for adolescents in Minnesota born during 2004-2007 using data from January 1, 2015, through December 31, 2018. Using logistic regression, we assessed the association between parental nativity and missed opportunities for HPV vaccine initiation, or receipt of other vaccines without receipt of the HPV vaccine. We adjusted for parent/child demographic and vaccination characteristics. We defined nativity as the number of non–US-born parents and maternal region of birth. Results Adolescents with mothers born in Eastern Europe (adjusted odds ratio [aOR] = 2.33; 95% CI, 2.01-2.73) and Africa (aOR = 1.36; 95% CI, 1.28-1.43) had greater adjusted odds of missed opportunities for HPV vaccination than adolescents with US-born mothers. However, adolescents with mothers from Latin America and the Caribbean had lower odds of missed opportunities than adolescents with US-born mothers (aOR = 0.61; 95% CI, 0.58-0.65). Adolescents with 1 or 2 non–US-born parents had lower odds of missed opportunities for HPV vaccination than adolescents with 2 US-born parents (1 parent: aOR = 0.92; 95% CI, 0.88-0.96; 2 parents: aOR = 0.90; 95% CI, 0.87-0.94). Conclusions Future studies should evaluate outreach to groups with HPV vaccination disparities and identify other drivers of missed opportunities among adolescents with US-born parents, such as multiparity.

Identifying Strategies to Reduce Missed Opportunities for HPV Vaccination in Primary Care: A Qualitative Study of Positive Deviants

2020 ◽  
Vol 59 (12) ◽  
pp. 1058-1068
Author(s):  
Cynthia M. Rand ◽  
Cathleen Concannon ◽  
Rachel Wallace-Brodeur ◽  
Wendy Davis ◽  
Christina S. Albertin ◽  
...  
Keyword(s):  
Hpv Vaccination ◽  
Organizational Factors ◽  
System Level ◽  
Multidisciplinary Teams ◽  
Missed Opportunities ◽  
Vaccination Rates ◽  
Collaborative Environment ◽  
Leadership Support ◽  
National Quality ◽  
Semistructured Interviews

The objectives of this study were to assess the contextual factors, practice strategies, and sustainability of interventions implemented during a national quality improvement (QI) project to raise human papillomavirus (HPV) vaccination rates. We conducted semistructured interviews with positive deviant practices that successfully reduced missed opportunities by ≥20% for HPV vaccination in the prior year. We assessed leadership support, motivators, interventions used, and sustainability. Key themes related to QI teams included strong leadership support, multidisciplinary teams, having a practice champion, and a collaborative environment. Themes related to the interventions included using a presumptive bundled recommendation for all appropriate vaccines at age 11, previsit planning, and reminders for preventive visits, which were sustainable for most practices 1-year postintervention. Both internal practice-level factors (multidisciplinary teams, collaboration, and previsit planning) and organizational factors (institutional support and health system–level reminders for preventive visits) were key to a successful QI intervention to improve HPV vaccination.

Receipt of Recommended Adolescent Vaccines Among Youth With Special Health Care Needs

2016 ◽  
Vol 56 (5) ◽  
pp. 451-460 ◽  
Author(s):  
Annie-Laurie McRee ◽  
Gary R. Maslow ◽  
Paul L. Reiter
Keyword(s):  
Health Care ◽  
Vaccination Coverage ◽  
Hpv Vaccination ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
Missed Opportunities ◽  
Using Data ◽  
Special Health

We examined vaccination coverage among youth with special health care needs (YSHCN) using data from parents of adolescents (11-17 years) who responded to a statewide survey in 2010-2012 (n = 2156). Using a validated screening tool, we identified 29% of adolescents as YSHCN. Weighted multivariable logistic regression assessed associations between special health care needs and receipt of tetanus booster, meningococcal, and human papillomavirus (HPV) vaccines. Only 12% of youth had received all 3 vaccines, with greater coverage for individual vaccines (tetanus booster, 91%; meningococcal, 32%; HPV, 26%). YSHCN had greater odds of HPV vaccination than other youth (33% vs 23%, OR = 1.70, 95% CI = 1.16-2.50) but vaccination coverage was similar ( P ≥ .05) for other outcomes. In subgroup analyses, HPV vaccination also differed depending on the number and type of special health care needs identified. Findings highlight low levels of vaccination overall and missed opportunities to administer recommended vaccines among all youth, including YSHCN.

scholarly journals P062: The feasibility of pertussis immunization in a Canadian emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S79-S79 ◽  
Author(s):  
D. Hansen ◽  
A. K. Sibley ◽  
M. MacSwain ◽  
H. Morrison ◽  
C. Rowswell
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Data Collection ◽  
Health Agency ◽  
Adult Patients ◽  
Control Group ◽  
Vaccination Rates ◽  
Tdap Vaccine ◽  
To Receive ◽  
Triage Time

Introduction: Despite clear health benefits, and Public Health Agency of Canada recommendations, vaccination rates among Canadian adults are low. Frequent patient contacts, wait times, and the availability of trained staff make the emergency department (ED) a potential location to target specific populations and administer vaccinations. We evaluated the feasibility of two strategies to administer the Tdap vaccine to adult patients presenting to a single referral ED. Methods: Two immunization strategies and a control group were randomly ordered from one to three. Data collection for group one started on study day one with data collection for groups two and three on study days two and three respectively. This sequence was repeated over 15 consecutive weekdays (Monday-Friday, 0730-1530), evenly assigning each group to 5 different days. On intervention days, adult patients were screened during the triage process for eligibility to receive the Tdap vaccine. An ED based (EDB) strategy offered patients vaccination during that visit. The second strategy offered eligible patients a public health referral (PHR) to receive the vaccine at a later date. On all study days, patient triage times (TT), as well as markers of ED efficiency (number of patient registrations, time to physician, length of stay, left without being seen, number of admissions, number of boarded patients) were recorded. Results: The primary outcome, the proportion of eligible adults immunized, was significantly higher at 66% (n=81) for the EDB strategy (228 screened, 122 eligible), compared with 21% (n=20) for the PHR strategy (217 screened, 94 eligible; x2 (2, n=216)=43.41, p<0.00001). In addition, 10 participants in the PHR group received a second vaccine (Pneumococcal (7), Influenza (2), Human Papillomavirus (1)). Reasons for vaccine ineligibility included having an up-to-date Tdap (EDB n=47 (21%), PHR n=46 (21%)) and being considered in too much distress by the triage nurse (EDB n=26 (11%), PHR n=19 (9%)). Triage time was less for the control group (M=5:55 [mins:secs], SD=2:48) than for the EDB (M=6:47, SD=3:12) and PHR (M=7:25, SD=2:45) strategies. Conclusion: An ED based screening and immunization strategy was highly effective in providing eligible adult patients with the Tdap vaccine. A resulting small increase in triage time was not clinically significant. Further studies are required to generalize these results.

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