Community-based Flu Outreach Clinics in South Los Angeles: Client Satisfaction and Experiences.

OBJECTIVE: This study sought to better understand and improve influenza vaccination in low-income populations regardless of their health insurance/immigration status. It assessed client satisfaction and experiences with services provided at community-based "flu outreach" clinics in South Los Angeles. The clinics represent a community-public agency partnership-a model of vaccine delivery that was relatively novel to the region. DESIGN AND SAMPLE: During 2011-2012, a self-administered questionnaire was distributed to clients of the local health department's 39 flu outreach clinics in South Los Angeles. MEASURES: The study utilized a 10-item satisfaction scale and survey questions that gauged client history and experiences with present and prior vaccinations. RESULTS: Of 4,497 adults who were eligible, 3,860 completed the survey (participation rate = 86%). More than 90% were satisfied with their experiences at the clinics. Younger adults were significantly more likely than adults aged 65+ to report not having been vaccinated in the previous year (p < .05). No statistical differences were observed by gender or race/ethnicity. CONCLUSIONS: High satisfaction with flu outreach services in South Los Angeles suggests that this model for vaccine delivery could lead to meaningful client experience of care. Local health departments could capitalize on this model to improve preventive services delivery for the underserved.

Burden of Bites by Dogs and Other Animals in Los Angeles County, California, 2009-2011.

OBJECTIVES: The objective of this study was to analyze all animal-to-human bite reports during a 3-year period from a regional surveillance database. Results helped to inform local efforts to reduce and prevent animal-to-human bites. METHODS: We reviewed all cases of animal-to-human bites occurring from 2009 through 2011 that were reported to the Los Angeles County Department of Public Health's Animal Bites Database. We collected data on the bite victim's date of birth, age, and address; bite circumstances (ie, date, time, location, how bite occurred); anatomic site and treatment of bite; type of reporting facility; and breed and management of biting animal. RESULTS: From 2009 through 2011, 26   169 animal-to-human bites were reported, of which 23   103 (88%) were dog bites. Most animal-to-human bites (n = 7673, 29%) occurred between 4 pm and 8 pm and peaked during the month of July (n = 2663, 10%). Most animal-to-human bites occurred outdoors (n = 8772, 34%) and while victims engaged in recreational activities (n = 4353, 17%). The hands were the most common injury site (n = 9130, 35%), and only 1% of animal bites (n = 267) resulted in hospitalization. A total of 4115 bite victims (16%) received tetanus vaccinations. Of all animal-to-human bite cases, medical organizations reported 13   451 (51%), and animal control agencies reported 10   682 (41%). CONCLUSIONS: Animal-to-human bites can often lead to medical complications. Surveillance is essential in helping to identify, manage, and reduce these highly preventable injuries and direct public health actions and policies on animal bite risk and prevention.

The influence of gender and self-efficacy on healthy eating in a low-income urban population affected by structural changes to the food environment.

Although U.S. obesity prevention efforts have begun to implement a variety of system and environmental change strategies to address the underlying socioecological barriers to healthy eating, factors which can impede or facilitate community acceptance of such interventions are often poorly understood. This is due, in part, to the paucity of subpopulation health data that are available to help guide local planning and decision-making. We contribute to this gap in practice by examining area-specific health data for a population targeted by federally funded nutrition interventions in Los Angeles County. Using data from a local health assessment that collected information on sociodemographics, self-reported health behaviors, and objectively measured height, weight, and blood pressure for a subset of low-income adults (n = 720), we compared health risks and predictors of healthy eating across at-risk groups using multivariable modeling analyses. Our main findings indicate being a woman and having high self-efficacy in reading Nutrition Facts labels were strong predictors of healthy eating (P < 0.05). These findings suggest that intervening with women may help increase the reach of these nutrition interventions, and that improving self-efficacy in healthy eating through public education and/or by other means can help prime at-risk groups to accept and take advantage of these food environment changes.

Knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a low-income, public health clinic population.

OBJECTIVE: The Public Health Center Vaccine Survey (PHCVS) examines the knowledge, attitudes, and beliefs about seasonal influenza and H1N1 vaccinations in a largely low-income, urban, public health clinic population in Los Angeles County, USA. DESIGN: A cross-sectional survey of vulnerable individuals at risk for severe influenza infection was conducted in one of the nation's largest local public health jurisdictions. SUBJECTS: A total of 1541 clinic patients were recruited in the waiting rooms of five large public health centers in Los Angeles County from June to August, 2010. RESULTS: Among prospective respondents who met eligibility criteria, 92% completed the survey. The majority was black or Latino and most were between the ages of 18 and 44 years. More than half were unemployed; two-thirds had no health insurance; and nearly one-half reported having a high school education or less. About one-fifth reported they had received the H1N1 vaccine during the previous flu season. In comparative analyses, negative beliefs about vaccine safety and efficacy were highly predictive of H1N1 vaccination. Blacks were less likely than non-black respondents to report receiving the H1N1 vaccine (OR=0.7, 95% CI=0.6-1.0). Blacks were also less likely than other respondents to agree that vaccines can prevent disease (OR=0.4, 95% CI=0.3-0.5), that vaccines are safe (OR=0.5, 95% CI=0.4-0.6), and that they trust doctors/clinicians who recommend vaccines (OR=0.5, 95% CI=0.4-0.7). CONCLUSIONS: Study findings provide a useful risk profile of vulnerable groups in Los Angeles County, which may be generalizable to other urban jurisdictions in the United States. They also describe real world situations that can be used to forecast potential challenges that vaccine beliefs may pose to national as well as local influenza pandemic planning and response, especially for communities with limited access to these preventive services.

Knowledge, attitudes and potential response to menu labelling in an urban public health clinic population.

OBJECTIVE: The present study examines the receptivity to and potential effects of menu labelling on food choices of low-income and minority individuals - a group often at disproportionate risk for preventable, lifestyle-related health conditions (e.g. obesity, diabetes and CVD). DESIGN: We conducted a cross-sectional survey to examine the knowledge, attitudes and potential response to menu labelling in an urban public health clinic population. SETTING: United States. SUBJECTS: A total of 639 clinic patients were recruited in the waiting rooms of six, large public health centres in Los Angeles County (2007-2008). These centres provide services to a largely uninsured or under-insured, low-income, Latino and African-American population. RESULTS: Among those approached and who met eligibility criteria, 88 % completed the survey. Of the 639 respondents, 55 % were overweight or obese based on self-reported heights and weights; 74 % reported visiting a fast food restaurant at least once in the past year, including 22 % at least once a week; 93 % thought that calorie information was 'important'; and 86 % thought that restaurants should be required to post calorie information on their menu boards. In multivariate analyses, respondents who were obese, female, Latino and supportive of calorie postings were more likely than others to report that they would choose food and beverages with lower calories as a result of menu labelling. CONCLUSIONS: These findings suggest that clinic patients are receptive to this population-based strategy and that they would be inclined to change their food selections in response to menu labelling.