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1.
AIDS Behav ; 23(7): 1888-1892, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30666521

RESUMO

The goal of this study was to explore the association between disclosure of same sex behavior to a healthcare provider and PrEP awareness in a sample of 192 Black MSM in Baltimore. After adjusting for age, education, sexual identity and employment status, we observed a trend of greater PrEP awareness among Black MSM who disclosed same sex behaviors to healthcare providers (adjusted odds ratio = 2.24, p = 0.08). This study provides new evidence of potential benefit of disclosure of same sex behavior to healthcare providers for awareness of new HIV biomedical interventions. Findings highlight the need to support patient-provider communication on sexual behaviors and PrEP with key populations at risk of HIV.


Assuntos
Revelação , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Homossexualidade Masculina/psicologia , Profilaxia Pré-Exposição , Adolescente , Adulto , Negro ou Afro-Americano , Conscientização , Baltimore , Educação em Saúde , Humanos , Masculino , Sexo sem Proteção/psicologia
2.
J Community Health ; 43(4): 647-655, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29318503

RESUMO

Colleges and universities are valuable partners for community health education outreach targeted to young adults. After the outbreak of Zika virus infection in the Americas was declared to be a Public Health Emergency of International Concern on February 1, 2016, postsecondary institutions played an important role in educating at-risk communities about health promotion and disease prevention strategies. In April 2016, we recruited 613 undergraduate students from a large public university to complete a survey about their Zika-related knowledge, attitudes, and information seeking behaviors. We standardized the results so that the participants' reports would be representative of the age, sex, major (course of study), and other characteristics of the university's student population. Most students knew that Zika virus is spread by mosquitoes (88.1%), but only about half knew that the virus could be transmitted through sexual intercourse (56.8%). Students perceived Zika to be a health risk for pregnant women in Zika-affected countries (83.0%), but did not personally feel at risk (12.1%). Many students (43.8%) reported not knowing where to get accurate information about Zika. Identifying gaps in scientific knowledge, misperceptions about personal susceptibility, and opportunities for behavioral risk reduction is an important foundation for designing community-based health interventions when future emerging infectious disease events occur.


Assuntos
Informação de Saúde ao Consumidor/métodos , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/estatística & dados numéricos , Infecção por Zika virus/epidemiologia , Adolescente , Fatores Etários , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Mosquitos Vetores/virologia , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Fatores Sexuais , Universidades , Adulto Jovem , Zika virus , Infecção por Zika virus/transmissão
3.
Am J Drug Alcohol Abuse ; 44(6): 678-685, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29863903

RESUMO

BACKGROUND: Research suggests that reduced retail alcohol outlet density may be associated with lower prevalence of HIV and other sexually transmitted infections (STIs). On-premise sale of alcohol for immediate consumption is theorized as increasing social interactions that can lead to sexual encounters. OBJECTIVE: We examined associations between on- and off-premise retail alcohol sales licenses and number of newly diagnosed HIV and STI cases in Texas counties. METHODS: Retail alcohol sales license data were obtained from the Texas Alcoholic Beverage Commission. HIV and bacterial STI data were obtained from the Texas Department of State Health Services. Associations between retail alcohol sales licenses and STIs were estimated using spatial linear models and Poisson mixed effects models for over-dispersed count data. RESULTS: Adjusting for county-specific confounders, there was no evidence of residual spatial correlation. In Poisson models, each additional on-premise (e.g., bar and restaurant) alcohol license per 10,000 population in a county was associated with a 1.5% increase (95% CI: 0.4%, 2.6%) in the rate of HIV and a 2.4% increase (95% CI: 1.9%, 3.0%) in the rate of bacterial STIs, adjusting for potential confounders. In contrast, number of off-premise licenses (e.g., take-out stores) was inversely associated with the incidence of STI and HIV, although the association with HIV was not statistically significant. CONCLUSIONS: This study adds to the limited literature on the association between retail alcohol availability and STIs. Additional research is needed on the role of alcohol availability (and policies affecting availability) in the spread of HIV and other STIs.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas , Comércio , Marketing , Infecções Sexualmente Transmissíveis/epidemiologia , Feminino , Humanos , Incidência , Masculino , Comportamento Sexual/estatística & dados numéricos , Texas/epidemiologia
4.
MMWR Morb Mortal Wkly Rep ; 64(1): 30, 2015 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-25590684

RESUMO

On May 9, 2014, a physician at hospital A in American Samoa noticed an abnormally high number of children presenting to the emergency department with bloody diarrhea. Based on preliminary testing of stool specimens, Entamoeba histolytica infection was suspected as a possible cause. Shigella was also suspected in a subset of samples. On May 22, the American Samoa Department of Health requested assistance from CDC with the outbreak investigation. The goals of the investigation were to establish the presence of an outbreak, characterize its epidemiology and etiology, and recommend control measures. The CDC field team reviewed the emergency department log book for cases of diarrheal illness during April 15-June 13, 2014. During this period, 280 cases of diarrheal illness were recorded, with a peak occurring on May 10. Twice as many cases occurred during this period in 2014 compared with the same period in 2011, the most recent year for which comparable surveillance data were available. Cases were widely distributed across the island. The highest number of cases occurred in children aged 0-9 years. Across age groups, cases were similarly distributed among males and females. These patterns are not consistent with the epidemiology of disease caused by E. histolytica, which tends to cause more cases in males of all ages.


Assuntos
Diarreia/epidemiologia , Surtos de Doenças , Disenteria Bacilar/epidemiologia , Shigella flexneri/isolamento & purificação , Samoa Americana/epidemiologia , Criança , Pré-Escolar , Diarreia/microbiologia , Disenteria Bacilar/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
5.
MMWR Morb Mortal Wkly Rep ; 64(26): 714-8, 2015 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-26158352

RESUMO

As of July 1, 2015, Guinea, Liberia, and Sierra Leone have reported a total of 27,443 confirmed, probable, and suspected Ebola virus disease (Ebola) cases and 11,220 deaths. Guinea and Sierra Leone have yet to interrupt transmission of Ebola virus. In January, 2016, Liberia successfully achieved Ebola transmission-free status, with no new Ebola cases occurring during a 42-day period; however, new Ebola cases were reported beginning June 29, 2015. Local cultural practices and beliefs have posed challenges to disease control, and therefore, targeted, timely health messages are needed to address practices and misperceptions that might hinder efforts to stop the spread of Ebola. As early as September 2014, Ebola spread to most counties in Liberia. To assess Ebola-related knowledge, attitudes, and practices (KAP) in the community, CDC epidemiologists who were deployed to the counties (field team), carried out a survey conducted by local trained interviewers. The survey was conducted in September and October 2014 in five counties in Liberia with varying cumulative incidence of Ebola cases. Survey results indicated several findings. First, basic awareness of Ebola was high across all surveyed populations (median correct responses = 16 of 17 questions on knowledge of Ebola transmission; range = 2-17). Second, knowledge and understanding of Ebola symptoms were incomplete (e.g., 61% of respondents said they would know if they had Ebola symptoms). Finally, certain fears about the disease were present: >90% of respondents indicated a fear of Ebola patients, >40% a fear of cured patients, and >50% a fear of treatment units (expressions of this last fear were greater in counties with lower Ebola incidence). This survey, which was conducted at a time when case counts were rapidly increasing in Liberia, indicated limited knowledge of Ebola symptoms and widespread fear of Ebola treatment units despite awareness of communication messages. Continued efforts are needed to address cultural practices and beliefs to interrupt Ebola transmission.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doença pelo Vírus Ebola , Características de Residência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Coleta de Dados , Feminino , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/psicologia , Doença pelo Vírus Ebola/terapia , Humanos , Libéria/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Health Promot Pract ; 15(4): 556-67, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24440920

RESUMO

The Advisory Committee on Immunization Practices recommended immunization schedule for adolescents includes three vaccines (tetanus, diphtheria, and acellular pertussis [Tdap]; human papillomavirus [HPV] vaccine; and meningococcal conjugate vaccine [MCV4]) and an annual influenza vaccination. Given the increasing number of recommended vaccines for adolescents and health and economic costs associated with nonvaccination, it is imperative that effective strategies for increasing vaccination rates among adolescents are developed. This article describes the development, theoretical framework, and initial first-year evaluation of an intervention designed to promote vaccine acceptance among a middle and high school-based sample of adolescents and their parents in eastern Georgia. Adolescents, parents, and teachers were active participants in the development of the intervention. The intervention, which consisted of a brochure for parents and a teacher-delivered curriculum for adolescents, was guided by constructs from the health belief model and theory of reasoned action. Evaluation results indicated that our intervention development methods were successful in creating a brochure that met cultural relevance and the literacy needs of parents. We also demonstrated an increase in student knowledge of and positive attitudes toward vaccines. To our knowledge, this study is the first to extensively engage middle and high school students, parents, and teachers in the design and implementation of key theory-based educational components of a school-based, teacher-delivered adolescent vaccination intervention.


Assuntos
Docentes , Pais , Serviços de Saúde Escolar/organização & administração , Vacinação , Adolescente , Fatores Etários , Criança , Georgia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Autoeficácia , Fatores Sexuais , Fatores Socioeconômicos
7.
Health Educ Res ; 28(4): 663-72, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23727620

RESUMO

Influenza remains a significant cause of morbidity and mortality in the United States. Vaccinating school-aged children has been demonstrated to be beneficial to the child and in reducing viral transmission to vulnerable groups such as the elderly. This qualitative study sought to identify reasons parents and students participated in a school-based influenza vaccination clinic and to characterize the decision-making process for vaccination. Eight focus groups were conducted with parents and students. Parents and students who participated in the influenza vaccination clinic stated the educational brochure mailed to their home influenced participation in the program. Parents of non-participating students mentioned barriers, such as the lengthy and complicated consent process and suspicions about the vaccine clinic, as contributing to their decision not to vaccinate their child. Vaccinated students reported initiating influenza vaccine discussion with their parents. Parental attitudes and the educational material influenced parents' decision to allow their child to receive influenza vaccine. This novel study explored reasons for participating in a school-based vaccination clinic and the decision-making process between parents and child(ren). Persons running future school-based vaccination clinics may consider hosting an 'information session with a question and answer session' to address parental concerns and assist with the consent process.


Assuntos
Atitude Frente a Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estudantes/psicologia , Adolescente , Tomada de Decisões , Feminino , Grupos Focais , Humanos , Masculino , Relações Pais-Filho , Educação de Pacientes como Assunto/métodos , Pesquisa Qualitativa , Serviços de Saúde Escolar/estatística & dados numéricos , Estados Unidos
8.
Health Educ Res ; 26(5): 751-60, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21536717

RESUMO

School-aged children were a priority group for receipt of the pandemic (2009) H1N1 influenza vaccine. Both parental and adolescent attitudes likely influence vaccination behaviors. Data were collected from surveys distributed to middle- and high-school students and their parents in two counties in rural Georgia. Multivariable logistic regression analyses were conducted to assess correlates of parental acceptance of H1N1 influenza vaccination for their children and adolescents' acceptance of vaccination for themselves. Concordance analyses were conducted to assess agreement between parent-adolescent dyads regarding H1N1 influenza vaccine acceptance. Parental acceptance of H1N1 influenza vaccination for their children was associated with acceptance of the vaccine for themselves and feeling motivated by the H1N1 influenza pandemic to get a seasonal influenza vaccine for their child. Adolescents' acceptance was associated with receipt of a seasonal influenza vaccine in the past year, fear of getting H1N1 influenza, feeling comfortable getting the vaccine and parental acceptance of H1N1 influenza vaccine. Half (50%) of parent-adolescent pairs included both a parent and child who expressed H1N1 influenza vaccine acceptance, and 19% of pairs would not accept the vaccine. This research highlights the need for interventions that target factors associated with H1N1 influenza vaccine acceptance among both parents and adolescents.


Assuntos
Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Criança , Estudos Transversais , Surtos de Doenças/prevenção & controle , Feminino , Georgia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/imunologia , Vacinas contra Influenza/provisão & distribuição , Influenza Humana/epidemiologia , Influenza Humana/imunologia , Masculino , Relações Pais-Filho , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Saúde da População Rural
9.
Hum Vaccin ; 7(11): 1146-52, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22048112

RESUMO

OBJECTIVE: This study examined changes in parental influenza vaccination attitudes and intentions after participating in school-based educational influenza vaccination intervention. METHODS: Participants were drawn from three counties participating in a school-based influenza vaccination intervention in rural Georgia (baseline N=324; follow-up N=327). Data were collected pre- and post-intervention from phone surveys with parents' with children attending middle- and high-school. Attitudes, beliefs, vaccination history, and intention to vaccinate were assessed. RESULTS: Parents who participated in the intervention conditions reported significantly higher influenza vaccination rates in their adolescents, relative to a control group, as well as increased vaccination rates post-intervention participation relative to their baseline rates. Intervention participants reported greater intention to have their adolescent vaccinated in the coming year compared to control parents. Significant differences were observed post intervention in perceived barriers and benefits of vaccination. CONCLUSIONS: These findings suggest that a school-delivered educational influenza vaccination intervention targeting parents and teens may influence influenza vaccination in rural communities. Future influenza vaccination efforts geared toward the parents of rural middle- and high-school students may benefit from addressing barriers and benefits of influenza vaccination.


Assuntos
Educação em Saúde , Vacinas contra Influenza/administração & dosagem , Intenção , Pais/psicologia , População Rural , Vacinação , Adolescente , Adulto , Feminino , Georgia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Influenza Humana/prevenção & controle , Masculino , Instituições Acadêmicas , Estudantes , Resultado do Tratamento , Vacinação/psicologia , Vacinação/estatística & dados numéricos
10.
Hum Vaccin ; 7(1): 89-95, 2011 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-21263225

RESUMO

OBJECTIVE: Teachers, like healthcare workers, may be a strategic target for influenza immunization programs. Influenza vaccination is critical to protect both teachers and the students they come into contact with. This study assessed factors associated with seasonal and H1N1 influenza vaccine uptake among middle- and high-school teachers. METHODS: Participants were recruited from two counties in rural Georgia. Data were collected from surveys in September 2009 and May 2010. Multivariate logistic regression was used to assess the association between teachers' attitudes toward seasonal and H1N1 influenza vaccination and vaccine uptake. RESULTS: Seventy-eight percent of teachers who planned to receive seasonal influenza vaccine and 36% of those who planned to receive H1N1 influenza vaccine at baseline reported that they did so. Seasonal vaccine uptake was significantly associated with perceived severity (odds ratio [OR] 1.57, P = 0.05) and self-efficacy (OR 4.46, P = 0.006). H1N1 vaccine uptake was associated with perceived barriers (OR 0.7, P = 0.014) and social norms (OR 1.39, P = 0.05). The number one reason for both seasonal and H1N1 influenza vaccine uptake was to avoid getting seasonal/H1N1 influenza disease. The number one reason for seasonal influenza vaccine refusal was a concern it would make them sick and for H1N1 influenza vaccine refusal was concern about vaccine side effects. CONCLUSIONS: There is a strong association between the intention to be vaccinated against influenza (seasonal or 2009 H1N1) and actual vaccination uptake. Understanding and addressing factors associated with teachers' influenza vaccine uptake may enhance future influenza immunization efforts.


Assuntos
Docentes , Conhecimentos, Atitudes e Prática em Saúde , Vacinas contra Influenza/administração & dosagem , Vacinação/estatística & dados numéricos , Adulto , Idoso , Feminino , Georgia , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , População Rural , Instituições Acadêmicas , Inquéritos e Questionários
11.
Health Educ Res ; 25(5): 853-64, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20603385

RESUMO

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recently expanded annual influenza vaccination recommendations to include all children 6 months through 18 years of age. Adolescent attitudes toward influenza vaccination may play a key role in reaching this newly added age group. This study examined the association between attitudes toward influenza vaccination and intention to be vaccinated among rural adolescents. Data were collected from baseline surveys distributed to adolescents in September/October 2008, prior to the H1N1 influenza pandemic, in two counties participating in a school-based influenza vaccination intervention trial in rural Georgia (N = 337). Survey items were based on constructs from the Health Belief Model and the Integrated Behavioral Model. Approximately one-third of participants (33.8%) intended to receive an influenza vaccination, 33.5% did not intend to be vaccinated and 28.8% were unsure. Controlling for background factors, intention to receive an influenza vaccination was associated with low perceived barriers [odds ratio (OR) = 0.77, P < 0.001], injunctive norms (OR = 1.23, P = 0.002) and receipt of influenza vaccination in the past year (OR =6.21, P < 0.001). Findings suggest that perceived barriers and injunctive social norms may influence vaccination acceptance among rural adolescents. Future influenza vaccination efforts geared toward rural middle and high school students may benefit from addressing adolescent attitudes toward influenza vaccination.


Assuntos
Programas de Imunização/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Intenção , População Rural , Adolescente , Criança , Feminino , Georgia , Pesquisas sobre Atenção à Saúde , Humanos , Masculino
12.
Health Promot Pract ; 11(3 Suppl): 42S-52S, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20488968

RESUMO

The Advisory Committee on Immunization Practices (ACIP) recently recommended that all children 6 months to 18 years old be vaccinated annually against influenza. School-based influenza vaccination interventions may potentially increase influenza vaccination rates among hard-to-reach populations, particularly rural adolescents. This article describes the theoretical framework, intervention development, and lessons learned from 1st-year implementation of a multicomponent intervention aimed to promote influenza vaccine acceptance among multiethnic (predominantly African American) adolescents attending middle and high school in rural Georgia. Adolescents, parents, and school administrators were active participants in the development and implementation of the intervention. The educational intervention, which consisted of a brochure and a school skit/ presentation, was guided by constructs from the Health Belief Model and social norms. Process evaluation results indicated that our intervention development methods were successful in creating a low-cost, theory-based educational intervention that garnered community investment and met the cultural relevance and literacy needs of our target audience. To our knowledge, this study is the first to extensively engage middle- and high-school students and parents in the design and implementation of key educational components of a theory-based influenza vaccination intervention.


Assuntos
Programas de Imunização/estatística & dados numéricos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Pais/educação , Instituições Acadêmicas , Adolescente , Georgia , Educação em Saúde/métodos , Humanos , Programas de Imunização/organização & administração , Modelos Teóricos , Aceitação pelo Paciente de Cuidados de Saúde , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , População Rural , Estudantes
13.
J Am Vet Med Assoc ; 255(4): 446-453, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31355724

RESUMO

OBJECTIVE: To use the Health Belief Model to identify factors associated with owner adherence to elimination diet trial (EDT) recommendations by veterinarians for dogs with suspected cutaneous adverse food reactions (CAFRs). SAMPLE: 192 owners of dogs prescribed an EDT between April 1, 2012, and April 1, 2017. PROCEDURES: Owners of dogs prescribed an EDT to diagnose CAFRs were identified through review of medical records from a single veterinary dermatology specialty practice. Identified owners were invited to participate in an anonymous online survey that was developed on the basis of the Health Belief Model. Multivariable logistic regression was used to evaluate associations between potential predictor variables and 100% adherence to EDT recommendations. RESULTS: 665 owners were invited to participate, and 192 (28.9%) completed the survey. Of the 192 respondents, 77 (40.1%) reported 100% adherence to EDT recommendations, and 115 (59.9%) reported < 100% adherence. Results indicated that the odds of owners reporting 100% adherence to EDT recommendations were significantly decreased by owner perception of barriers (adjusted OR [ORa] = 0.86) and were significantly increased by owner knowledge regarding diets and CAFRs in dogs (ORa = 1.30) and by self-efficacy or confidence in performing an EDT as directed (ORa = 1.18). CONCLUSIONS AND CLINICAL RELEVANCE: Findings indicated that most prescribed EDTs were not followed strictly. Interventions to help owners reduce perceived barriers, increase self-efficacy, and improve related knowledge could improve adherence to EDT recommendations and, thereby, increase the diagnostic utility of EDTs.


Assuntos
Ração Animal , Cães , Propriedade , Médicos Veterinários , Animais , Dieta , Humanos , Inquéritos e Questionários
14.
Vaccine ; 37(38): 5770-5776, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-30253888

RESUMO

BACKGROUND: More than 1.8 million American children ages 5-17 are being educated at home. The percentage of school-aged children in the United States who are homeschooled increased from 1.7% in 1999 to 3.4% in 2012. Every state has established school-entry vaccination requirements for kindergarten students, but most states exempt homeschoolers from these regulations. The goal of this study was to use qualitative methods to examine the vaccination perceptions and practices of Christian homeschooling families in Pennsylvania. METHODS: A qualitative study (focus groups) of Christian homeschooling parents representing a diversity of vaccination practices (full, partial/delayed, and no vaccination) was conducted in south-central Pennsylvania in 2017. An analysis using a grounded theory approach identified themes that strongly aligned with constructs from the Health Belief Model. RESULTS: Many of the perspectives expressed by the study population aligned with those of the general American population, including uncertainty about the risk from vaccine-preventable diseases, concerns about the efficacy and safety of vaccines, and confusion about conflicting vaccine information. The Christian homeschooling parents expressed two especially prominent perceptions: a belief that they had a very low risk of contracting infectious diseases because God has provided them with the natural tools necessary for health and a stronger-than-typical sense of empowerment related to parental decision-making and autonomy. Participants expressed that they were generally open to honest communication about vaccination with physicians who respect parental authority. CONCLUSIONS: Homeschooling families have diverse vaccination practices. Pediatricians and other healthcare practitioners should not make assumptions about health beliefs in this community, and should instead engage parents in conversations about their risk perceptions and vaccine decisions.


Assuntos
Cristianismo , Conhecimentos, Atitudes e Prática em Saúde , Instituições Acadêmicas , Vacinação , Vacinas , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Grupos Focais , Humanos , Masculino , Pennsylvania , Pesquisa Qualitativa , Estudantes , Vacinação/métodos , Vacinas/imunologia , Adulto Jovem
15.
Hum Vaccin Immunother ; 15(1): 121-133, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30199302

RESUMO

Uninsured Latin American immigrant women are at increased risk for vaccine preventable diseases, such as cervical cancer; yet gaps in vaccine coverage persist. The purpose of this study was to explore vaccine-related knowledge, attitudes and decision-making for tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, meningococcal conjugate vaccine (MenACWY), and human papillomavirus (HPV) vaccine among uninsured Latin American immigrant mothers of adolescent daughters. A purposive sample of 30 low-income, uninsured, predominantly Latin-American immigrant mothers of adolescent daughters aged 13-17 were recruited from two academic-community managed health clinics in Virginia. From March-September 2016, data were collected through in-person, semi-structured interviews, in English or Spanish. For data analysis, conventional content analysis was employed. The majority of participants self-identified as Hispanic and had less than a high-school level education. Key themes included: general acceptance of vaccines; associating vaccines with prevention/protection; minimal vaccine hesitancy; and lack of knowledge regarding vaccine-preventable diseases, vaccines recommended for adolescents, and adolescent daughters' vaccination history. Doctors' recommendation, school requirements, and the media were key influencers of vaccination. Mothers were the primary decision-maker regarding vaccine uptake among their adolescent daughters. Findings highlight the need for efforts to help uninsured Latin American immigrant mothers better understand vaccines, and provide linkages to affordable, accessible vaccines among under-resourced populations.


Assuntos
Tomada de Decisões , Emigrantes e Imigrantes/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Pessoas sem Cobertura de Seguro de Saúde/psicologia , Mães/psicologia , Vacinação/psicologia , Adolescente , Adulto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Hispânico ou Latino/psicologia , Humanos , Pessoas sem Cobertura de Seguro de Saúde/etnologia , Vacinas Meningocócicas/administração & dosagem , Pessoa de Meia-Idade , Núcleo Familiar , Vacinas contra Papillomavirus/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde , Pobreza , Pesquisa Qualitativa , Vacinas Conjugadas/administração & dosagem , Virginia
16.
Ann Behav Med ; 35(3): 358-62, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18633685

RESUMO

BACKGROUND: Theory-based health behavior change programs are thought to be more effective than those that do not use theory. No previous reviews have assessed the extent to which theory is used (that is, operationalized and tested) in empirical research. PURPOSE: The purpose of this study was to describe theory use in recent health behavior literature and to assess the proportion of research that uses theory along a continuum from: informed by theory to applying, testing, or building theory. METHODS: A sample of empirical research articles (n = 193) published in ten leading public health, medicine, and psychology journals from 2000 to 2005 was coded to determine whether and how theory was used. RESULTS: Of health behavior articles in the sample, 35.7% mentioned theory. The most-often-used theories were The Transtheoretical Model, Social Cognitive Theory, and Health Belief Model. Most theory use (68.1%) involved research that was informed by theory; 18% applied theory; 3.6% tested theory; and 9.4% sought to build theory. CONCLUSIONS: About one third of published health behavior research uses theory and a small proportion of those studies rigorously apply theory. Patterns of theory use are similar to reports from the mid-1990s. Behavioral researchers should strive to use theory more thoroughly by applying, testing, and building theories in order to move the field forward.


Assuntos
Comportamentos Relacionados com a Saúde , Modelos Psicológicos , Pesquisa/tendências , Medicina Baseada em Evidências , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Hum Vaccin Immunother ; 14(7): 1665-1671, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29333950

RESUMO

The 2014-2016 Ebola virus outbreak in West Africa led to advances in the development of vaccines against Ebola. This study examined factors associated with willingness to pay for an Ebola vaccine among a U.S. national sample during the recent Ebola outbreak. From April 30-May 8, 2015, a national survey was conducted using the GfK Group's KnowlegePanel®. Main outcome measures included willingness to pay at least $1; more than $50; and more than $100 for an Ebola vaccine. Analyses were conducted using weighted multivariable logistic regression. Among participants (N = 1,447), 583 (40.3%) would not pay for an Ebola vaccine; 864 (59.7%) would pay at least $1. Among those willing to pay at least $1: 570 (66.0%) would pay $1-50; 174 (20.1%) would pay $51-100; and 120 (13.9%) would pay more than $100. Willingness to pay at least $1 for an Ebola vaccine was associated with international travel; interest in getting an Ebola vaccine; and beliefs that the U.S. government should spend money to control Ebola and assume worldwide leadership in confronting emerging epidemics. Willingness to pay more than $50 was associated with similar variables. Willingness to pay more than $100 was associated with international travel; interest in getting an Ebola vaccine; information seeking; and beliefs that the U.S. government should assume worldwide leadership in confronting emerging epidemics. International travel and interest in an Ebola vaccine were key predictors of willingness to pay across all price points. Understanding willingness to pay for vaccines against emerging infectious diseases remains critical.


Assuntos
Atitude Frente a Saúde , Vacinas contra Ebola/economia , Gastos em Saúde , Doença pelo Vírus Ebola/prevenção & controle , Adulto , África Ocidental , Idoso , Surtos de Doenças , Ebolavirus , Epidemias/prevenção & controle , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
18.
Health Educ Behav ; 45(3): 444-453, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29073834

RESUMO

Licensure of an HIV vaccine could reduce or eliminate HIV among vulnerable populations. However, vaccine effectiveness could be undermined by risk compensation (RC), defined by an increase in risky behavior due to a belief that the vaccine will confer protection. Interest in an HIV vaccine for reasons indicative of RC may serve as an indicator of actual RC in a postlicensure era. This study assessed factors associated with interest in an HIV vaccine for reasons indicative of RC among African American women aged 18 to 55 years, recruited from a hospital-based family planning clinic in Atlanta, Georgia ( N = 321). Data were collected using audio-computer-assisted surveys. Survey items were guided by risk homeostasis theory and social cognitive theory. Multivariable logistic regression was used to assess determinants of interest in an HIV vaccine for reasons indicative of RC. Thirty-eight percent of the sample expressed interest in an HIV vaccine for at least one reason indicative of RC. In the final model, interest in an HIV vaccine for reasons indicative of RC was positively associated with higher impulsivity, perceived benefits of sexual risk behaviors, and perceived benefits of HIV vaccination; it was negatively associated with having at least some college education, positive future orientation, and self-efficacy for sex refusal. Results suggest that demographic, personality, and theory-based psychosocial factors are salient to wanting an HIV vaccine for reasons indicative of RC, and underscore the need for risk-reduction counseling alongside vaccination during the eventual rollout of an HIV vaccine.


Assuntos
Vacinas contra a AIDS/uso terapêutico , Negro ou Afro-Americano/psicologia , Assunção de Riscos , Adulto , Feminino , Georgia , Infecções por HIV/prevenção & controle , Humanos , Pessoa de Meia-Idade , Comportamento Sexual/psicologia , Teoria Social , Inquéritos e Questionários , Populações Vulneráveis , Adulto Jovem
19.
Vaccine ; 35(4): 508-512, 2017 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-28040206

RESUMO

To better understand the association between Ebola-related attitudes and interest in receiving an Ebola virus vaccine, a survey was administered to a U.S. national sample using GfK's KnowledgePanel®. Among participants (N=1417), 34.1% expressed interest in an Ebola vaccine for themselves. In the subset of participants with children aged 0-17 (N=410), 38.1% expressed interest in an Ebola vaccine for their child. In multivariable analyses, vaccine interest for oneself was associated with perceived susceptibility to Ebola (p=0.009), beliefs that the U.S. government should spend money to control Ebola (p=0.002), and beliefs Ebola posed a national threat (p=0.007). Vaccine interest for one's child was associated with perceived severity of Ebola (p=0.018) and beliefs that the U.S. government should spend money to control Ebola (p=0.003). Findings highlight the influence of personal and national threat beliefs on vaccine interest. Understanding the impact of threat beliefs may benefit vaccine campaign development during future pandemic threats.


Assuntos
Surtos de Doenças , Vacinas contra Ebola/administração & dosagem , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Adolescente , África Ocidental/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Inquéritos e Questionários , Estados Unidos
20.
Vaccine ; 35(6): 960-965, 2017 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-28069360

RESUMO

BACKGROUND: Zika virus vaccine development is underway. We examined interest in receiving a Zika virus vaccine (after one becomes commercially available) among students at a large public university in Northern Virginia. METHODS: An online survey of Zika virus-related knowledge, attitudes, and interest in receiving a Zika vaccine was completed by 619 undergraduate students in April, 2016. Stepwise logistic regression with backward elimination was used to identify the variables most strongly associated with interest in being vaccinated against Zika virus. RESULTS: More than half of participants (52.8%) reported that they would be likely or very likely to be vaccinated against Zika virus. Vaccination interest was significantly higher among participants who received an influenza vaccine in the past year (p=0.002), had higher levels of knowledge about Zika virus (p=0.046), reported knowing where to access information about Zika virus (p=0.041), had higher perceived susceptibility to Zika virus (p<0.001), and believed that the U.S. Government should prioritize actions to control Zika virus (p=0.001). CONCLUSIONS: Communication and intervention strategies encouraging vaccine uptake may benefit from increasing knowledge of Zika virus, addressing perceived susceptibility, and reaching students, travelers, and others who may be seeking information about prevention of Zika virus and other emerging infectious diseases.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Imunização/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estudantes/psicologia , Universidades , Zika virus/imunologia , Adolescente , Adulto , Feminino , Humanos , Imunização/estatística & dados numéricos , Vacinas contra Influenza/administração & dosagem , Masculino , Inquéritos e Questionários , Vacinas Virais/provisão & distribuição , Virginia , Zika virus/patogenicidade , Infecção por Zika virus/imunologia , Infecção por Zika virus/prevenção & controle
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