Relationships between State Health Departments and medical professional organizations regarding immunizations.

OBJECTIVE: To assess relationships between State Health Department (SHD) immunization programs and the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). METHODS: Surveys were distributed to SHD immunization managers and AAP and AAFP chapter/district heads. RESULTS: Most AAP and AAFP respondents reported contact with the SHD (73% and 62%, respectively). Most SHDs reported contact with the AAP and AAFP (74% and 57%, respectively). More SHDs reported discussing immunization information with the AAP than the AAFP (83% and 61%, respectively, P = .02). SHDs rarely reported using e-mail to communicate with physicians (4%), while AAP and AAFP respondents commonly reported communicating with members via e-mail (80% and 72%, respectively). Most SHD respondents reported satisfaction with relationships with the AAP (78%) and AAFP (65%). Similarly, most AAP and AAFP respondents reported satisfaction with their SHD relationship (80% and 62%, respectively). The majority of SHD, AAP, and AAFP respondents expressed willingness to further strengthen relationships (86%, 79%, and 90%, respectively). CONCLUSIONS: Good relationships exist between medical professional organizations and SHDs and there is support for improvement of the partnerships. SHDs may consider enhancing e-mail communications with physicians and medical professional organizations.

Adolescents' knowledge, beliefs, and behaviors regarding hepatitis B: Insights and implications for programs targeting vaccine-preventable diseases.

PURPOSE: To gain a better understanding of adolescents' knowledge, beliefs, and behaviors regarding hepatitis B. METHOD: Three types of data were collected as part of this investigation: (a) 45 in-depth individual interviews with staff from 20 adolescent health, sexually transmitted disease (STD), and family planning clinics; (b) 96 individual interviews with adolescents and young adults; and (c) questionnaires completed by 17,063 adolescents and young adults. All instruments focused on one or more of the following five topics: (a) knowledge about vaccines; (b) knowledge about hepatitis B; (c) barriers to vaccine acceptance, and ways to overcome these barriers; (d) benefits of the vaccine acceptance, and ways to enhance these benefits; and (e) eight hepatitis B risk factors. Interview data was analyzed using qualitative thematic note-based analyses. Survey data was analyzed using descriptive statistics and Chi-square tests. RESULTS: Adolescents and young adults seen in these clinics know very little about vaccinations in general, or hepatitis B, in particular. Adolescents exhibit low levels of perceived susceptibility, severity, response efficacy, and self-efficacy toward hepatitis B and the hepatitis B vaccine. On average, these adolescents engage in 2.36 high-risk behaviors (the most frequent of which include sexual activity, body piercing, and tattooing). Those who were sexually active, had a tattoo, had a STD, or worked with blood were significantly more likely to begin the vaccination series. CONCLUSIONS: There is a clear need for additional educational efforts regarding both vaccinations in general, and hepatitis B in particular. Though adolescents are engaging in a variety of high-risk behaviors, most perceive their risk to be low, and therefore many are not taking the necessary precautions to protect themselves.