J Prim Care Community Health
February 2024
Introduction/objectives: With growing vaccination misinformation and mistrust, strategies to improve vaccination communication across community-based settings are needed.
Methods: The Rural Adolescent Vaccine Enterprise (RAVE), a 5-year (2018-2022) stepped-wedge cluster randomized study, tested a clinic-based practice facilitation intervention designed to improve HPV vaccination. An exploratory aim sought to explore the use of partnerships between primary care clinics and a community partner of their choosing, to implement a social marketing campaign related to HPV immunization.
Objectives: Addressing parental/caregivers' coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to improving vaccine uptake in children. Common concerns have been previously reported through online surveys, but qualitative data from KII and focus groups may add much-needed context. Our objective was to examine factors impacting pediatric COVID-19 vaccine decision-making in Black, Spanish-speaking, and rural white parents/caregivers to inform the content design of a mobile application to improve pediatric COVID-19 vaccine uptake.
View Article and Find Full Text PDFTo describe satisfaction with the telehealth aspect of a pediatric obesity intervention among families from multiple rural communities and assess differences in satisfaction based on sociodemographic factors. This is a secondary analysis of data from a pilot randomized controlled trial of a 6-month intensive lifestyle intervention (iAmHealthy) delivered through telehealth to children 6-11 years old with BMI ≥85th%ile and their parents from rural communities. Parents completed a sociodemographic survey and a validated survey to assess satisfaction with the telehealth intervention across four domains (technical functioning, comfort of patient and provider with technology and perceived privacy, timely and geographic access to care, and global satisfaction) on a 5-point Likert scale.
View Article and Find Full Text PDFImportance: To our knowledge, there are no published randomized clinical trials of recruitment strategies. Rigorously evaluated successful recruitment strategies for children are needed.
Objective: To evaluate the feasibility of 2 recruitment methods for enrolling rural children through primary care clinics to assess whether either or both methods are sufficiently effective for enrolling participants into a clinical trial of a behavioral telehealth intervention for children with overweight or obesity.
Purpose: Human papillomavirus (HPV) infection contributes to vaccine-preventable malignancies. Rural populations experience lower HPV vaccination rates despite similar rates of other childhood vaccinations. Individual- and clinic-level characteristics likely contribute to this disparity, but little is known about the separate roles of each.
View Article and Find Full Text PDFBackground: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19.
View Article and Find Full Text PDFBackground/objective: Prior to the COVID-19 pandemic, our research group initiated a pediatric practice-based randomized trial for the treatment of childhood obesity in rural communities. Approximately 6 weeks into the originally planned 10-week enrollment period, the trial was forced to pause all study activity due to the COVID-19 pandemic. This pause necessitated a substantial revision in recruitment, enrollment, and other study methods in order to complete the trial using virtual procedures.
View Article and Find Full Text PDFVaccine refusal is increasing. Objectives were to assess frequency of declining or dismissing patients who refuse vaccines, which vaccine(s) prompt pediatricians to decline/dismiss patients, and demographics of pediatricians who decline/dismiss patients. Active members of the Oklahoma American Academy of Pediatricians (AAP) were surveyed.
View Article and Find Full Text PDFCompletion of the Human Papilloma Virus (HPV) vaccine series remains low. Partnerships between primary care (PC) clinics and local pharmacies could boost vaccination rates. We conducted a scoping literature review to address what is known and what gaps exist on the interface between U.
View Article and Find Full Text PDFWe provide guidance for conducting clinical trials with Indigenous children in the United States. We drew on extant literature and our experience to describe 3 best practices for the ethical and effective conduct of clinical trials with Indigenous children. Case examples of pediatric research conducted with American Indian, Alaska Native, and Native Hawaiian communities are provided to illustrate these practices.
View Article and Find Full Text PDFA significant percentage of clinical trials fail due to poor recruitment. Despite this, few studies exist to evaluate clinical trial recruitment strategies using a randomized approach in any population, and none exist to test recruitment strategies for trials involving children or rural populations. For clinical trials focused on weight control, evaluating retention and dose are extremely important, as poor retention can lead to biased samples and existing research shows that dose (i.
View Article and Find Full Text PDFBackground: Previous work suggests provider recommendation improves vaccine delivery. Less examined is the role of practice's front office staff and nurses in vaccine communication. Messaging and communication about vaccines should be consistent across all levels of the pediatric practice.
View Article and Find Full Text PDFThis study explored the association between provider recommendation and adolescent vaccine coverage. We analyzed data from the 2008 to 2018 National Immunization Survey-Teen including coverage with one dose of quadrivalent meningococcal conjugate vaccine (MenACWY), Tetanus-diphtheria-acellular pertussis vaccine (Tdap), and one and three doses of Human papillomavirus (HPV) vaccine. We compared vaccine coverage between those who recalled a provider recommendation and those who did not.
View Article and Find Full Text PDFImportance: Oklahoma ranked 43 in the 2017 America's Health Rankings largely due to health behaviors such as adult obesity, lack of physical activity and smoking. Oklahoma children also suffer from adverse childhood experiences that contribute to poor health outcomes. Community engagement, a process that involves people affiliated by geographic location and shared interest working together to address issues affecting community wellbeing, is a common model that has had some success in Oklahoma communities addressing child health.
View Article and Find Full Text PDFObjectives: To test the effectiveness of a comprehensive team-based intervention to improve human papillomavirus (HPV) vaccination completion rates and reduce missed opportunities to vaccinate in rural Oregon.
Design: Stepped-wedge cluster randomized trial.
Participants: Forty family physicians and pediatricians who are members of the Oregon Rural Practice-based Research Network.
. To evaluate the association between characteristics known to be associated with under-immunization and participation in immunization campaigns among Peruvian children. .
View Article and Find Full Text PDFBackground: Direct-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message.
Methods: We distributed a survey to parents of 10-17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age.
Background And Objectives: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics.
Methods: Staff and providers in 8 resident clinics participated in a 12-month QI study.
Objective: Human papillomavirus (HPV) vaccination rates remain low, in part because of missed opportunities (MOs) for vaccination. We used a learning collaborative quality improvement (QI) model to assess the effect of a multicomponent intervention on reducing MOs.
Methods: Study design: pre-post using a QI intervention in 33 community practices and 14 pediatric continuity clinics over 9 months to reduce MOs for HPV vaccination at all visit types.
Anecdotal experiences raise concerns that abusive head trauma (AHT) is significantly underdiagnosed and perhaps poorly recognized in Latin American settings. With increasing interest in international collaboration in pediatrics, differences in perspectives regarding complex diagnoses should be explored to facilitate a productive exchange of knowledge and ideas. The purpose of this study was to describe the medical literature pertaining to AHT available to physicians who read only in Spanish.
View Article and Find Full Text PDFNational data on vaccine up-to-date (UTD) suggest that insufficient numbers of adolescents receive needed vaccines. This study analyzed public use data of the National Immunization Survey-Teen (NIS-Teen) from 2010 through 2013 for South Carolina (SC) adolescents and compared immunization rates to those of United States (US) adolescents. We also examined trends for each vaccine recommended for adolescents for both SC and US adolescents.
View Article and Find Full Text PDFBecause adolescents make relatively few visits to clinics for preventive care, their vaccination rates suffer. We examined rates among Minnesota youths to see how they compared with those among teens throughout the United States. We used National Immunization Survey-Teen (NIS-Teen) data to estimate vaccination rates for 13- to 17-year-olds in Minnesota from 2008 through 2013 and compared them to national rates for MCV4, Tdap and HPV vaccines.
View Article and Find Full Text PDF