Publications by authors named "Stephanie Phibbs"
Background: Adult immunizations prevent morbidity and mortality yet coverage remains suboptimal, in part due to missed opportunities. Clinical decision support systems (CDSSs) can improve immunization rates when integrated into routine work flow, implemented wherever care is delivered, and used by staff who can act on the recommendation.
Methods: An adult immunization improvement project was undertaken in a large integrated, safety-net health care system.
Background: Internet-based developmental screening is being implemented in pediatric practices across the United States. Little is known about the application of this technology in poor urban populations.
Objective: We describe here the results of focus groups, surveys, and in-depth interviews during home visits with families served by an urban safety-net organization to address the question of whether it is possible to use Internet or e-mail communication for medical previsit engagement in a population that is majority Hispanic, of low socioeconomic status, and has many non-English-speaking families.
Objective: To test a stepped intervention of reminder/recall/case management to increase infant well-child visits and immunization rates.
Methods: We conducted a randomized, controlled, practical, clinical trial with 811 infants born in an urban safety-net hospital and followed through 15 months of life. Step 1 (all infants) involved language-appropriate reminder postcards for every well-child visit.
Background: The addition of hydralazine/isosorbide dinitrate (H-ISDN) to a standard heart failure treatment regimen in the African-American Heart Failure Trial was associated with a 43% reduction in mortality. However, the effectiveness of H-ISDN in a community sample of African-American patients and other racial/ethnic groups is unknown.
Objective: The aim of this study was to assess the associations between treatment with H-ISDN and mortality or hospitalization for heart failure in veterans with the disease.
The goal of this effort was to improve adult immunization rates within a large urban health care system. To measure improvement efforts, we calculated each month the percentage of adults 65 years and older who leave clinic visits with up-to-date pneumococcal vaccination were calculated. This was accomplished through the development of three key aspects: standing orders, an immunization registry, and an algorithm to recommend vaccinations based on age and past vaccination history, but also on health history and risk factors for specific diseases.
View Article and Find Full Text PDFWe used participatory research to develop a theoretically based online STD/HIV and pregnancy prevention intervention that would be entertaining and captivating for 15-25 year olds while delivering key messages about condom use. We conducted six focus groups with 15-25 year olds attending reproductive health clinics and completed a content analysis with focus group data. Youth had expectations that websites contain features such as graphics and flash technology.
View Article and Find Full Text PDFObjective: To describe clinician delivery of injury prevention anticipatory guidance and injury visits in a birth cohort, and to describe the association of injury prevention anticipatory guidance with subsequent injury visits.
Methods: We performed a prospective cohort study of 2610 infants born from July 1, 1998 to June 30, 1999, at an urban safety-net hospital and seen subsequently for well child care (WCC, visits = 10558) and/or injury by 16 months of age. Injury guidance was defined as the proportion of recommended injury prevention anticipatory guidance items delivered to those expected, given the WCC visits the child attended.
Objective: Clinic-based immunization rates are used to evaluate clinic performance and immunization interventions, but they typically exclude so-called inactive patients (ie, those who no longer receive care at the clinic). We assessed the effect of enhanced ascertainment of inactive patients on clinic-based immunization rates and on the conclusions of a randomized controlled trial.
Methods: The study was a post hoc analysis of a cluster-randomized controlled trial.
Objective: To define a clinical prediction rule for underimmunization in children of low socioeconomic status.
Methods: We assessed a cohort of 1160 infants born from July 1998 through June 1999 at an urban safety net hospital that received primary care at 4 community health centers. The main outcome measure was up-to-date status with the 3:2:2:2 infant vaccine series at 12 months of age.
Objective: To measure the effect of a multimodal intervention on well-child care visit (WCV) and immunization rates in an inner-city population.
Design: Cluster randomized controlled trial.
Setting And Participants: One-year cohort of 2843 infants born at a hospital in an integrated inner-city health care system.
Background: Healthcare systems have been challenged to ensure the timely administration of immunizations. Immunization registries have been proposed to improve the accuracy and completeness of immunization information and to promote effective practice.
Methods: Comparison of randomly selected samples from two birth cohorts (1993 and 1998) from Denver Health Medical Center.