Mixed-Methods Evaluation of the Washington State Practice Transformation Support Hub.

Purpose: Practice transformation initiatives have the potential to promote collaborations between public health, primary care, and behavioral health, but limited empirical evidence is available on how these programs affect participating clinical practices.

Objective: To report the findings from a mixed-methods program evaluation of the Washington Practice Transformation Support Hub (Hub), a publicly funded, multicomponent practice transformation initiative in Washington State.

Design: We used quantitative and qualitative methods to evaluate the impact of Hub activities on participating primary care and behavioral health practices.

Use cases for genetic epidemiology in malaria elimination.

Background: While traditional epidemiological approaches have supported significant reductions in malaria incidence across many countries, higher resolution information about local and regional malaria epidemiology will be needed to efficiently target interventions for elimination. The application of genetic epidemiological methods for the analysis of parasite genetics has, thus far, primarily been confined to research settings. To illustrate how these technical methods can be used to advance programmatic and operational needs of National Malaria Control Programmes (NMCPs), and accelerate global progress to eradication, this manuscript presents seven use cases for which genetic epidemiology approaches to parasite genetic data are informative to the decision-making of NMCPs.

Risk factors for infections in international travelers: an analysis of travel-related notifiable communicable diseases.

Background: We sought to describe travel-related illness among our residents and gain insight into targeting pre-travel health advice to prevent travel-related illness.

Methods: A supplemental travel questionnaire was developed and administered for cases with a legally notifiable communicable disease reported in 2011-2012, who spent at least part of their exposure period outside the United States.

Results: Among 451 cases meeting the eligibility criteria, 259 were interviewed.

2009 pandemic influenza A vaccination of pregnant women: King County, Washington State, 2009-2010.

Purpose: The objectives were to estimate 2009 pandemic influenza A (pH1N1) vaccination coverage among pregnant women and identify associated factors.

Methods: A multimodal survey was distributed to 5341 women who gave birth between November 1, 2009, and January 31, 2010, identified by hospitals in King County, Washington State, with maternity services (n=11).

Results: Of 4205 respondents, 3233 (76.

2009 pandemic influenza a vaccination of pregnant women--King County, Washington State, 2009-2010.

Objectives: Our objectives were to estimate 2009 pandemic influenza A (pH1N1) vaccination coverage among pregnant women and identify associated factors.

Methods: We distributed a multimodal survey to 5341 women who gave birth between November 1, 2009, and January 31, 2010, identified by hospitals in King County, Washington State, with maternity services (n = 11).

Results: Of 4205 respondents, 3233 (76.

Infant pertussis epidemiology and implications for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination: King County, Washington, 2002 through 2007.

Objectives: To describe the epidemiology of infant pertussis in King County, Washington, and to better understand the implications for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination among older children, adolescents, and adults.

Design: Retrospective analysis of reported pertussis cases among infants younger than 1 year, January 1, 2002, through December 31, 2007.

Setting: King County, Washington.

Shedding of pandemic (H1N1) 2009 virus among health care personnel, Seattle, Washington, USA.

The Centers for Disease Control and Prevention (CDC) recommends that health care personnel (HCP) infected with pandemic influenza (H1N1) 2009 virus not work until 24 hours after fever subsides without the use of antipyretics. During an influenza outbreak, we examined the association between viral shedding and fever among infected HCP. Participants recorded temperatures daily and provided nasal wash specimens for 2 weeks after symptom onset.

Spring 2009 H1N1 influenza outbreak in King County, Washington.

Background: In April 2009, King County, Washington, experienced a sustained outbreak of 2009 H1N1 influenza A. This report describes the epidemiology of that outbreak in King County, home to a diverse population of 1.9 million people.

Toxic shock associated with Clostridium sordellii and Clostridium perfringens after medical and spontaneous abortion.

Objective: To better understand the risk of fatal toxic shock caused by Clostridium sordellii in women who had a recent medical abortion with mifepristone and misoprostol.

Methods: We performed active and passive surveillance for cases of toxic shock associated with medical or spontaneous abortion. To identify the cause of toxic shock, immunohistochemical assays for multiple bacteria were performed on formalin-fixed surgical and autopsy tissues.

Health services utilization by low-income limited English proficient adults.

Objectives: We evaluated the health care utilization of limited English proficiency (LEP) compared to English proficient (EP) adults with the same health insurance (Medicaid managed care) and full access to professional medical interpreters.

Methods: Health care utilization over two years was compared for 567 LEP and 1162 EP adults. Multivariate analysis controlled for age, gender, months enrolled in Medicaid and morbidity.

Effectiveness of a parental educational intervention in reducing antibiotic use in children: a randomized controlled trial.

Objective: To determine whether an educational intervention aimed at parents leads to fewer antibiotic prescriptions for their children.

Design: Placebo-controlled, randomized controlled trial.

Setting: Offices of primary care pediatricians who are members of a regional practice-based research network.

Effectiveness of an educational intervention in modifying parental attitudes about antibiotic usage in children.

Objective: To determine the effectiveness of educational materials in improving the attitudes of parents of young children about the judicious use of antibiotics.

Methods: We conducted a randomized controlled trial by recruiting parents of children who were younger than 24 months and being seen for any reason in primary care pediatric offices. At the time of enrollment, study parents indicated their level of agreement with 16 statements, including 9 statements about antibiotic usage and 7 about injury prevention.