scholarly journals 3112 Factors Associated with Hesitancy of Human Papillomavirus Vaccination Among Latina Immigrant Mothers Despite Physician Recommendation

2019 ◽  
Vol 3 (s1) ◽  
pp. 89-89
Author(s):  
Alexandra B Khodadadi ◽  
David Redden ◽  
Isabel Scarinci
Keyword(s):  
Health Insurance ◽  
Perceived Risk ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Vaccine Hesitancy ◽  
Insurance Status ◽  
Physician Recommendation ◽  
Immigrant Mothers ◽  
Health Insurance Status ◽  
To Receive

OBJECTIVES/SPECIFIC AIMS: The purpose of this study was to examine factors associated with Latina immigrant mothers’ hesitancy in having their 9-12 year old daughters vaccinated against HPV despite a physician recommendation. METHODS/STUDY POPULATION: The data analyzed for this study was from a previous effort that examined the efficacy of an intervention to promote HPV vaccination among daughters (9-12 years of age) of Latina immigrants (N=317) through a randomized trial. Baseline data among Latina immigrant mothers with unvaccinated daughters was collected prior to this intervention. Participants were surveyed on sociodemographic characteristics, knowledge and perceptions of cervical cancer and HPV, and intention to vaccinate their daughters with the HPV vaccine if recommended by the daughter’s physician. RESULTS/ANTICIPATED RESULTS: Out of 317 participants, 205 reported willingness to vaccinate following a physician recommendation (64.7%) while 112 reported hesitancy (defined as an answer of “maybe”) to vaccinate their daughters (35.3%). None of the participants indicated “no”. No sociodemographic factors were significantly associated with vaccine hesitancy except for the daughter’s health insurance status (p = 0.03). A significant difference existed in the mother’s perceived risk of cervical cancer in herself based on hesitancy and willingness to vaccination (p < 0.001). Mother’s awareness of HPV (p < 0.0001), knowledge of HPV (p < 0.01), her perceived risk of HPV infection in herself (p < 0.01) and in her daughter (p < 0.0001), and her worry about her daughter being infected with HPV (p = 0.02) were also significant. Finally, there were differences among mothers in confidence of being able to have their daughters complete all three doses of the vaccine (p < 0.0001), and having the time (p < 0.0001) and the money (p < 0.0001) to complete the vaccination series. Factors that were significant in the univariate analysis were then incorporated into a binary logistic multivariable regression. HPV knowledge score was excluded from this analysis due to its limited sample size (n = 169). The five variables that were strongly associated with the outcome of vaccine hesitancy included: HPV awareness, mother’s perceived risk of HPV infection in their daughter, confidence in the ability to receive all three shots in vaccine series, confidence in being able to afford the vaccine series, and daughter’s health insurance. All were positively correlated with intention to vaccinate except for daughter’s health insurance status. DISCUSSION/SIGNIFICANCE OF IMPACT: Despite research showing Latinos are pro-vaccination and the association between HCP provider recommendation and vaccine acceptability among parents, over 35% of Latina immigrant mothers in our study were still hesitant about having their daughters vaccinated against HPV following a physician recommendation. Factors that strongly contributed to this hesitancy included HPV awareness, mother’s perceived risk of their daughter being infected with HPV, self-efficacy (ability to receive all required shots and finding time to complete the HPV vaccination series), and daughter’s health insurance status. These results indicate that HCP recommendation may be not enough of a driving factor to motivate Latina immigrant mothers to vaccinate their daughters against HPV. Further research efforts should focus on heightening perceived risk of HPV infection, improving knowledge of HPV, and boosting their self-efficacy to get their children vaccinated against HPV.

scholarly journals HPV Vaccination Hesitancy Among Latina Immigrant Mothers Despite Physician Recommendation

2020 ◽  
Vol 30 (4) ◽  
pp. 661-670
Author(s):  
Alexandra B. Khodadadi ◽  
David T. Redden ◽  
Isabel C. Scarinci
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Hpv Vaccine ◽  
Self Efficacy ◽  
Perceived Risk ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Vaccine Hesitancy ◽  
Immigrant Mothers ◽  
Factors Associated

Purpose: Human papillomavirus (HPV) vaccination uptake continues to be low in the United States. While a recommenda­tion from a health care provider (HCP) has been shown to be associated with vaccine acceptability among parents, little is known about factors associated with hesitancy despite HCP recommendation. We exam­ined factors associated with HPV vaccine hesitancy, despite a physician recommenda­tion, among Latina immigrant mothers of daughters aged 9-12 years.Methods: As part of a group randomized trial to promote HPV vaccination between 2013 and 2016, we conducted a baseline interviewer-administered survey of mothers to assess sociodemographics, knowledge and perceived risk of cervical cancer/HPV infection, self-efficacy, and intention to vaccinate their unvaccinated daughters. Hesitancy was defined as “don’t know/not sure” (DK/NS) in response to the question: “If your daughter’s doctor recommended that she gets the HPV vaccine, would you let her get it?”Results: Of the 317 participants, 35.3% indicated hesitancy to vaccinate their daughters if their physician recommended it. Although a number of variables were as­sociated with HPV vaccine hesitancy in the univariate model, five remained significant in the final multivariable model: daughter’s health insurance status; HPV awareness; perceived risk of HPV infection for their daughters; perceived self-risk of cervical cancer; and a self-efficacy score of ability to complete the HPV vaccination series.Conclusions: A recommendation by a health care provider may be not enough to motivate Latina immigrant mothers to vaccinate their daughters. Further efforts should focus on increasing awareness re­garding HPV and cervical cancer, heighten­ing perceived risk of HPV infection among daughters and boosting self-efficacy to get their children vaccinated against HPV.Ethn Dis. 2020; 30(4):661-670; doi:10.18865/ed.30.4.661

scholarly journals Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 765
Author(s):  
Amel Ahmed Fayed ◽  
Abeer Salem Al Shahrani ◽  
Leenah Tawfiq Almanea ◽  
Nardeen Ibrahim Alsweed ◽  
Layla Mohammed Almarzoug ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Perceived Risk ◽  
Online Survey ◽  
Seasonal Influenza ◽  
Vaccination Campaign ◽  
Vaccine Uptake ◽  
Influenza Vaccines ◽  
Vaccine Hesitancy ◽  
Cross Sectional ◽  
To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

Health Insurance Status as a Predictor of Mode of Colon Cancer Detection but Not Stage at Diagnosis: Implications for Early Detection

2021 ◽  
pp. 003335492199917
Author(s):  
Lindsey A. Jones ◽  
Katherine C. Brewer ◽  
Leslie R. Carnahan ◽  
Jennifer A. Parsons ◽  
Blase N. Polite ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Health Insurance ◽  
Early Detection ◽  
Late Stage ◽  
Early Stage ◽  
Insurance Status ◽  
Stage At Diagnosis ◽  
Health Insurance Status ◽  
Percentage Point Increase ◽  
Point Increase

Objective For colon cancer patients, one goal of health insurance is to improve access to screening that leads to early detection, early-stage diagnosis, and polyp removal, all of which results in easier treatment and better outcomes. We examined associations among health insurance status, mode of detection (screen detection vs symptomatic presentation), and stage at diagnosis (early vs late) in a diverse sample of patients recently diagnosed with colon cancer from the Chicago metropolitan area. Methods Data came from the Colon Cancer Patterns of Care in Chicago study of racial and socioeconomic disparities in colon cancer screening, diagnosis, and care. We collected data from the medical records of non-Hispanic Black and non-Hispanic White patients aged ≥50 and diagnosed with colon cancer from October 2010 through January 2014 (N = 348). We used logistic regression with marginal standardization to model associations between health insurance status and study outcomes. Results After adjusting for age, race, sex, and socioeconomic status, being continuously insured 5 years before diagnosis and through diagnosis was associated with a 20 (95% CI, 8-33) percentage-point increase in prevalence of screen detection. Screen detection in turn was associated with a 15 (95% CI, 3-27) percentage-point increase in early-stage diagnosis; however, nearly half (47%; n = 54) of the 114 screen-detected patients were still diagnosed at late stage (stage 3 or 4). Health insurance status was not associated with earlier stage at diagnosis. Conclusions For health insurance to effectively shift stage at diagnosis, stronger associations are needed between health insurance and screening-related detection; between screening-related detection and early stage at diagnosis; or both. Findings also highlight the need to better understand factors contributing to late-stage colon cancer diagnosis despite screen detection.

scholarly journals Health Insurance Coverage before and after the Affordable Care Act in the USA

Sci ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Jesse Patrick ◽  
Philip Q. Yang
Keyword(s):  
Health Insurance ◽  
National Health ◽  
Affordable Care Act ◽  
The United States ◽  
Insurance Status ◽  
Health Insurance Status ◽  
Full Implementation ◽  
Before And After ◽  
The Affordable Care Act ◽  
Partial Implementation

The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.

scholarly journals Association of Health Insurance Status with Outcomes of Sepsis in Adult Patients: A Retrospective Cohort Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5777
Author(s):  
Gaon-Sorae Wang ◽  
Kyoung-Min You ◽  
You-Hwan Jo ◽  
Hui-Jai Lee ◽  
Jong-Hwan Shin ◽  
...  
Keyword(s):  
Health Insurance ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Cohort Analysis ◽  
Adult Patients ◽  
Multivariate Logistic Regression Model ◽  
Insurance Status ◽  
Matched Cohort ◽  
Health Insurance Status ◽  
Significant Difference

(1) Background: Sepsis is a life-threatening disease, and various demographic and socioeconomic factors affect outcomes in sepsis. However, little is known regarding the potential association between health insurance status and outcomes of sepsis in Korea. We evaluated the association of health insurance and clinical outcomes in patients with sepsis. (2) Methods: Prospective cohort data of adult patients with sepsis and septic shock from March 2016 to December 2018 in three hospitals were retrospectively analyzed. We categorized patients into two groups according to their health insurance status: National Health Insurance (NHI) and Medical Aid (MA). The primary end point was in-hospital mortality. The multivariate logistic regression model and propensity score matching were used. (3) Results: Of a total of 2526 eligible patients, 2329 (92.2%) were covered by NHI, and 197 (7.8%) were covered by MA. The MA group had fewer males, more chronic kidney disease, more multiple sources of infection, and more patients with initial lactate > 2 mmol/L. In-hospital, 28-day, and 90-day mortality were not significantly different between the two groups and in-hospital mortality was not different in the subgroup analysis. Furthermore, health insurance status was not independently associated with in-hospital mortality in multivariate analysis and was not associated with survival outcomes in the propensity score-matched cohort. (4) Conclusion: Our propensity score-matched cohort analysis demonstrated that there was no significant difference in in-hospital mortality by health insurance status in patients with sepsis.

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