bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Geographic Information Systems and Data Confidentiality Guidelines in STD Programs
Authors: Bissette Jennifer M. , Stover Jeffrey A. , Newman Lori M. , Delcher Philip Christopher , Bernstein Kyle T. , Matthews Lindsey 
Published: July 2017

Objective. Advancements in technology, such as geographic information systems (GIS), expand sexually transmitted disease (STD) program capacity for data analysis and visualization, and introduce additional confidentiality considerations. We developed a survey to examine GIS use among STD programs and to better understand existing data confidentiality practices. Methods. A Web-based survey of eight to 22 questions, depending on program-specific GIS capacity, was e-mailed to all STD program directors through the National Coalition of STD Directors in November 2004. Survey responses were accepted until April 15, 2005. Results. Eighty-five percent of the 65 currently funded STD programs responded to the survey. Of those, 58% used GIS and 54% used geocoding. STD programs that did not use GIS (42%) identified lack of training and insufficient staff as primary barriers. Mapping, spatial analyses, and targeting program interventions were the main reasons for geocoding data. Nineteen of the 25 programs that responded to questions related to statistical disclosure rules employed a numerator rule, and 56% of those used a variation of the “Rule of 5.” Of the 28 programs that responded to questions pertaining to confidentiality guidelines, 82% addressed confidentiality of GIS data informally. Conclusions. Survey findings showed the increasing use of GIS and highlighted the struggles STD programs face in employing GIS and protecting confidentiality. Guidance related to data confidentiality and additional access to GIS software and training could assist programs in optimizing use of spatial data.
California Gonorrhea Surveillance System: Methodologic Aspects and Key Results of a Sample-Based System
Authors: Samuel Michael C. , Mocello A. Rain , Gilson Denise , Bradbury K. Jayne , Bolan Gail 
Published: July 2017

Objectives. This article describes findings from the California Gonorrhea Surveillance System (CGSS), developed in response to the need for detailed risk behavior data and clinical data required to control increasing gonorrhea (GC) infections in California. Methods. CGSS is a sample-based surveillance system implemented throughout California in 2007. In 34 of 61 local health jurisdictions (LHJs), 10% of GC cases are sampled for interview; in the other 27 LHJs, all cases are followed. A standardized case investigation record collects case-reported risk data and provider-reported clinical data, and is electronically prepopulated with available contact data. Exclusion criteria include age younger than 14 years, a GC diagnosis within the previous 30 days, and provider request that patient not be contacted. Analyses are weighted to account for sample design. Results. In 2007, 31,192 cases of GC were reported in California. Of these, 5,388 were sampled for follow-up and 2,715 were interviewed, for a response rate of 54.2%. Of those interviewed, 49.6% were female, 28.8% were heterosexual males, and 21.6% were men who have sex with men (MSM). CGSS collects a wide range of behavioral and clinical data for targeted programmatic action. Findings from the 2007 CGSS included data on the following areas: incarceration (highest among heterosexual males [22.4%]); methamphetamine use (high overall [12.2%] and lower among African Americans [4.6%]); co-infection with human immunodeficiency virus (high among MSM [31.9%] and very low among heterosexual males and females [<0.5%]); and improper antibiotic use (8.3% overall; 25.6% among patients attending urgent care clinics). Conclusion. CGSS, an innovative sample-based surveillance system, is effective and flexible. The system provides actionable data on an ongoing basis.
Discrimination and Mental Health Problems among Homeless Minority Young People
Authors: Milburn Norweeta G. , Batterham Philip , Ayala George , Rice Eric , Solorio Rosa , Desmond Kate , Lord Lynwood , Iribarren Javier , Rotheram-Borus Mary Jane 
Published: July 2017

Objective. We examined the associations among perceived discrimination, racial/ethnic identification, and emotional distress in newly homeless adolescents. Methods. We assessed a sample of newly homeless adolescents ( n=254) in Los Angeles, California, with measures of perceived discrimination and racial/ethnic identification. We assessed emotional distress using the Brief Symptom Inventory and used multivariate linear regression modeling to gauge the impact of discrimination and racial identity on emotional distress. Results. Controlling for race and immigration status, gender, and age, young people with a greater sense of ethnic identification experienced less emotional distress. Young people with a history of racial/ethnic discrimination experienced more emotional distress. Conclusion. Intervention programs that contextualize discrimination and enhance racial/ethnic identification and pride among homeless young people are needed.
Intimate Partner Violence Perpetration, Immigration Status, and Disparities in a Community Health Center-Based Sample of Men
Authors: Gupta Jhumka , Acevedo-Garcia Dolores , Hemenway David , Decker Michele R. , Raj Anita , Silverman Jay G. 
Published: July 2017

Objective. We examined disparities in male perpetration of intimate partner violence (IPV) based on immigration status. Methods. From 2005 to 2006, 1,668 men aged 18–35 who were recruited from community health centers anonymously completed an automated, computer-assisted self-interview. Men self-reported their immigrant status (e.g., native-born, <6 years in the U.S. [recent immigrants], or ≥6 years in the U.S. [non-recent immigrants]) and IPV perpetration. We calculated differences in IPV perpetration based on immigrant status. Among immigrant men, we further examined differences in IPV perpetration based on English-speaking ability. Results. Recent immigrants were less likely to report IPV perpetration than native-born men in the overall sample (adjusted odds ratio [AOR] = 0.60, 95% confidence interval [CI] 0.36, 1.00). However, we observed no differences in IPV perpetration between non-recent immigrants and native-born men (AOR=0.88, 95% CI 0.63, 1.23). Among immigrant men, those who were non-recent immigrants and reported limited English-speaking ability were at the highest risk for IPV perpetration, compared with recent immigrants with high English-speaking ability (AOR=7.48, 95% CI 1.92, 29.08). Conclusions. Although immigrant men were at a lower risk as a group for IPV perpetration as compared with non-immigrants, this lower likelihood of IPV perpetration was only evident among recent immigrants. Among immigrant men, those who arrived in the U.S. more than six years ago and reported speaking English relatively poorly appeared to be at greatest risk for using violence against partners. Future research should examine the effects of fear of legal sanctions, discrimination, and changes in gender roles to clarify the present findings.
Pregnancy and HIV Infection in Young Women in North Carolina
Authors: Torrone Elizabeth A. , Wright Janell , Leone Peter A. , Hightow-Weidman Lisa B. 
Published: July 2017

Objectives. We described young women in North Carolina (NC) who were pregnant at the time of diagnosis with human immunodeficiency virus (HIV) infection to identify an at-risk population that could be targeted for increased HIV screening. We investigated the combined effect of partner counseling and referral services (PCRS) and comprehensive prenatal HIV screening. Methods. We conducted a retrospective review of PCRS charts on young women newly diagnosed with HIV in NC between 2002 and 2005. We determined the prevalence of pregnancy in the study sample and conducted bivariate analyses to assess predictors of pregnancy at the time of HIV diagnosis, calculating prevalence ratios (PRs) with 95% confidence intervals (CIs). We analyzed results of partner notification efforts, including timing and stage of diagnosis of HIV-positive partners. Results. During the four-year period, 551 women aged 18–30 years were newly diagnosed with HIV; 30% were pregnant at the time of HIV diagnosis. Pregnant women were more likely to be Hispanic (PR=1.58, 95% CI 1.15, 2.17) and not report typical risk factors. Fourteen percent of pregnant women's partners had an undiagnosed infection compared with slightly more than 8% of nonpregnant women's partners ( p<0.01). Conclusions. Ethnic differences in co-diagnosis of pregnancy and HIV suggest that young Hispanic women may have differential access to and acceptance of routine HIV screening. Comprehensive prenatal screening combined with partner notification can be effective in reaching infected male partners who are undiagnosed.
Adult Blood Lead Reporting in New York State, 1994–2006
Authors: Gelberg Kitty H. , Fletcher Alicia 
Published: July 2017

Objectives. Laboratories that test New York State (NYS) employees and adult residents for lead exposure are required to report blood lead test results to the NYS Department of Healths Heavy Metals Registry. This registry is used to monitor exposures and to identify new high-risk occupational and nonoccupational activities. Methods. We used interviews conducted with people having blood lead levels of ≥25 micrograms/deciliter (μg/dL) reported to the Heavy Metals Registry to determine the primary source of lead exposure. We reviewed this information, together with demographic information, for the years 1994 through 2006. Results. While overall there has been an increase in the number of tests being conducted on NYS residents since 1994, the vast majority of the increase is among those with the lowest blood lead levels (<10 μg/dL). Conversely, there has been a decline in the number of adults tested with blood lead levels of ≥25 μg/dL in NYS due primarily to occupational exposures. However, nonoccupational exposures do represent a relatively large percentage of the individuals with severely elevated blood lead levels (≥60 μg/dL). Conclusions. Although a surveillance system based on blood lead levels cannot identify the true magnitude of adult lead poisoning, the NYS Heavy Metals Registry has proven to be an important tool for identifying situations in which adult lead poisoning is occurring, and assists in guiding lead poisoning prevention among adults.
The Association between Intentional Delay of Vaccine Administration and Timely Childhood Vaccination Coverage
Authors: Smith Philip J. , Humiston Sharon G. , Parnell Trish , Vannice Kirsten S. , Salmon Daniel A. 
Published: July 2017

Objectives. We evaluated the association between intentional delay of vaccine administration and timely vaccination coverage. Methods. We used data from 2,921 parents of 19- to 35-month-old children that included parents' reports of intentional delay of vaccine administration. Timely vaccination was defined as administration with ≥4 doses of diphtheria, tetanus, and pertussis; ≥3 doses of polio vaccine; ≥1 dose of measles, mumps, and rubella vaccine; ≥3 doses of Haemophilus influenzae type b vaccine; ≥3 doses of hepatitis B vaccine; and ≥1 dose of varicella vaccine by 19 months of age, as reported by vaccination providers. Results. In all, 21.8% of parents reported intentionally delaying vaccinations for their children. Among parents who intentionally delayed, 44.8% did so because of concerns about vaccine safety or efficacy and 36.1% delayed because of an ill child. Children whose parents intentionally delayed were significantly less likely to receive all vaccines by 19 months of age than children whose parents did not delay (35.4% vs. 60.1%, p<0.05). Parents who intentionally delayed were significantly more likely to have heard or read unfavorable information about vaccines than parents who did not intentionally delay (87.6% vs. 71.9%, p<0.05). Compared with parents who intentionally delayed only because their child was ill, parents who intentionally delayed only because of vaccine safety or efficacy concerns were significantly more likely to seek additional information about their decision from the Internet (11.4% vs. 1.1%, p<0.05), and significantly less likely to seek information from a doctor (73.9% vs. 93.9%, p<0.05). Conclusions. Intentionally delayed vaccine doses are not uncommon. Children whose parents delay vaccinations may be at increased risk of not receiving all recommended vaccine doses by 19 months of age and are more vulnerable to vaccine-preventable diseases. Providers should consider strategies such as educational materials that address parents' vaccine safety and efficacy concerns to encourage timely vaccination.
State-Based Estimates of Mammography Screening Rates Based on Information from Two Health Surveys
Authors: Davis William W. , Parsons Van L. , Xie Dawei , Schenker Nathaniel , Town Machell , Raghunathan Trivellore E. , Feuer Eric J. 
Published: July 2017

Objectives. We compared national and state-based estimates for the prevalence of mammography screening from the National Health Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), and a model-based approach that combines information from the two surveys. Methods. At the state and national levels, we compared the three estimates of prevalence for two time periods (1997–1999 and 2000–2003) and the estimated difference between the periods. We included state-level covariates in the model-based approach through principal components. Results. The national mammography screening prevalence estimate based on the BRFSS was substantially larger than the NHIS estimate for both time periods. This difference may have been due to nonresponse and noncoverage biases, response mode (telephone vs. in-person) differences, or other factors. However, the estimated change between the two periods was similar for the two surveys. Consistent with the model assumptions, the model-based estimates were more similar to the NHIS estimates than to the BRFSS prevalence estimates. The state-level covariates (through the principal components) were shown to be related to the mammography prevalence with the expected positive relationship for socioeconomic status and urbanicity. In addition, several principal components were significantly related to the difference between NHIS and BRFSS telephone prevalence estimates. Conclusions. Model-based estimates, based on information from the two surveys, are useful tools in representing combined information about mammography prevalence estimates from the two surveys. The model-based approach adjusts for the possible nonresponse and noncoverage biases of the telephone survey while using the large BRFSS state sample size to increase precision.
Coverage of Obesity Treatment: A State-by-State Analysis of Medicaid and State Insurance Laws
Authors: Lee Jennifer S. , Sheer Jennifer L.O. , Lopez Nancy , Rosenbaum Sara 
Published: July 2017

Objectives. We determined whether state Medicaid programs cover recommended treatments for adult and pediatric obesity and to what extent states regulate the treatment and coverage of obesity by private insurers. Methods. We conducted a state-by-state document review of Medicaid manuals and private insurance laws and regulations. Results. Eight state Medicaid programs appear to cover all recommended obesity treatment modalities for adults. Only 10 states appear to reimburse for obesity-related treatment in children. In the small-group insurance market, 35 states expressly allow obesity to be used for rate adjustments, while 10 states do so in the individual market. Two states expressly allow obesity to be used in eligibility decisions in the individual market. Five states provide for coverage of one or more treatments for obesity in both small-group and individual markets. Conclusions. Very few states ensure coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states allow obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market.
Pre-Risk HIV-Prevention Paradigm Shift: The Feasibility and Acceptability of the Parents Matter! Program in HIV Risk Communities
Authors: Miller Kim S. , Maxwell Karl D. , Fasula Amy M. , Parker J. Terry , Zackery Shannon , Wyckoff Sarah C. 
Published: July 2017

Objectives. Many youth begin human immunodeficiency virus (HIV) sexual risk behaviors in preadolescence, yet risk-reduction programs are typically implemented in middle or late adolescence, missing an important window for prevention. Parent-based programming may play an important role in reaching youth early with prevention messages. One such program is the Parents Matter! Program (PMP), a five-session theory- and evidence-based intervention for parents of children aged 9 to 12 years. A randomized controlled trial showed PMP to be efficacious in promoting effective parent-child communication about sexuality and sexual risk reduction. We assessed the feasibility and acceptability of PMP when implemented under typical programmatic circumstances in communities at high risk for HIV infection. Methods. We selected 15 sites (including health departments, local education agencies, community-based organizations, and faith-based organizations) throughout the U.S. and Puerto Rico to participate in delivering PMP. Sites were provided training, program materials, and ongoing technical assistance. We collected multilevel data to assess the feasibility of program implementation and delivery, program relevance, and satisfaction with PMP activities and materials. Results. PMP was successfully implemented and evaluated in 13 of 15 sites; 76% of parents attended at least four of five sessions. Organization-, facilitator-, and parent-level data indicated the feasibility and acceptability of PMP, and overall high satisfaction with PMP activities and materials. Conclusion. The results of this project demonstrate that HIV pre-risk prevention programs for parents can be implemented and embraced by a variety of community organizations in HIV at-risk communities. The time to embrace parents as partners in public health HIV-prevention efforts has come.
The State Public Health Laboratory System
Authors: Inhorn Stanley L. , Astles J. Rex , Gradus Stephen , Malmberg Veronica , Snippes Paula M. , Wilcke Burton W. , White Vanessa A. 
Published: July 2017

This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.
Public Health Laboratory System Improvement Program: Development and Implementation
Authors: Milne Kathleen C. , Milne Thomas L. 
Published: July 2017

Instruments designed to measure the performance of public health systems at state and local levels were supported by the Centers for Disease Control and Prevention (CDC) and implemented in 2002. This article describes the process and outcomes of a system and tool designed to measure performance of State Public Health Laboratory Systems, accomplished by the Association of Public Health Laboratories (APHL) in partnership with CDC. We describe the process used to develop the instrument and its subsequent pilot testing and field testing in 11 states. Throughout the field testing and early implementation phases, both CDC and APHL recognized that the core rationale for measuring system performance would be to provide the basis for subsequent system improvement. APHL implemented the Laboratory System Improvement Program (L-SIP) in 2007 and conducted an evaluation of the field testing of the instrument and related materials that same year. We conclude with a summary of future implications for L-SIP, the program's recognition as an international standard for laboratory systems, and the critical importance of its continuation.
Systematic Review of Antibiograms: A National Laboratory System Approach for Improving Antimicrobial Susceptibility Testing Practices in Michigan
Authors: Boehme Martha S. , Somsel Patricia A. , Downes Frances Pouch 
Published: July 2017

Objectives. Public health surveillance is often dependent on sentinel testing performed in clinical microbiology laboratories, and recognition of emerging/unusual antimicrobial resistance is especially challenging. We obtained cumulative antibiograms from hospitals to determine whether clinical laboratories recognized unusual resistance or reported antimicrobials inappropriate for various bacterial species, as measured before and after public health laboratory (PHL) educational and technical-support interventions. Methods. We compared cumulative antibiogram data from 81 clinical laboratories servicing 86 hospitals in Michigan from 2000 through 2005 with a standardized checklist derived from Clinical and Laboratory Standards Institute (CLSI) antimicrobial susceptibility testing (AST) documents. We considered the reporting of unlikely percent-susceptible results and/or inappropriate antimicrobials serious errors, and we calculated error rates for each data year. We used CLSI-recommendation compliance as a measure to determine whether laboratories were implementing changes. Results. Ninety-five of 239 (28%) cumulative antibiograms examined had one or more serious errors. The annual number of cumulative antibiograms with serious errors did not change radically (range: 10–13); however, when expressed as a percentage of cumulative antibiograms received, the occurrence of these errors declined from 59% in 2000 to 19% in 2005. The reporting of misleading or dangerous antimicrobial-organism combinations occurred less frequently than the reporting of unlikely percent-susceptible results. Compliance with new CLSI recommendations did not improve significantly. Conclusions. AST is complex and nuanced. PHL programs can provide resources, guidance, and technical support to help clinical microbiologists differentiate questionable AST results from true emerging antimicrobial resistance.