bluuebunny/crossref_metadata_2025_split huggingface dataset:
The San Diego Immunization Survey: A Model for Local Vaccination Coverage Assessment
Authors: Davila Jill C. , Wang Wendy , Gustafson Kathe W. , Smith Philip J. 
Published: January 2017

Objectives. Assessing vaccination coverage as part of a comprehensive intervention has been demonstrated to result in increased coverage rates. The National Immunization Survey provides coverage estimates at the national level and selected urban areas. However, it is important for other localities to understand vaccination coverage in their areas. The San Diego Immunization Branch conducts the San Diego Immunization Survey (SDIS) to gather vaccination coverage information in San Diego County. This article describes the methodology and results of the SDIS. Methods. The SDIS is a two-phase immunization survey. The first phase is a random-digit-dialing survey in which vaccination information is obtained by phone. The second phase involves the verification of this information and/or obtaining vaccination information via the registry or the child's provider(s). Results. In 2005, the sample size included 839 respondents. From 1995 to 2005, coverage for the following individual vaccines increased: diphtheria and tetanus toxoids, and acellular pertussis (92.0% to 96.5% for ≥3 doses, and 75.0% to 89.0% for ≥4 doses), polio (83.0% to 94.7%), measles-mumps-rubella (85.0% to 95.8%), Haemophilus influenzae type b (87.0% to 93.2%), and hepatitis B (67.0% to 93.6%). Conclusion. The results of the SDIS demonstrate that San Diego County has exceeded the Healthy People 2010 goal to reach at least 80% coverage for the series of universally recommended vaccinations.
A Profile of State-Level Differences in the Oral Health of People with and without Disabilities, in the U.S., in 2004
Authors: Armour Brian S. , Swanson Mark , Waldman H. Barry , Perlman Steven P. 
Published: January 2017

Objectives. The aim of this study was to provide state-level surveillance data to assess the oral health of people with disabilities. Methods. Data from the 2004 Behavioral Risk Factor Surveillance System (BRFSS)—a state-based, random-digit-dialed telephone survey of the U.S. civilian noninstitutionalized population 18 years of age and older—were used to estimate disability prevalence and state-level differences in oral health among people with and those without disabilities. Results. Nationally, people with disabilities were less likely than people without disabilities to visit a dentist or dental clinic in the past year. The percentage of people with disabilities who reported they had visited a dentist in the past year was lowest in Mississippi (48.9%) and highest in Connecticut (74.5%). Among people without disabilities reporting they had visited a dentist or dental clinic in the past year, the percentage was lowest in Mississippi (60.7%) and highest in Minnesota (80.7%). Edentulism was higher among people with disabilities compared with those without disabilities. Among people with disabilities, edentulism was lowest in the District of Columbia (4.1%) and highest in Kentucky (18.7%). Among people without disabilities, edentulism was lowest in California (2.7%) and highest in Kentucky (11.3%). Conclusions. Despite numerous studies and reports documenting the unmet oral health needs of people with disabilities, there has been no systematic national surveillance of oral health among people with disabilities in the United States. This article provides much-needed state-by-state and national epidemiologic data regarding the oral health of people with disabilities.
Measles Outbreak Associated with a Church Congregation: A Study of Immunization Attitudes of Congregation Members
Authors: Kennedy Allison M. , Gust Deborah A. 
Published: January 2017

Objectives. Although measles has not been endemic in the U.S. since 1997 due to high vaccination coverage, recent U.S. measles outbreaks have been associated with individuals and groups who have refused vaccination for philosophical, cultural, or religious reasons. One such outbreak occurred in Indiana among a group of church members in May and June of 2005. Our objectives were to: ( 1) determine attitudes and beliefs of church leaders and members regarding vaccinations and the outbreak experience, ( 2) describe reasons for vaccine acceptance and nonacceptance, and ( 3) assess the feasibility of a knowledge and attitudes study in the context of a vaccine-preventable disease outbreak. Methods. We conducted a focus group with church leaders and families and held 12 structured household interviews with church members directly and indirectly involved in the outbreaks. Results. A combination of safety concerns, personal experience, and religious beliefs contributed to vaccination refusal among a subgroup of church members. While the experience with measles disease did not necessarily translate into a more positive perception of vaccines, most families that refused vaccination would accept some future vaccines under unique circumstances, such as disease presence in the community or if vaccination could be delayed until a child was older. Conclusions. Lessons learned from this outbreak experience can inform future outbreak investigations elsewhere. Maintaining open communication with parents who refuse immunizations, as well as working with their trusted social networks, can help public health professionals facilitate alternative means of disease control during a vaccine-preventable disease outbreak in the community.
Purchasing Patterns and Smoking Behaviors after a Large Tobacco Tax Increase: A Study of Chinese Americans Living in New York City
Authors: Cantrell Jennifer , Hung Dorothy , Fahs Marianne C. , Shelley Donna 
Published: January 2017

Objectives. Tobacco taxes are one of the most effective policy interventions to reduce tobacco use. Tax avoidance, however, lessens the public health benefits of higher-priced cigarettes. Few studies examine responses to cigarette tax policies, particularly among high-risk minority populations. This study examined the prevalence and correlates of tax avoidance and changes in smoking behaviors among Chinese American smokers in New York City after a large tax increase. Methods. We conducted a cross-sectional study with data for 614 male smokers from in-person and telephone interviews using a comprehensive household-based survey of 2,537 adults aged 18–74 years. Interviews were conducted in multiple Chinese dialects. Results. A total of 54.7% of respondents reported engaging in at least one low- or no-tax strategy after the New York City and New York State tax increases. The more common strategies for tax avoidance were purchasing cigarettes from a private supplier/importer and purchasing duty free/overseas. Higher consumption, younger age, and number of years in the U.S. were consistently associated with engaging in tax avoidance. Younger and heavier continuing smokers were less likely to make a change in smoking behavior in response to the tax increase. Despite high levels of tax avoidance and varying prices, nearly half of continuing smokers made a positive change in smoking behavior after the tax increase. Conclusions. Expanded legislation and enforcement must be directed toward minimizing the availability of legal and illegal low- or no-tax cigarette outlets. Public education and cessation assistance customized for the Chinese American community is key to maximizing the effectiveness of tobacco tax policies in this population.
Comparability of Contraceptive Prevalence Estimates for Women from the 2002 Behavioral Risk Factor Surveillance System
Authors: Santelli John , Lindberg Laura Duberstein , Finer Lawrence B. , Rickert Vaughn I. , Bensyl Diana , Posner Sam , Makleff Shelly , Kost Kathryn , Singh Susheela 
Published: January 2017

Objective. This article assesses the comparability of contraceptive use estimates for adult women obtained from the 2002 Behavioral Risk Factor Surveillance System (BRFSS), using the 2002 National Survey of Family Growth (NSFG) as a benchmark. The 2002 BRFSS uses data collection methods that are considerably different from the NSFG. Method. We compared demographic differences and national estimates of current contraceptive methods being used and reasons for nonuse. Variables were recoded in the BRFSS and NSFG systems to make the two samples comparable. Results. Women in the NSFG and BRFSS were similar in age and race/ethnicity. Compared with the NSFG, the BRFSS sample was more educated and of higher income, less likely to be cohabiting, and more likely to be married. After adjusting for differences in the coding of hysterectomy, many BRFSS estimates for current contraceptive use were statistically similar to those from the NSFG. Small but statistically significant differences were found for vasectomy (7.7% and 6.3%), the pill (21.9% and 19.6%), rhythm (1.5% and 1.0%), the diaphragm (0.5% and 0.2%), and withdrawal (0.3% and 2.7%) for the BRFSS and NSFG, respectively. Major reasons for nonuse were similar: seeking pregnancy and currently pregnant. The percentage of women who were not currently sexually active was higher in the BRFSS (16.0%) compared with the NSFG (12.5%). Conclusions. The BRFSS is a useful source of population-based data on contraceptive use for reproductive health program planning; however, planners should be cognizant that lower-income women are not fully represented in telephone surveys.
Surveillance of Births Conceived with Various Infertility Therapies in Massachusetts, January-March 2005
Authors: Lu Emily , Barfield Wanda D. , Wilber Nancy , Diop Hafsatou , Manning Susan E. , Fogerty Sally 
Published: January 2017

Objective. Nationally, infertility therapies (IFTs) are increasingly used to overcome fecundity issues. However, it is unclear to what extent noninvasive IFTs are used compared with assisted reproductive technology. To better understand outcomes related to the increasing use of all types of IFTs, we compared self-reported IFT use from a Massachusetts pilot Pregnancy Risk Assessment Monitoring System (MA-PRAMS) to IFT use recorded on birth certificates (BCs). Methods. In 2005, Massachusetts conducted a three-month pilot study modeled after the Centers for Disease Control and Prevention's PRAMS, a population-based surveillance system that monitors pregnancy experiences. Descriptive and bivariate analyses compared responses to MA-PRAMS survey questions regarding IFT use with data collected on BCs from the same women sampled. Results. According to MA-PRAMS, 6.1% of live births were conceived using IFTs compared with 3.1% reported on BCs. Reported IFT use varied by maternal age and plurality. For women aged 18–34 years, IFT use reported on MA-PRAMS (5.0%) was 2.5 times higher than that reported on BCs (2.0%). For women aged 35 years or older, reported IFT use was comparable in both systems. For women giving birth to singletons, IFT use reported on MA-PRAMS (5.5%) was three times higher than that reported on BCs (1.8%). Conclusions. Higher use of IFTs was reported by MA-PRAMS than on BCs, particularly among younger women and those having singleton births. These findings suggest that self-reported IFT use might be a more sensitive method for states to use in assessing population-based IFT usage among women and monitoring trends in adverse birth outcomes.
State of Emergency Preparedness of Kentucky's Rural Public Health Workforce: Assessing its Ability to Identify Community Health Problems
Authors: Williams John C. 
Published: January 2017

Objective. The author examined the emergency preparedness readiness of all workgroups within Kentucky's rural public health departments as it related to the 10 Essential Public Health Services. This article describes the results related to the three emergency preparedness competencies for the first Essential Public Health Service: the ability to monitor health status to identify community health problems. Methods. Onsite surveys were conducted in one urban and 93 rural Kentucky public health agencies during 2005 and 2006. Categorical data were analyzed using univariate and multivariate analysis techniques. The author compared responses to the level of confidence (LOC) and need for training (NFT) among the seven workgroup classifications. Results. One thousand nine hundred ninety-four public health workers completed the surveys. Of these, 1,813 workers represented 55% of the state's rural local public health workforce. Kentucky's rural public health workforce can be described as predominantly Caucasian, female, and not planning to retire within the next five years. There were significant differences among workgroups for LOC and NFT for each competency examined. Across all workgroups, there was a mean LOC (58%) in the ability to describe the actions to take and procedures to follow in an emergency. There was a correspondingly higher mean perceived NFT (73%) for this competency. Conclusion. This study raises the question of whether we are adequately prepared to monitor our communities' health status. Further research that minimizes the limitations of self-reports and, instead, requires the worker to demonstrate the competency may provide a more accurate assessment of emergency preparedness.
Health Status and Access to Health Care of Migrant Workers in China
Authors: Hesketh Therese , Jun Ye Xue , Lu Li , Mei Wang Hong 
Published: January 2017

Objectives. We explored living and working conditions, health status, and health-care access in Chinese rural-to-urban migrants and compared them with permanent rural and urban residents. Methods. A questionnaire was administered to 1,958 urban workers, 1,909 rural workers, and 4,452 migrant workers in Zhejiang Province, Eastern China, in 2004. Blood samples for human immunodeficiency virus (HIV) and syphilis were taken from the migrant and urban workers. Results. Migrants were young, worked very long hours, and their living conditions were very basic. Nineteen percent had some form of health insurance and 26% were entitled to limited sick pay compared with 68% and 66%, respectively, for urban workers. Migrants had the best self-rated health and reported the least acute illness, chronic disease, and disability, after controlling for age and education. There were no HIV infections detected in either the migrant or urban workers. However, 15 urban workers (0.68%, 95% confidence interval [CI] 0.35, 1.02) and 20 migrants (0.48%, 95% CI 0.26, 0.66, p=0.06) tested positive for syphilis. The high cost of health care in the city was a barrier to health-care access in the last year for 15% of the migrants and 8% of the urban workers. Forty-seven percent of the migrants were unwilling to make contributions to health insurance. Conclusions. These migrants demonstrated the “healthy migrant effect.” However, poor living conditions and inattention to health may make migrants vulnerable to poor long-term health. Because health insurance schemes will remain limited for the forseeable future, attention should focus on providing affordable health care to both uninsured migrants and the urban poor.
Partnering to Meet Training Needs: A Communicable-Disease Continuing Education Course for Public Health Nurses in North Carolina
Authors: Alexander Lorraine K. , Dail Kathy , Horney Jennifer A. , Davis Mary V. , Wallace John W. , Maillard Jean-Marie , MacDonald Pia 
Published: January 2017

In 2004, the General Communicable Disease Control Branch of the North Carolina Division of Public Health and the North Carolina Center for Public Health Preparedness partnered to create a free continuing education course in communicable-disease surveillance and outbreak investigations for public health nurses. The course was a competency-based curriculum with 14 weeks of Internet-based instruction, culminating in a two-day classroom-based skills demonstration. In spring 2006, the course became mandatory for all public health nurses who spend at least three-fourths of their time on tasks related to communicable diseases. As of December 2006, 177 nurses specializing in communicable diseases from 74 North Carolina counties had completed the course. Evaluations indicated that participants showed statistically significant improvements in self-perceived confidence to perform competencies addressed by the course. This course has become a successful model that combines academic expertise in curriculum development and teaching technologies with practical expertise in course content and audience needs. Through a combination of Internet and classroom instruction, this course has delivered competency-based training to the public health professionals who perform as frontline epidemiologists throughout North Carolina.
Distributing Free Fresh Fruit and Vegetables at School: Results of a Pilot Outcome Evaluation
Authors: Coyle Karin K. , Potter Susan , Schneider Doris , May Gary , Robin Leah E. , Seymour Jennifer , Debrot Karen 
Published: January 2017

Objectives. Consumption of fruit and vegetables among children is generally below recommended levels. This evaluation addressed two questions: ( 1) To what extent did children's attitudes toward, familiarity with, and preferences for fruit and vegetables change during the school year? and ( 2) To what extent did children's consumption of fruit and vegetables change during the school year? Methods. During the 2004–2005 school year, the Mississippi Department of Education, Child Nutrition Programs initiated a pilot program to distribute free fruit and vegetables to students (kindergarten through 12th grade) during the school day. Data were collected in 2004–2005 within a one-group pretest/posttest design using a self-report questionnaire ( n=725) and 24-hour dietary recalls ( n=207) with a sample of students from five schools in Mississippi. Data were analyzed in 2006–2007. Results. Results showed greater familiarity with fruit and vegetables at all grade levels ( p<0.05) and increased preferences for fruit among eighth- and 10th-grade students ( p<0.01). Eighth-grade students also reported more positive attitudes toward eating fruit and vegetables ( p<0.01), increased perceived self-efficacy to eat more fruit ( p<0.01), and increased willingness to try new fruit. Finally, results showed increased consumption of fruit, but not vegetables, among eighth- and 10th-grade students ( p<0.001). Conclusions. Distributing free fruit and vegetables at school may be a viable component of a more comprehensive approach for improving students' nutrition attitudes and behaviors. More program emphasis is needed on ways to promote vegetable consumption.
Improvements in Access to Care for Vulnerable Children in California between 2001 and 2005
Authors: Stevens Gregory D. , Seid Michael , Tsai Kai-Ya , West-Wright Carmen , Cousineau Michael R. 
Published: January 2017

Objective. We examined population changes in access to care for children in California during a period of major efforts to improve access to care for children. Methods. We used cross-sectional data on 36,010 children aged 0–19 years from the 2001 and 2005 California Health Interview Survey to assess population changes in access to care. We assessed changes in access by individual risk factors and a composite risk profile. Results. In 2005, a smaller proportion of children were uninsured (8.2% vs. 10.9% in 2001), living in poverty (20.7% vs. 23.2% in 2001), and in families without a high school education (20.8% vs. 23.6% in 2001), all p<0.001. Before and after adjusting for these changes in risk, children were more likely in 2005 to have had a physician visit (odds ratio [OR] = 1.09, 95% confidence interval [CI] 1.07, 1.12) and dental visit (OR=1.11, 95% CI 1.08, 1.14). Children were slightly less likely in 2005 to have a regular source of care (OR=0.94, CI 0.91, 0.96). Children who had the highest risk profiles (≥4 risk factors) experienced the largest gains in access. For example, children with three and ≥4 risk factors had gains in dental visits of 11 and 20 percentage points, respectively ( p<0.001 for each), compared with ≤3 percentage points for children with fewer risk factors. Conclusions. This study found improvements in physician and dental visits between 2001 and 2005 that were not fully explained by changes in insurance coverage or other demographic risk factors. Vulnerable children fared well during this period, suggesting that California may be making important and potentially replicable strides in reducing disparities.
Time Trends and Seasonal Patterns of Health-Related Quality of Life among U.S. Adults
Authors: Jia Haomiao , Lubetkin Erica I. 
Published: January 2017

Objectives. Although numerous studies have examined health-related quality of life (HRQOL) longitudinally, little is known about the impact of seasonality on HRQOL. We examined trend and seasonal variations of population HRQOL. Methods. We used data from the monthly Behavioral Risk Factor Surveillance System (BRFSS). We examined monthly observed mean physically and mentally unhealthy days from January 1993 to December 2006, using the structural time-series model to estimate the trend and seasonality of HRQOL. Results. We found overall worsening physical and mental health during the time period and a significant and regular seasonal pattern in both physical and mental health. The worst physical health was during the winter and the best physical health was during the summer. The mean number of physically unhealthy days in January was 0.63 days higher than in July. The worst mental health occurred during the spring and fall, but the magnitude of the seasonal effect was much smaller. The difference between the best and worst months of mentally unhealthy days was approximately 0.23 days. We found significant differences in unadjusted and season-adjusted unhealthy days in many counties. Conclusions. Our findings can be used to examine time-varying causal factors and the impact of interventions, such as policies designed to improve population health. Our findings also demonstrated the need for calculating season-adjusted HRQOL scores when examining cross-sectional factors on the population HRQOL measures for continuous surveys or longitudinal data.
Alcohol Control Policies and Practices at Professional Sports Stadiums
Authors: Lenk Kathleen M. , Toomey Traci L. , Erickson Darin J. , Kilian Gunna R. , Nelson Toben F. , Fabian Lindsey E.A. 
Published: January 2017

Objective. Alcohol-related problems such as assaults and drinking-driving at or near professional sporting events are commonly reported in the media. An important strategy to reduce such problems may be the use of alcohol control policies at sports stadiums. The objective of this study was to examine alcohol control policies and practices at professional sports stadiums in the U.S. Methods. We conducted a telephone survey of food/beverage managers from 66 of the 100 U.S professional sports stadiums that house a professional hockey, basketball, baseball, and/or football team. The survey consisted of 18 items pertaining to policies regulating alcohol sales and consumption. Results. Most managers indicated that their stadium had a range of alcohol control policies and practices. For example, all or nearly all reported their stadium allows no more than two alcoholic beverages per sale and their alcohol servers are required to check age identification of patrons who appear younger than age 30. In contrast, only about half prohibit servers younger than 21 years of age from selling alcohol both in seating areas and at concession booths, and approximately one-third designate sections of their stadiums as alcohol-free. Conclusions. Although we found that some alcohol control policies appear to be common across stadiums, others are uncommon, leaving room for potential areas of improvement in reducing or preventing alcohol-related problems at professional sporting events. The results provide an important starting point for identifying policies that can be evaluated to determine their effectiveness in reducing alcohol-related injuries and deaths at sporting events.