Biomedical subjects

K Michael Peddecord

Publications and source records attributed to K Michael Peddecord.

5 recordsLinked to original sources

PubMed2005

Hepatitis A vaccine uptake in San Diego County: Hispanic children are better immunized.

BACKGROUND: Few studies have examined compliance with hepatitis A vaccination recommendations or factors likely to predict vaccination against hepatitis A virus. OBJECTIVES: To investigate hepatitis A coverage among 3- to 17.9-year-olds in San Diego County and examine predictors of child and adolescent hepatitis A immunization. DESIGN, SETTING, AND PARTICIPANTS: A total of 1455 participants completed a random-digit dial telephone survey that assessed hepatitis A immunization status of 3- to 17.9-year-old children from May 1 to June 24, 2003. Analysis was limited to the 983 respondents with available immunization records or verified immunization histories. MAIN OUTCOME MEASURES: Receipt of at least 1 hepatitis A vaccine administered on or after the child's second birthday and differences in the frequencies of vaccination based on vaccine availability, sex, ethnicity, type of health care provider, mother's highest level of education, and parental knowledge of the hepatitis A vaccine recommendation. RESULTS: Participant response rate was 77.1%. Among all respondents aged 3 to 17.9 years, 59% received at least 1 hepatitis A vaccine and 41% completed the 2-shot regimen. The adjusted odds that a child received at least 1 hepatitis A vaccine was 3.6 times greater among Hispanic children compared with non-Hispanic children. Other predictors of hepatitis A immunization included child's age, having a public health care provider, lower maternal education, and parental knowledge of the vaccine recommendation. CONCLUSIONS: Results challenge historical patterns of underimmunization among Hispanic children compared with white children. Public health education and community awareness should be sustained in Hispanic communities, but interventions are needed in non-Hispanic communities.

Adolescent↗

PubMed2004

A middle school immunization law rapidly and substantially increases immunization coverage among adolescents.

OBJECTIVES: This study assessed the effectiveness of a middle school vaccination requirement for raising second-dose measles, mumps, and rubella vaccine and hepatitis B vaccine coverage among adolescents. METHODS: Random-digit-dialed telephone surveys were conducted before (1998) and after (1999) the implementation of a vaccination requirement for entry into the seventh grade in San Diego, Calif. RESULTS: Vaccination coverage was higher among children subject to the vaccination requirement (seventh-grade students; 60%) than among fifth- and sixth-grade students 1 year before the requirement (13%, P <.001), and 8th- through 12th-grade students not subject to the requirement (27%, P <.0001). CONCLUSIONS: Middle school-entry vaccination requirements can rapidly and substantially raise vaccination coverage among students subject to the law.

Adolescent↗

PubMed2003

Implementing a seventh grade vaccination law: school factors associated with completion of required immunizations.

OBJECTIVES: We investigated school factors associated with successful implementation of a seventh grade vaccination requirement. METHODS: The proportion of students vaccinated with hepatitis B vaccine and measles containing vaccine was determined from records of schools in San Diego County, California. A school survey identified compliance strategies. Analysis identified factors associated with coverage. RESULTS: In October 1999, 67.2% of 38,875 students had received the required vaccine doses. Of 315 schools, coverage was less than 40% in 60 schools and exceeded 80% in 111 schools. Factors associated with high coverage included private schools, early and frequent notice to parents, and, for public schools, higher overall socioeconomic status of students. CONCLUSIONS: In preparation for a middle school vaccination requirement, early and frequent notification of parents improves coverage. Schools with a high percentage of low socioeconomic status students may require extra resources to support implementation.

Adolescent↗

PubMedDate not supplied

Comparing telephone and written surveys to assess local adolescent immunization coverage rates.

To identify adolescent hepatitis B coverage levels, a survey was conducted of seventh grade parents in San Diego County, California, using a random digit-dial telephone survey. A written survey was fielded also that was distributed at selected schools. Results were validated using data from a mandated report from all schools. Both survey methods overestimated the proportion completing the hepatitis B series by about 10%. Parents accurately reported immunization shot dates from the child's parent-held immunization shot record on the telephone and written surveys. The written survey, in addition to having a somewhat lower cost, may be useful when focusing on a localized area, whereas the telephone survey permits a more representative sample of a larger county-wide population.

Adolescent↗

PubMedDate not supplied

Effects of reorganization on laboratory quality: preliminary findings and lessons learned.

Reorganization and downsizing are common challenges for managers. This case study describes the implementation of a major restructuring of a clinical laboratory within a large, integrated medical-delivery organization. Economic trends prompted us to evaluate the effects of a major laboratory reorganization, with a significant shift from clinical laboratory scientists to lower waged, nonlicensed technical staff, on the analytic quality and other indicators of laboratory performance. Although a laboratory reorganization may be implemented slowly, this reorganization effort was completed quickly. Data were collected during both the pre- and post-reorganization period. Postimplementation performance indicators show no reductions in analytic quality. Effectively dealing with the human side of significant change appears to be the biggest challenge for managers, both in the short term and well after the reorganization. These results and qualitative information and insights might be of value to laboratory management contemplating a laboratory reorganization.

California↗