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Mshigeni S, Samuel G, Scott W. A survey of college students' knowledge and attitudes regarding vaccination practices. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:530-539. [PMID: 35298358 DOI: 10.1080/07448481.2022.2047700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/19/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Objective: The prevalence of illnesses related to VPDs is higher among older adults and college students experience them despite decades of vaccine availability. The Centers for Disease Control and Prevention and American College Health Association (ACHA) emphasizes that all students should provide vaccine proof or receive immunizations prior to class registration. Methods: Using the KAP model, this study investigates the perceptions of first-generation university students regarding campus vaccine requirements. Data were collected using the Web-based survey software Qualtrics regarding students' vaccine knowledge and attitudes. Results: Of the 1,327 responses, the majority were female (74.23%), Hispanic (56.67%), and ages 18-25 years (35.57%). Participants were familiar with the function of vaccines (96.64%) and believed that vaccines prevent contagious diseases (92.70%). These responses were significantly associated with vaccination compliance however, 18.48% of students were not in full compliance. There were significant differences in vaccination compliance across academic standing, age, and race. Conclusion: Implications for public health practices on university campuses are discussed.
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Affiliation(s)
- Salome Mshigeni
- Department of Health Science and Human Ecology, California State University San Bernardino, San Bernardino, California, USA
| | - Gilna Samuel
- Jack H. Brown College, California State University San Bernardino, San Bernardino, California, USA
| | - Winifred Scott
- Jack H. Brown College, California State University San Bernardino, San Bernardino, California, USA
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Anderson EM, Browne S, Moser CA, Feemster K. College health administrator's perceptions of the impacts of COVID-19 on college immunization programs. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37713306 DOI: 10.1080/07448481.2023.2239364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 06/07/2023] [Accepted: 07/09/2023] [Indexed: 09/17/2023]
Abstract
College immunization policies vary. To evaluate the landscape of college immunization programs, we distributed a 45-item survey to college health administrators between July and September 2021. Items measured perceptions of institutionally recommended and required vaccines, enforcement strategies, barriers to vaccine uptake, and the impact of the COVID-19 pandemic. Of 566 invitations sent, only 66 college health administrators completed the survey (11.7% response rate). The majority of participating institutions (89%) required at least one vaccine, with measles-mumps-rubella (MMR) being the most commonly required (83%). Geographic region, school type, or size was not significantly correlated with immunization policies but state-level political leanings were. Common barriers to vaccine program implementation identified by respondents included student-based and institutional concerns. The COVID-19 pandemic was described as both exacerbating existing immunization program barriers and providing opportunities to strengthen programs. Future work will evaluate identified themes in a larger study population and monitor change in perceptions over time.
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Affiliation(s)
- Elizabeth M Anderson
- Vaccine Education Center at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Office of the Assistant Secretary for Health, Region 3, US Department of Health and Human Services, Philadelphia, Pennsylvania, USA
| | - Safa Browne
- Vaccine Education Center at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Charlotte A Moser
- Vaccine Education Center at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kristen Feemster
- Vaccine Education Center at Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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3
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Takahata H, Onishi K, Nomoto H, Iwamoto N, Hayashi K, Hori N, Kutsuna S, Kodama EN, Ohmagari N. Surveillance and risk assessment of health screening for vaccine-preventable diseases among international students in Japan: A cross-sectional study in 2020. Hum Vaccin Immunother 2022; 18:2136914. [PMID: 36399767 DOI: 10.1080/21645515.2022.2136914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a cross-sectional study using a structured questionnaire in three major Japanese cities from August 03 to 24, 2020 to clarify the current situation of health checkups, including vaccine-preventable diseases (VPDs), among international students at Japanese universities (JUs) and Japanese language schools (JLSs). The total response rate was 36%: 69 JUs (31%) and 137 JLSs (39%). Over 90% of these institutions conducted chest X-ray screening for tuberculosis among their students, whereas only 24.6% of JUs and 15.3% of JLSs performed general blood tests for health screening. Only 14.5% and 2.2% of the JUs and JLSs, respectively, required the submission of vaccination or antibody certificates for admission. The difficulties in requesting vaccination certificates from international students are due to poor legal requirements and concerns about rising costs for schools. From 2017 to 2019, 183 international students, principally from East Asia and Southeast Asia, were infected with VPDs, particularly tuberculosis (99 cases) and varicella (71 cases). Whereas the majority of Japanese educational institutions screen international students for tuberculosis (TB) at admission, only a few institutions request proof of antibody testing relating to other VPDs or of vaccination. These findings will help formulate guidelines for checkups related to vaccination for international students required to protect the educational institutions in Japan from the spread of VPDs. In addition, providing multifaceted social support, including financial compensation for institutions and enhanced international students' health issues, would be helpful.
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Affiliation(s)
- Hanako Takahata
- Department of Nursing, National Center for Global Health and Medicine, Tokyo, Japan.,International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan.,Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Kazunari Onishi
- Division of Environmental Health, Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.,AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kuniyoshi Hayashi
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Narumi Hori
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eiichi N Kodama
- Division of Infectious Diseases, International Research Institute of Disaster Science, Graduate School of Medicine, and Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, National Center for Global Health and Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.,AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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Wu T, He H, Wei S, Pan J, Yang J, Huang S, Gan S, Ye C, Huo H, Tang Z, Feng Q. How to Optimize Tuberculosis Health Education in College Under the New Situation? Based on a Cross-Sectional Study Among Freshmen of a Medical College in Guangxi, China. Front Public Health 2022; 10:845822. [PMID: 35400065 PMCID: PMC8987022 DOI: 10.3389/fpubh.2022.845822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChina is a country with a high burden of tuberculosis (TB), and students are the high-risk group for TB. The enrollment scale of colleges has increased dramatically due to the advancement of the enrollment expansion system of Chinese colleges. Consequently, this has brought severe challenges to TB prevention and control in colleges. In 2017, a new TB control guide for schools was issued in China, which included the 8 core knowledge of TB. The target of the overall awareness rate on TB among population was “≥85%,” which was proposed by the “13th Five-Year” National TB Control Plan in China. The cognition of the 8 core knowledge of TB in the new guide among college students is crucial to achieve this target, but few studies on this have been reported. Based on the abovementioned new situation and the new guide, this study aimed to investigate and analyze the cognition, attitudes, and health education needs on TB among freshmen of a medical college in Guangxi province, and discuss how to optimize TB health education in colleges in China.MethodsA cross-sectional study was conducted among freshmen of a medical college in Guangxi, China. A self-designed questionnaire was used to conduct an on-site questionnaire survey. The data was entered in Epidata 4.4.2.1 and was analyzed using SPSS version 25.0. Including descriptive statistics and t-test, and the criterion for statistically significant difference was p < 0.05.ResultsA total of 583 freshmen responded to the survey questionnaires. Regarding cognition about the 5 related knowledge of TB, 551 (94.5%) freshmen knew about the predilection site of TB, while 333 (57.1%), 328 (56.4%), 257 (44.1%), and 201 (34.5%) freshmen knew about the pathogen, the policies about free treatment, the designated hospitals, and the World TB Day, respectively. Regarding cognition on the 8 core knowledge of TB, the overall awareness rate among the freshmen is 73.3%(3,420/4,664); the awareness rate of the knowledge that “guarantee adequate sleep, reasonable diet, and strengthen physical exercise can reduce the incidence of TB” among them was the highest at 88.7% (517/583); and the awareness rate of the knowledge that “coughing or sputum expectoration occurred for more than 2 weeks should be suspected of infecting TB and seeking medical treatment in time” among them was the lowest at 47.5% (277/583). Whether students received health education on TB (T = 4.267, p = 0.000) and whether students heard of TB (T = 3.739, p = 0.000) are the main factors of cognition. Five hundred sixty-two (96.4%) and 565 (96.9%) freshmen were willing to learn and tell others about the knowledge of TB, respectively. Three hundred seventy (63.5%.) freshmen, the highest amount, were willing to accept TB health education in the forms of “website, Weibo, and WeChat.”ConclusionThe cognition on the 5 related knowledge of TB among freshmen is unbalanced, and the overall awareness rate of the 8 core knowledge of TB among freshmen still needs to be improved. Freshmen who have not heard of TB and have not received TB health education before enrollment are the key intervention groups. It is recommended that institutions make full use of modern multimedia technology, continuously optimize the health education forms, implement precise policies, and strengthen the theoretical and practical health education on TB from the initial entry of freshmen into colleges.
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Affiliation(s)
- Tengyan Wu
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
- *Correspondence: Tengyan Wu
| | - Huimin He
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Suosu Wei
- Editorial Board of Chinese Journal of New Clinical Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jian Pan
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Jingjuan Yang
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Shi Huang
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Shijie Gan
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Chengpeng Ye
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Haiying Huo
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Zhong Tang
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
| | - Qiming Feng
- Department of Health Service Management, School of Information and Management, Guangxi Medical University, Nanning, China
- Qiming Feng
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Caleb S, Thompson D, Haimowitz R, Ciotoli C, Dannenbaum M, Fu LY. How colleges intervene to increase student body vaccination coverage. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:428-435. [PMID: 32407196 DOI: 10.1080/07448481.2020.1752698] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/12/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The interventions colleges use to help students be compliant with vaccinations is unknown. This study describes colleges' use of practices consistent with Centers for Disease Control and Prevention (CDC) recommendations to encourage student body vaccination. PARTICIPANTS Participants were a convenience sample of 136 student health center (SHC) administrators from colleges across the U.S. METHODS An online survey assessed SHCs' use of various practices, policies and services to improve student body vaccination coverage. RESULTS There was wide variability in use of evidence-based interventions overall and with respect to specific vaccinations. While most SHCs (92.7%) coordinated vaccination outreach events on campus, only half (50%) accessed an immunization registry to verify vaccination histories. While 88.6% requested student vaccination histories for MMR, only 39.7% requested it for human papillomavirus (HPV). CONCLUSIONS The discrepancies in SHC implementation of interventions to increase coverage of the recommended vaccinations for students suggest that helping colleges expand their capacity to intervene may decrease coverage rate disparities.
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Affiliation(s)
- Susan Caleb
- Children's National Hospital, Washington, DC, USA
| | | | | | - Carlo Ciotoli
- Department of Medicine, New York University, New York, NY, USA
| | - Martha Dannenbaum
- Department of Student Health Services, Texas A&M University, College Station, Texas, USA
| | - Linda Y Fu
- Children's National Hospital, Washington, DC, USA
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6
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Schaffer DeRoo S, Torres RG, Fu LY. Meningococcal disease and vaccination in college students. Hum Vaccin Immunother 2021; 17:4675-4688. [PMID: 34613863 DOI: 10.1080/21645515.2021.1973881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Neisseria meningitidis is a bacterial pathogen capable of causing rapidly progressing illness from nonspecific symptoms to end-organ failure or death in a matter of hours to days. Despite the availability of meningococcal vaccines, there remains a notable disease incidence peak among individuals aged 18-19 years, with college students at increased risk for disease relative to non-college students. Between 2007 and 2017, as many as one in five colleges in the United States experienced an outbreak of meningococcal disease at their own or a nearby institution. Evidence-based strategies to promote meningococcal vaccination among students can be adapted for the college setting, but barriers exist that limit widespread implementation of these strategies by colleges. In this article, we review meningococcal disease characteristics and epidemiology among US college students, vaccination indications and coverage levels among US college students, as well as college vaccination policies and practices that can impact students' vaccine uptake.
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Affiliation(s)
| | - Rachel G Torres
- Center for Translational Research, Children's National Hospital, Washington, DC, USA
| | - Linda Y Fu
- Department of Pediatrics, Children's National Hospital, Washington, DC, USA.,Center for Translational Research, Children's National Hospital, Washington, DC, USA
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7
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Joining the herd? U.S. public opinion and vaccination requirements across educational settings during the COVID-19 pandemic. Vaccine 2021; 39:2375-2385. [PMID: 33810906 PMCID: PMC7985928 DOI: 10.1016/j.vaccine.2021.03.055] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Abstract
With effective and safe COVID-19 vaccines beginning to be distributed across the United States, questions about who should receive the vaccine first have been the focus of public discussions. Yet, over the long-term, questions about the order of distribution will be displaced by questions about how to achieve high levels of vaccination rates. Historically, absent incentives or mandates, Americans have shown ambivalence, if not general antipathy, towards vaccinations, and vaccination rates have generally been low for many vaccines. There is evidence that vaccination requirements across educational settings are an effective policy instrument to increase vaccination rates. We administered a large national survey to assess American's attitudes towards vaccination requirements across three educational settings (daycare, K-12 schools, and universities) in general and for COVID-19 specifically. Partisanship, gender, race, rurality, and perceptions about the appropriate role schools should play in providing health services are substantive predictors of public opinion. While Americans generally support vaccination mandates across all three settings for both types of requirements, support is consistently and significantly lower for COVID19 requirements. The effect of partisanship is accentuated for COVID-19 requirements as compared to general requirements. Drop off in support between general and COVID-19 specific requirements are driven by partisanship, gender, political knowledge, rurality, and having children in the household. Nonetheless, mandates are supported by a majority of Americans. Assessing Americans' opinions of vaccination requirements in educational settings offers an important opportunity to explore the potential of mandates as policy instrument in the government's arsenal against COVID-19 and guide public policy on the issues.
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8
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Takaya S, Kutsuna S, Katanami Y, Yamamoto K, Takeshita N, Hayakawa K, Kato Y, Kanagawa S, Ohmagari N. Varicella in Adult Foreigners at a Referral Hospital, Central Tokyo, Japan, 2012-2016. Emerg Infect Dis 2021; 26:114-117. [PMID: 31855138 PMCID: PMC6924900 DOI: 10.3201/eid2601.170565] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report a case series of varicella among adult foreigners at a referral hospital in central Tokyo, Japan, during 2012–2016. This series highlights differences in varicella vaccination schedules by country and epidemiology by climate and identifies immigrants and international students as high-risk populations for varicella.
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9
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Sandler K, Srivastava T, Fawole OA, Fasano C, Feemster KA. Understanding vaccine knowledge, attitudes, and decision-making through college student interviews. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:593-602. [PMID: 30908142 DOI: 10.1080/07448481.2019.1583660] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/26/2018] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
Objective: We aimed to explore knowledge, attitudes, and beliefs about vaccines required for college-entry and vaccine-related behaviors among college students. Participants: Thirty-three full-time undergraduate students, ≥ 18 years old, enrolled at public (2) and private (3) colleges and universities in metropolitan Philadelphia in fall 2016. Methods: We conducted semistructured interviews, which were double-coded with 5,015 comments overall and 99.3% intercoder reliability (κ = 0.779) using NVivo 11 software. Results: Six key themes emerged: (1) low knowledge about vaccines and requirements; (2) mixed attitudes about required vs. recommended vaccines; (3) high trust in medical professionals; (4) low perceived risk for vaccine-preventable disease outbreaks; (5) substantial parental influence on students' decision-making; and (6) low utilization of Student Health Services. Conclusions: This study revealed lack of knowledge about and low prioritization of vaccination despite overall positive attitudes towards vaccines. Prematriculation education of college students is critical to increasing vaccine knowledge and use.
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Affiliation(s)
- Kayla Sandler
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, Pennsylvania, USA
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tuhina Srivastava
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, Pennsylvania, USA
| | - Oluwatunmise A Fawole
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, Pennsylvania, USA
| | - Caitlin Fasano
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, Pennsylvania, USA
| | - Kristen A Feemster
- Children's Hospital of Philadelphia, Vaccine Education Center, Philadelphia, Pennsylvania, USA
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
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10
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Rencken CA, Dunsiger S, Gjelsvik A, Amanullah S. Higher education associated with better national tetanus vaccination coverage: A population-based assessment. Prev Med 2020; 134:106063. [PMID: 32197975 DOI: 10.1016/j.ypmed.2020.106063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/25/2020] [Accepted: 03/13/2020] [Indexed: 01/05/2023]
Abstract
Vaccination coverage among United States (U.S.) adults for tetanus continues to be lower than the national goals. Education has demonstrated a positive impact on vaccination coverage. However, recently there have been outbreaks of vaccine preventable conditions in areas with high college completion rates. This study assessed the relationship between education and tetanus vaccination. Data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS), a self-reported annual survey for non-institutionalized adults in the US from the Centers for Disease Control, was analyzed in 2019. The outcome was up-to-date tetanus vaccination if received within the last 10 years. Education was categorized into 1) grade 11 or less, 2) grade 12/GED, 3) college 1-3 years, and 4) college 4 or more years. Bivariate analyses and multivariable logistic regression were conducted on the analytic sample (n = 417,473) using Stata 15, accounting for weighting and the complex survey design. In 2016, 59.9% of U.S. adults had up-to-date tetanus vaccination. Higher education level was associated with increased odds of up-to-date tetanus vaccination. The highest odds were for those with 4 or more years of college education [aOR = 1.31; 95% (CI: 1.26-1.35)]. Female sex, Black (non-Hispanic), unemployed, not being married, not having insurance or a personal health care provider, and above 45 years of age had lower odds of up-to-date tetanus vaccination. Targeted community specific vaccination education programs for those without tertiary education may help enhance the knowledge and thus the overall vaccination status in the U.S.
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Affiliation(s)
- Camerin A Rencken
- Brown University School of Public Health, Providence, RI, United States of America.
| | - Shira Dunsiger
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States of America
| | - Annie Gjelsvik
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Siraj Amanullah
- Department of Emergency Medicine, Department of Pediatrics, Brown Medical School, Providence, RI, United States of America; Department of Health Services Policy and Practice, Brown University School of Public Health, Providence, RI, United States of America
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Spinazze PA, Kasteleyn MJ, Aardoom JJ, Car J, Chavannes NH. Cross-Sectional Analysis of University Students' Health Using a Digitised Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093009. [PMID: 32357473 PMCID: PMC7246463 DOI: 10.3390/ijerph17093009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/25/2022]
Abstract
University student years are a particularly influential period, during which time students may adopt negative behaviours that set the precedent for health outcomes in later years. This study utilised a newly digitised health survey implemented during health screening at a university in Singapore to capture student health data. The aim of this study was to analyze the health status of this Asian university student population. A total of 535 students were included in the cohort, and a cross-sectional analysis of student health was completed. Areas of concern were highlighted in student’s body weight, visual acuity, and binge drinking. A large proportion of students were underweight (body mass index (BMI) < 18.5)—18.9% of females and 10.6% of males—and 7% of males were obese (BMI > 30). Although the overall prevalence of alcohol use was low in this study population, 9% of females and 8% of males who consumed alcohol had hazardous drinking habits. Around 16% of these students (male and female combined) typically drank 3–4 alcoholic drinks each occasion. The prevalence of mental health conditions reported was very low (<1%). This study evaluated the results from a digitised health survey implemented into student health screening to capture a comprehensive health history. The results reveal potential student health concerns and offer the opportunity to provide more targeted student health campaigns to address these.
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Affiliation(s)
- Pier A. Spinazze
- Department of Primary Care and Public Health, Global Digital Health Unit, School of Public Health, Imperial College London, London W6 8RP, UK;
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Correspondence: ; Tel.: +65-8332-5290
| | - Marise J. Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jiska J. Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Josip Car
- Department of Primary Care and Public Health, Global Digital Health Unit, School of Public Health, Imperial College London, London W6 8RP, UK;
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Niels H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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12
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Fawole OA, Srivastava T, Feemster KA. Student health administrator perspectives on college vaccine policy development and implementation. Vaccine 2019; 37:4118-4123. [PMID: 31164307 DOI: 10.1016/j.vaccine.2019.05.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/14/2019] [Accepted: 05/24/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Immunization policies at colleges and universities differ greatly for many reasons, including prior experience with disease outbreaks and state immunization requirements. Few studies comprehensively explore the range of factors that influence the development of college vaccine policies or facilitators and barriers to their implementation. OBJECTIVE To explore the perceptions and decision-making process that influence college vaccine policy development and implementation from the perspective of student health administrators. METHODS This qualitative study used semi-structured interviews with student health administrators (N = 10) from ten U.S. colleges and universities purposefully sampled by school type (public vs. private) and geographic region. A descriptive codebook was developed from the interview guide, and each interview was double-coded using NVivo 11 software (κ = 0.87; inter-observer reliability = 99.4%). RESULTS We coded 5785 phrases. Administrators positively viewed their institutions' vaccine requirements, but some expressed concerns about the acceptance of philosophical and religious exemptions. They noted that students were generally ambivalent towards vaccine requirements, and while students recognized the benefits of vaccination, they did not prioritize immunizations. All administrators cited reliance on governmental and professional organizations as well as state regulations for decisions regarding vaccine requirements and recommendations at their institutions. Partnerships with other school departments, pharmaceutical companies, immunization coalitions, and healthcare providers were frequently cited as facilitators of college vaccine programs. Costs of purchasing, storing, and tracking vaccines were identified as major barriers. CONCLUSIONS We identified key themes that can be evaluated in subsequent studies to identify factors associated with successful implementation of university immunization programs and inform initiatives to increase vaccine acceptance and optimize immunization rates on college and university campuses.
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Affiliation(s)
- Oluwatunmise A Fawole
- Children's Hospital of Philadelphia, Vaccine Education Center, 3615 Civic Center Boulevard, Suite 1202 ARC, Philadelphia, PA 19104, United States.
| | - Tuhina Srivastava
- Children's Hospital of Philadelphia, Vaccine Education Center, 3615 Civic Center Boulevard, Suite 1202 ARC, Philadelphia, PA 19104, United States.
| | - Kristen A Feemster
- Children's Hospital of Philadelphia, Vaccine Education Center, 3615 Civic Center Boulevard, Suite 1202 ARC, Philadelphia, PA 19104, United States; University of Pennsylvania, Philadelphia, PA 19104, United States; Philadelphia Department of Public Health, 1101 Market St, Philadelphia, PA 19107, United States.
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Johnson-Mallard V, Darville G, Mercado R, Anderson-Lewis C, MacInnes J. How Health Care Providers Can Use Digital Health Technologies to Inform Human Papillomavirus (HPV) Decision Making and Promote the HPV Vaccine Uptake Among Adolescents and Young Adults. Biores Open Access 2019; 8:84-93. [PMID: 31223517 PMCID: PMC6581018 DOI: 10.1089/biores.2018.0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
High-risk stains of human papillomavirus (HPV) is linked to causing cancer, is highly prevalent, and has increased incidence among adolescents and young adults. However, vaccination rates are low. Health care provider recommendation is the biggest influencer toward vaccine uptake. Since more health care providers are using digital health technologies in their medical practices, this study investigated the feasibility of technology to increase informed decision making. A convenience sample of 210 students completed an online survey. Participants were 18–25 years of age (88%), female (85%), Caucasian (60%), and never been diagnosed with HPV (92.9%). Overwhelmingly, participants owned a smartphone (98.9%) and used mobile apps for health/health tracking (65.5%). However, only 29.3% indicated that they received text messages from their health care provider. Digital health technology can be a cost-effective way for increasing HPV knowledge, removing barriers, and increasing vaccine uptake. Health care providers should explore using various platforms to empower their health care decision making.
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Affiliation(s)
- Versie Johnson-Mallard
- Department of Family, Community and Health System Science, University of Florida, Gainesville, Florida
| | - Gabrielle Darville
- Department of Academic Affairs, College of Public Health, University of Georgia, Athens, Georgia
| | - Rebeccah Mercado
- Department of Pediatrics in the College of Medicine, University of Florida, Gainesville, Florida
| | | | - Jann MacInnes
- Department of Human Development and Organization Studies in Education, College of Education, University of Florida, Gainesville, Florida
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Britt RK, Englebert AM. Behavioral determinants for vaccine acceptability among rurally located college students. Health Psychol Behav Med 2018; 6:262-276. [PMID: 34040832 PMCID: PMC8114363 DOI: 10.1080/21642850.2018.1505519] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/25/2018] [Indexed: 11/14/2022] Open
Abstract
Background: College-aged adults in a rural and medically-underserved area often struggle to receive proper vaccinations due to lower socioeconomic status coupled with life demands. Objectives: The Theory of Planned Behavior (TPB) was used as the theoretical basis to explore behavioral determinants associated with vaccination uptake in the population. Methods: This study used a questionnaire distributed to college students (n = 208) located in a rural area to assess the effects of social and behavioral factors on vaccination uptake. Results: Attitudes and normative beliefs towards vaccination uptake were positive but were largely impacted by work demands. Perceived behavioral control did not contribute towards the intent to receive necessary vaccines. Conclusions: Researchers conducting vaccination interventions, along with physician-patient communication, need to target attitudes and subjective norms in rural and medically underserved communities to increase vaccines, particularly HPV. In addition, results showed that promoting vaccine uptake among minorities is necessary to aid in vaccine acceptability in these communities.
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Affiliation(s)
- Rebecca K. Britt
- Department of Journalism and Creative Media, College of Communication & Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
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Fawole OA, Srivastava T, Fasano C, Feemster KA. Evaluating Variability in Immunization Requirements and Policy Among U.S. Colleges and Universities. J Adolesc Health 2018; 63:286-292. [PMID: 30236997 DOI: 10.1016/j.jadohealth.2018.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/11/2018] [Accepted: 06/21/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To evaluate variation in vaccine requirements, recommendations, and enforcement strategies among U.S. four-year colleges and universities. METHODS We conducted a cross-sectional study abstracting information from Web sites among a sample of 216 four-year colleges and universities from all 50 states and District of Columbia. Our primary outcomes of interest included: type and number of vaccines required for school entry, vaccines recommended by schools for students, and vaccines supplied through student health services. Covariates of interest included: school type, region, school size, mention of American College Health Association recommendations, presence of an accredited health center, mention of state requirements, presence of an enforcement strategy, and exemption stringency of the state in which the school was located. RESULTS Almost all (94%) schools required at least one vaccine for school entry, and 48% required three or more vaccines. The most commonly required vaccines were measles, mumps, and rubella (88.4%) and meningococcal vaccine (51.9%). All schools required the same vaccines included in state requirements but 65% also required additional vaccines. Most schools (67.1%) used registration hold to enforce requirements, while 14.8% restricted students from campus housing and 2.8% dismissed noncompliant students. Seventeen percent of schools had no published enforcement strategies. A higher proportion of private compared to public universities required three or more vaccines (57% vs. 37.3%, p = .014). CONCLUSIONS While most schools have immunization requirements, there is significant variation in number and type of vaccines required. This suggests potential inconsistent uptake of recommended vaccines for college students and underlies the need to characterize facilitators and barriers to immunization program implementation on college campuses.
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Affiliation(s)
- Oluwatunmise A Fawole
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tuhina Srivastava
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Caitlin Fasano
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kristen A Feemster
- Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
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Stevens T, Golwalkar M. Immunization documentation practices and vaccine-preventable disease surveillance capacity among institutions of higher education in Indiana. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:106-113. [PMID: 28937940 DOI: 10.1080/07448481.2017.1381967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Complete and accurate documentation of immunization records and surveillance of disease transmission are critical to the public health response to outbreaks of communicable disease in institutions of higher education (IHEs). This study aims to describe immunization documentation practices and disease surveillance capacity among IHEs in Indiana in order to inform public health action. METHODS IHEs in Indiana were identified and included in the study if they offered on-campus housing and had a dedicated student health center. Phone surveys were administered in September 2015 to each institution, inquiring about current immunization documentation policies and practices, disease surveillance capacity, and use of statewide electronic reporting systems. Additionally, IHE websites were searched to identify immunization documentation requirements for matriculating students. RESULTS Surveys were completed for 33 of 38 eligible IHEs. Twenty-three (70%) IHEs reported that student immunization records are entered into an accessible electronic system or database. Matriculating student immunization requirements were identified for 32 institutions. Of these, 22 (69%) required a physician-signed proof of immunization. No IHEs reported documenting historical immunizations in the statewide electronic immunization system and three IHEs (9%) reported utilizing the state electronic disease surveillance program. CONCLUSIONS Immunization documentation practices vary among IHEs in Indiana and use of statewide immunization and disease reporting systems is minimal. Robust utilization of immunization and disease surveillance systems has been shown to improve public health response to communicable disease outbreaks. Improving mutual understanding of policy and practice between health departments and IHEs could improve the ability to respond to public health challenges.
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Affiliation(s)
- Taryn Stevens
- a Indiana State Department of Health , Epidemiology Resource Center , Indianapolis , IN , USA
| | - Mugdha Golwalkar
- a Indiana State Department of Health , Epidemiology Resource Center , Indianapolis , IN , USA
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Shah NS, Flood-Bryzman A, Jeffries C, Scott J. Toward a generation free of tuberculosis: TB disease and infection in individuals of college age in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:17-22. [PMID: 28800282 PMCID: PMC9394587 DOI: 10.1080/07448481.2017.1363765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To assess the magnitude of active TB disease and latent TB infection (LTBI) in young adults of college age. PARTICIPANTS Individuals who were aged 18-24 years in 2011 were used as a proxy for college students. METHODS Active TB cases reported to the 2011 US National TB Surveillance System (NTSS) were included. LTBI prevalence was calculated from the 2011-2012 National Health and Nutrition Examination Survey. The 2011 American Community Survey was used to calculate population denominators. Analyses were stratified by nativity. RESULTS Active TB disease incidence among persons aged 18-24 years was 2.82/100,000, 18.8/100,000 among foreign-born individuals and 0.9/100,000 among US-born individuals. In 2011, 878 TB cases were reported; 629 (71.6%) were foreign-born. LTBI prevalence among persons of 18-24 years was 2.5%: 8.7% and 1.3% among foreign-born and US-born, respectively. CONCLUSION Active screening and treatment programs for foreign-born young adults could identify TB cases earlier and provide an opportunity for prevention efforts.
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Affiliation(s)
- N. S. Shah
- National Center for HIV/AIDS, Hepatitis, STD and TB Prevention, Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - C. Jeffries
- National Center for HIV/AIDS, Hepatitis, STD and TB Prevention, Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J. Scott
- Department of Mathematics & Statistics, Colby College, Waterville, Maine, USA
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