Comparison of vaccine coverage levels from the National Immunization Survey and the Texas Retrospective Immunization Survey

The purpose of this study was to compare National Immunization Survey (NIS) vaccine coverage rates with Texas Retrospective Immunization Survey (TRIS) vaccine coverage levels. Up-to-date rates for children 19 through 35 months of age as of October 1, 1994, were calculated for single vaccines and two vaccine combinations. The TRIS weighted statewide up-to-date rates for 4-3-1 and 4-3-1-3 were 66 percent and 60 percent, respectively, versus 71 percent and 68 percent for the NIS. Existing retrospective survey procedures can be modified to produce results that may be compared with the NIS.

Texas physician immunization practices

INTRODUCTION

Immunization levels among young children could be improved if physicians administered immunizations at both well and urgent visits, provided simultaneous vaccinations, and knew the guidelines on valid contraindications, part of the Standards for Pediatric Immunization Practices (Standards). We report on a survey measuring the immunization knowledge and practice of Texas pediatricians, family practitioners, and general practitioners.

METHODS

A survey was mailed to a random sample of physicians. Questionnaire items covered 8 of the 18 Standards.

RESULTS

The response rate was 62% (608 of 976 eligible physicians). The mean summary adherence-to-Standards score was 4.1 for pediatricians, 3.6 for family practitioners, and 3.0 for general practitioners. Specialty and practice location were significant predictors of the summary score, whereas gender, managed-care participation, and graduation year were not.

DISCUSSION

Our study results suggest that in Texas, pediatricians and rural physicians most often adhere to the Standards. Improving the reimbursement level of administrative costs for immunization delivery, educating physicians on the Standards, and encouraging the use of patient immunization tracking systems are actions that could potentially improve immunization rates.

Language differences in interpretation of breast cancer health messages

BACKGROUND

Little is known about how women interpret terminology used in breast cancer messages. The authors assessed the understanding of common cancer terms and whether understanding differed by language of interview.

METHODS

In interviews, low-income women 50 years old or older were asked open-ended questions about the meanings of specific terms and phrases in commonly used health messages.

RESULTS

Of 232 completed interviews, 167 were conducted in English and 65 in Spanish. Both English- and Spanish-speaking women poorly understood the terms "risk factors," "at risk," and "cancer." Spanish speakers were less likely to provide technical definitions of "diagnosed" and "mammogram" and had different interpretations of several cancer terms compared with English speakers.

CONCLUSIONS

Cancer terms mean different things to English and Spanish speakers. Client education could be vastly improved if these cultural differences in interpretation were addressed.

Why a peer intervention program for Mexican-American women failed to modify the secular trend in cancer screening

INTRODUCTION

We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening.

METHODS

The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older.

RESULTS

Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical.

CONCLUSIONS

Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.

Knowledge, behavior, and fears concerning breast and cervical cancer among older low-income Mexican-American women

INTRODUCTION

Although recent studies have documented the low participation level of Hispanic women in cancer screening, few have examined their predisposing knowledge and attitudes concerning cancer. We documented the knowledge and fears concerning cancer of an older population of Mexican-American women and how these factors relate to screening behavior and sociodemographic characteristics.

METHODS

The data are from baseline surveys conducted before the start of a community cancer awareness and prevention program. Nine hundred twenty-three Mexican-American women were interviewed in-person about their knowledge, attitudes, and Pap smear and mammogram screening practices.

RESULTS

Knowledge and attitude about cancer varied with age, education, type of health insurance, ability to speak English, and place of birth. Women 65 years of age and older were least knowledgeable of cancer-detection methods and screening guidelines. Those with only Medicare or Medicaid knew far less even compared to uninsured women. Women who did not speak English well were more likely not to know the cancer signs and symptoms, risk factors, and screening guidelines. Women who had knowledge of guidelines and detection methods were more likely to have had a recent screening. Older Mexican-American women with more fatalistic and fearful attitudes toward cancer were less likely to have had a recent Pap smear.

CONCLUSIONS

The low screening participation among Mexican-American women may be due to their limited awareness and knowledge about breast and cervical cancer screening examinations. Our study highlights the need for wide-scale cancer screening interventions consistent with Mexican-American beliefs.

Serological characterisation of Neisseria gonorrhoeae by co-agglutination technique

Antibiotic susceptibility pattern in cases of acute gonococcal urethritis, was studied by single disc diffusion technique and minimum inhibitory concentration (MIC) by agar dilution technique were determined for 5 antibiotics, viz penicillin, ampicillin, tetracycline, gentamicin and norfloxacin. All the penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG strains were sensitive to norfloxacin. 72% of the isolates belonged to serogroup WII/WIII by co-agglutination technique.

Salmonella phage types in Bombay from 1983 to 1987

A total of 156 strains of Salmonella isolated at T.N. Medical College and B.Y.L. Nair Ch. Hospital, Bombay over a period of 5 years from 1983 to 1987 were subjected to Phage Typing. Out of the 111 Salmonella typhi strains, phage type A was found in highest proportion (45.95%), followed by phage type E1 (15.32%), 0(9.91%), Deg. Vi. (9.91%) and C5(5.41%). Salmonella paratyphi A had phage type pattern of 1(60.0%), 2(22.86%) and Untypable (14.29%). Majority of the Salmonella typhimurium isolates (90.0%) were untypable.