Journal of community health
-
This study examines the relationship between rurality as well as the proportion of non-physician clinicians and county rates of ambulatory care sensitive hospitalizations (ACSHs) for pediatric, adult and elderly populations in Nebraska. The study design was a cross-sectional observational study of county level factors that affect the county level rates of ACSHs using Poisson regression models. ⋯ The proportion of primary care providers who are non-physician clinicians does not have a significant association with ACSHs for any of the age groups. The results indicate that rurality may have a greater impact on pediatric and adult ACSHs and the proportion of NPCs in the primary care provider workforce does not significantly impact ACSH rates.
-
Influenza can spread quickly among children and caregivers in child day care settings. Vaccination is the most effective method to prevent influenza. We determined 2009 pandemic influenza A (H1N1) (pH1N1) and seasonal influenza vaccination rates during the 2009-2010 influenza season among child care center employees, assessed knowledge and attitudes regarding the vaccines, and determined factors associated with vaccine receipt. ⋯ The most common reasons cited for not getting either vaccine were "I don't think I need the vaccine," "I don't think the vaccine will keep me from getting the flu," and "the vaccine is not safe." Factors independently associated with receipt of either vaccine included belief in its efficacy, having positive attitudes towards it, and feeling external pressure to get it. Child care center employees had low rates of pH1N1 and seasonal influenza vaccination largely due to misconceptions about the need for and efficacy of the vaccine. Public health messages should address misconceptions about vaccines, and employers should consider methods to maximize influenza vaccination of employees as part of a comprehensive influenza prevention program.