Browsing by Author "Thompson, Erika L."
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Item Association between patient characteristics and HPV vaccination recommendation for postpartum patients: A national survey of Obstetrician/Gynecologists(Elsevier Inc., 2022-04-20) Lake, Paige W.; Head, Katharine J.; Christy, Shannon M.; DeMaria, Andrea L.; Thompson, Erika L.; Vadaparampil, Susan T.; Zimet, Gregory D.; Kasting, Monica L.Human papillomavirus (HPV) vaccination rates in the U.S. are relatively low. Provider recommendation rates for HPV vaccination often vary by patient age and relationship status. Obstetrician/gynecologists (OB/GYNs) represent a key provider group that can recommend the HPV vaccine. This study examined differences in OB/GYN recommendation of HPV vaccination for inpatient postpartum patients by age, parity, and marital status. Data were collected from OB/GYNs nationally via a cross-sectional survey. Participants were randomized to two vignette groups (23-year-old patient or 33-year-old patient). Within each group, participants received 4 vignettes that were identical except for patient marital status (married/not in a committed relationship) and number of children (first/third child), and were asked to indicate HPV vaccination recommendation likelihood on a scale of 0 (definitely would not) to 100 (definitely would). A 2 x 2 2 general linear model with repeated measures was used to examine main and interaction effects of patient age, relationship status, and parity. 207 OB/GYNs were included in the final analyses. Recommendation was high for 23-year-old patients (range: 64.5-84.6 out of 100). When marital status and parity were held constant, recommendation likelihood was higher for the younger vs. older patient and was also higher for patients not in a committed relationship, compared to married patients (all p-values < 0.001). Differences in recommendation exist when considering age and relationship status, which provides insight into OB/GYN clinical decision-making. Findings highlight the need to address barriers to HPV vaccination recommendation, including awareness of risk factors to consider when recommending the vaccine.Item Community perspectives on AI/ML and health equity: AIM-AHEAD nationwide stakeholder listening sessions(PLOS, 2023-06-30) Vishwanatha, Jamboor K.; Christian, Allison; Sambamoorthi, Usha; Thompson, Erika L.; Stinson, Katie; Syed, Toufeeq A.Artificial intelligence and machine learning (AI/ML) tools have the potential to improve health equity. However, many historically underrepresented communities have not been engaged in AI/ML training, research, and infrastructure development. Therefore, AIM-AHEAD (Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity) seeks to increase participation and engagement of researchers and communities through mutually beneficial partnerships. The purpose of this paper is to summarize feedback from listening sessions conducted by the AIM-AHEAD Coordinating Center in February 2022, titled the "AIM-AHEAD Community Building Convention (ACBC)." A total of six listening sessions were held over three days. A total of 977 people registered with AIM-AHEAD to attend ACBC and 557 individuals attended the listening sessions across stakeholder groups. Facilitators led the conversation based on a series of guiding questions, and responses were captured through voice and chat via the Slido platform. A professional third-party provider transcribed the audio. Qualitative analysis included data from transcripts and chat logs. Thematic analysis was then used to identify common and unique themes across all transcripts. Six main themes arose from the sessions. Attendees felt that storytelling would be a powerful tool in communicating the impact of AI/ML in promoting health equity, trust building is vital and can be fostered through existing trusted relationships, and diverse communities should be involved every step of the way. Attendees shared a wealth of information that will guide AIM-AHEAD's future activities. The sessions highlighted the need for researchers to translate AI/ML concepts into vignettes that are digestible to the larger public, the importance of diversity, and how open-science platforms can be used to encourage multi-disciplinary collaboration. While the sessions confirmed some of the existing barriers in applying AI/ML for health equity, they also offered new insights that were captured in the six themes.Item COVID-19 clinical trial participation and awareness in Texas(Informa UK Limited, trading as Taylor & Francis Group, 2024-04-25) Luningham, Justin M.; Akpan, Idara N.; Alkhatib, Sarah; Taskin, Tanjila; Desai, Palak; Vishwanatha, Jamboor K.; Thompson, Erika L.The COVID-19 pandemic required the rapid development of COVID-19 vaccines and treatments, necessitating quick yet representative clinical trial enrollment to evaluate these preventive measures. However, misinformation around the COVID-19 pandemic and general concerns about clinical trial participation in the U.S. hindered clinical trial enrollment. This study assessed awareness of, willingness to participate in, and enrollment in COVID-19 vaccine and treatment clinical trials in Texas. A quota sample of 1,089 Texas residents was collected online from June - July 2022. Respondents were asked if they were aware of, willing to participate in, and had enrolled in clinical trials for COVID-19 vaccines or treatments. Overall, 45.8% of respondents reported being aware of clinical trials for COVID-19 treatments or vaccines, but only 21.7% knew how to enroll and only 13.2% had enrolled in a COVID-19 clinical trial. Respondents with bachelor's or graduate degrees were more likely to be aware of clinical trials, more likely to have enrolled in trials, and more willing to participate in treatment trials. Women were less willing to participate and less likely to have enrolled in COVID-19 clinical trials than men. Respondents aged 55 years and older were more willing to participate, but less likely to have enrolled in COVID-19 clinical trials than 18-to-24-year-olds. Common reasons given for not participating in clinical trials included concerns that COVID-19 treatments may not be safe, government distrust, and uncertainty about what clinical trial participation would entail. Substantial progress is needed to build community awareness and increase enrollment in clinical trials.Item Demographic and Psychosocial Correlates of COVID-19 Vaccination Status among a Statewide Sample in Texas(MDPI, 2023-04-28) Luningham, Justin M.; Akpan, Idara N.; Taskin, Tanjila; Alkhatib, Sarah A.; Vishwanatha, Jamboor K.; Thompson, Erika L.The COVID-19 pandemic has been a global public health concern since early 2020 and has required local and state-level responses in the United States. There were several Food and Drug Administration (FDA) approved vaccines available for the prevention of COVID-19 as of August 2022, yet not all states have achieved high vaccination coverage. Texas is a particularly unique state with a history of opposing vaccination mandates, as well as a large and ethnically/racially diverse population. This study explored the demographic and psychosocial correlates of COVID-19 vaccinations among a statewide sample in Texas. A quota sample of 1089 individuals was surveyed online from June-July 2022. The primary outcome in this study was COVID-19 vaccination status (fully vaccinated, partially vaccinated, or unvaccinated) and included independent variables related to demographics, COVID-19 infection/vaccine attitudes and beliefs, and challenges related to the COVID-19 pandemic. Hispanic/Latinx individuals were more likely than non-Hispanic White individuals to be partially vaccinated as opposed to unvaccinated. Higher education levels and confidence that the FDA would ensure a safe COVID-19 vaccine were strongly associated with a higher likelihood of being fully vaccinated. In addition, some challenges brought on by the pandemic and concerns about becoming infected or infecting others were associated with a higher likelihood of being partially or fully vaccinated. These findings emphasize the need to further investigate the interaction between individual and contextual factors in improving COVID-19 vaccination rates, especially among vulnerable and disadvantaged populations.Item Effect of 2018 American College of Cardiology/American Heart Association Guideline Change on Statin Prescription for People Living with HIV(Elsevier B.V., 2023-03-28) Pan, Meng; Agovi, Afiba Manza-A.; Anikpo, Ifedioranma O.; Fasanmi, Esther O.; Thompson, Erika L.; Reeves, Jaquetta M.; Thompson, Caitlin T.; Johnson, Marc E.; Golub, Vitaly; Ojha, Rohit P.The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines were updated in 2018 to explicitly recommend statin use for primary cardiovascular disease prevention among people living with HIV (PLWH), but little is known about the effect of this guideline change. We aimed to assess the effect of the 2018 ACC/AHA guideline change on statin prescription among PLWH. We used data from an institutional HIV registry to identify PLWH aged 40-75 years, engaged in HIV care between June 2016 and May 2021, had a LDL cholesterol between 70 and 189 mg/dl, 10-year atherosclerotic cardiovascular disease (ASCVD) risk score >/=7.5%, no prior statin prescription, and no history of diabetes or ASCVD. Our outcome of interest was a new statin prescription within 12 months of eligibility. We estimated standardized risk difference (RD) with 95% confidence limits (CL) by comparing prescription probabilities before and after guideline change. Our study population comprised 251 PLWH (171 before, 80 after the guideline change), of whom 57% were aged <55 years, 82% were male, and 45% were non-Hispanic black. The standardized 12-month statin prescription risk was 43% (95% CL: 31%, 60%) after the guideline change and 19% (95% CL: 13%, 26%) before the guideline change (RD = 25%, 95% CL: 9.1%, 40%). Our results suggest that the 2018 ACC/AHA guideline change increased statin prescription among PLWH, but a sizable proportion of eligible PLWH were not prescribed statin. Future studies are needed to identify strategies to enhance implementation of statin prescription guidelines among PLWH.Item The Effect of Trusted News Sources on the Confidence in the Safety of COVID-19 Vaccination(2023) Alkhatib, Sarah A.; Luningham, Justin M.; Akpan, Idara N.; Taskin, Tanjila; Vishwanatha, Jamboor K.; Thompson, Erika L.Purpose: COVID-19 vaccination prevents severe disease manifestations; yet uptake has been suboptimal. Confidence in the safety and efficacy of the vaccine influences COVID-19 vaccination decisions. Exposure to information from a trusted news source can impact perceptions and may contribute to vaccine decisions. This study assessed the association between trusted news sources and confidence in the safety of COVID-19 vaccination among Texas adults. Methods: Participants were recruited through an online panel using quota sampling based on the racial and ethnic distribution of Texas in July 2022 (n=1089). The primary predictor variable was self-reported trusted news sources for COVID-19 related news (16 options), in which respondents were asked to endorse any news source they trusted, with options ranging from print media to cable news to local news. The outcome was confidence in the safety of the COVID-19 vaccine (not at all confident to very confident). Multinomial regression analyses were conducted to model confidence in COVID-19 vaccination and trusted news sources while controlling for education, age, gender, and self-reported race. Results: Through an initial descriptive analysis, Fox News, local cable TV programs, and news broadcasting from one’s home abroad were associated with lower confidence levels. After grouping those three sources as "top news sources” and assessing their effect on confidence through a multinomial model, it was found that individuals who trusted those top sources were significantly less likely to endorse "somewhat confident” (OR=0.59, 95%CI 0.4-0.89) or "very confident” (OR=0.41, 95%CI 0.27- 0.62) compared to being "not at all confident” in the safety of the COVID-19 vaccine. Conclusions: Study findings show that some trusted news sources contributed to participants having less confidence or no confidence in the safety of the COVID-19 vaccine. Public health initiatives should consider how to address vaccine confidence among the public given the diversity of information sources people rely on.Item Effectiveness of provider communication training for increasing human papillomavirus vaccine initiation at a safety-net health system(Elsevier Inc., 2024-03-01) Meadows, Rachel J.; Gehr, Aaron W.; Lu, Yan; Maynard, Grace; Akpan, Idara N.; Taskin, Tanjila; Fulda, Kimberly G.; Patel, Divya; Matches, Sarah; Ojha, Rohit P.; Thompson, Erika L.BACKGROUND: Strong provider recommendation can increase uptake of human papillomavirus (HPV) vaccination. Therefore, we developed and implemented a provider education intervention on communication strategies for recommending HPV vaccination with clinic-level audit and feedback (HPV: Communicating about HPV to Adults and Teens [HPV CHAT]). We aimed to evaluate the effect of HPV CHAT on HPV vaccine uptake in seven family medicine and pediatric clinics in a large urban health system (USA). METHODS: We used a quasi-experimental design, where the eligible population included people aged 9-26 years with at least one encounter in June 2020-February 2023 at one of the participating community health clinics. We used interrupted time-series analysis to assess changes in the prevalence of HPV vaccine uptake. We used segmented Poisson regression with a log link function to estimate prevalence ratios (PR) and 95% confidence limits (CL) for level (immediate) and slope (over time) changes with adjustment for seasonality using Fourier transformation. RESULTS: Our study population comprised 60,328 observations in which the median age was 17 years (interquartile range: 13-21). A majority (58%) were female and 87% were racial/ethnic minorities. Overall, we observed no sizeable effect of the intervention on HPV vaccination uptake. Nonetheless, heterogeneity was observed by age group with modest increases in individuals aged 9-12 and 13-17 years. CONCLUSION: Our provider feedback intervention had minimal effect on increasing prevalence of HPV vaccination in seven family medicine and pediatric clinics. Novel strategies are needed to address provider barriers related to HPV vaccination.Item Examining Reasons for Intent to Discontinue and Remove LARCs: National Survey of Family Growth 2017-2019(2021) Poleon, Suprena; Thompson, Erika L.Background Long-acting reversible contraception (LARC) are highly-effective forms of contraception, which can reduce the risk of unintended pregnancy. Despite LARCs effectiveness, women may desire to discontinue this method. This study will examine reasons for intent to discontinue and remove LARCs among US women aged 15-49 from 2017-2019. Methods The National Survey of Family Growth2017-2019 was utilized with a sample of 6141 female respondents. Descriptive statistics for intention to discontinue LARCs, difficulty removing LARCs, and reasons for LARC discontinuation and removal were examined. Rao-Scott chi-square tests were conducted in SAS. Results Overall, 22.9% of women reported ever using LARCs. Among LARC users, most women (81.2%) reported using LARC in the past 10-years. Among these women, 63.9% intended to discontinue LARCs, and 11.5% had difficulty removing LARCs. Reasons for wanting to discontinue LARCs include decided to get pregnant (15.9%), side effects (29.6%), LARC complications (19.3%), and LARC expiration (26.8%). Primary reasons reported for difficulty removing LARCs included: complications (68.3%), discouragement by provider (6.8%), provider's inability to remove (4.9%), removal not covered by insurance (3.8%), and could not get removed (3.7%). Conclusion Given that women who use a LARC method rely on providers to remove this contraceptive method, understanding the reasons for discontinuation and difficulties encountered are needed. Findings from this nationally representative sample identified provider-level and system-level barriers for LARC removal. In order to respect the reproductive autonomy of LARC users method for pregnancy prevention, these barriers must be overcome.Item Factors associated with HPV vaccination intention among U.S. 27-45-year-olds(2021) Moore, Jonathan; Garg, Ashvita; Galvin, Annalynn; Kasting, Monica; Wheldon, Christopher; Thompson, Erika L.Introduction: HPV vaccination recommendations now include shared clinical decision-making for adults aged 27-45 years. We investigated how knowledge, attitudes, and beliefs were associated with likelihood of asking a healthcare provider about the HPV vaccine and the likelihood of getting the HPV vaccine among adults ages 27-45 years old. Methods: A cross-sectional survey was distributed to U.S. adults between 27-45 years old between April-May 2020 (n=691). Outcomes of interest included likelihood of asking their provider about the HPV vaccine and likelihood of getting the HPV vaccine. Covariates included demographic factors, knowledge, attitudes, and beliefs. Adjusted models were estimated for each outcome variable using a log function and Poisson distribution. Results: Likelihood of asking their provider about the HPV vaccine was significantly associated with perceived likelihood of benefitting from the vaccine (aOR=2.45, 95% CI: 1.69-3.57). Likelihood of receiving the vaccine was associated with HPV vaccine attitudes (aOR=1.04, 95% CI:1.01-1.07), perceived effectiveness against HPV infection (aOR=4.03, 95% CI=1.20-13.53), and perceived likelihood of benefitting from the vaccine (aOR=4.31, 95% CI=2.64-7.03). Conclusions: These findings suggest increasing positive vaccine attitudes, perceived effectiveness, and perceived likelihood of benefitting from the vaccination are important factors in facilitating a shared clinical decision for HPV vaccination. Understanding factors associated with likelihood of discussing and receiving the HPV vaccine among 27-45-year-olds is important to implement guidelines for shared clinical decision-making.Item Implementation of an unconscious bias course for the National Research Mentoring Network(BioMed Central Ltd., 2022-05-21) Javier, Damaris; Solis, Linda Grace; Paul, Mirabelle Fernandes; Thompson, Erika L.; Maynard, Grace; Latif, Zainab; Stinson, Katie; Ahmed, Toufeeq; Vishwanatha, Jamboor K.Purpose: Increased awareness and mitigation of one's unconscious bias is a critical strategy in diversifying the Science, Technology, Engineering, Mathematics, and Medicine (STEMM) disciplines and workforce. Greater management of unconscious bias can enhance diverse recruitment, persistence, retention, and engagement of trainees. The purpose of this study was to describe the implementation of an asynchronous course on unconscious bias for people in STEMM. Specifically, we explored who engaged with the course and reflections from participation. Method: A five-part, asynchronous Unconscious Bias Course was developed and was hosted on a national mentoring platform starting in July 2020. To examine course engagement, we assessed the demographics of course participants and completion. Participant responses to reflection questions after each module were also synthesized using qualitative methods. Results: Overall, 977 people registered for the course and 42% completed all modules. In the reflection responses, participants reflected on their unconscious biases in their lived experiences and how it relates to actions, judgements, external factors, stereotypes, and un-intentionality. Participants also reflected on microaggressions, their impact on the recipients and others, and the relationship between microaggressions and unconscious bias. Participants reported four key strategies used by allies against unconscious bias: immediately acting (83%), reflection (46%), improving the organizational culture (30%), and individual-level ally-ship (44%). Strategies for self-awareness included: reflection, pausing/breathing, and self-observation. Conclusion: The assessment of the Unconscious Bias Course implementation revealed the course reached a wide cross-section of people in STEMM and demonstrated that participants were able to reflect on the underpinnings of the course. This course, and its suite of offerings, support a nationwide effort to mitigate bias and prepare individuals to be culturally competent in a diverse society in order to foster a STEMM environment that caters to individuals' success and diversification of these fields.Item Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents(Elsevier Inc., 2021-09-17) Francis, Jenny K.R.; Rodriguez, Serena A.; Dorsey, Olivia; Blackwell, James-Michael; Balasubramanian, Bijal A.; Kale, Neelima; Day, Philip; Preston, Sharice M.; Thompson, Erika L.; Pruitt, Sandi L.; Tiro, Jasmin A.Parental vaccine hesitancy is a growing concern. Less is known about provider or practice characteristics that encounter HPV-specific vaccine-hesitant parents, the providers' confidence in responding to HPV vaccine concerns, and the attitudes and use of vaccine dismissal policies (i.e., removing patients from the practice). North Texas providers completed an online survey. Dependent variables assessed: (1) percentage of HPV vaccine-hesitant parents encountered in practice defined as substantive, or high (≥11%, or among more than one out of ten adolescent patient encounters) versus low (≤10%) levels; (2) confidence in responding to 11 HPV vaccine concerns; (3) attitudes and use of vaccine dismissal policies. Chi-square and Fisher's exact tests were conducted. Among 156 providers, 29% reported high HPV vaccine hesitancy (≥11% of patient population). Overall, providers reported being "very confident" in addressing vaccine concerns (mean: 3.37 out of 4, SD: 0.57). Mean confidence scores were significantly higher for white (vs. non-white) providers and for pediatricians (vs. family practitioners). Providers were least confident in responding to parents' religious/personal beliefs (69%). Some providers (25%) agreed with policies that dismissed vaccine-hesitant parents after repeated counseling attempts. More providers used dismissal policies for childhood (19%) than adolescent (10%) immunizations. Provider communication training should include parental religious/personal beliefs to effectively address HPV vaccine hesitancy. Other regions should examine their HPV-specific vaccine hesitancy levels to understand how the use of dismissal policies might vary between adolescent and childhood immunizations.Item Relationship Between Sexual Dating Violence and Feeling Sad or Hopeless Among High School Students(2019-03-05) Thompson, Erika L.; Edochie, ChineloPurpose: Sexual dating violence among high school students is estimated to be on the rise. Effects of sexual dating violence in teenage years can carry on to adulthood and result in depression and suicidality, but there is a need to examine both conditions during adolescence. The purpose of the study was to assess the relationship between sexual dating violence and feeling sad or hopeless among 9th-12th graders in the U.S. Methods: The Youth Risk Behavior Survey (YRBS) 2017 is a nationally representative survey of 9-12th graders in the US (N=14,765). The analytic sample size for this study was limited to a complete case analysis (N=8,244). The outcome variable was feeling sad or hopeless in the past 12 months (yes/no). The exposure variable was experience of sexual dating violence in the last 12 months (yes/no). A survey-weighted adjusted logistic regression model estimated the association of sexual dating violence with feeling sad or hopeless while controlling for covariates (age, sex, race/ethnicity and binge drinking), using SAS 9.4. Results: In the sample, 18% reported feeling sad or hopeless and 4% experienced sexual dating violence. Students who experienced sexual dating violence were significantly more likely to feel sad or hopeless while controlling for age, sex, race and binge drinking (OR=4.58, 95% CI 3.63, 5.80). Additionally, females were nearly three times more likely to feel sad or depressed compared to the males (OR=2.98, 95% CI 2.61, 3.41). Conclusions: The findings indicate that there may be an association between sexual dating violence and feeling sad or hopeless when controlling for gender, binge drinking and race among adolescents. Promoting safe, healthy relationships through social-emotional programs for high-schoolers may also promote positive mental health. Next steps would be to examine the association using a longitudinal study design among adolescents.Item Use of a Health Advocacy Model for Survivors of Interpersonal Violence(MDPI, 2020-12-02) Grace, Jessica; Walters, Scott T.; Gallegos, Irene; Thompson, Erika L.; Spence, Emily E.This article examines the implementation of a health advocacy model designed for survivors of interpersonal violence (IPV) in a metropolitan area of North Texas. Using a framework influenced by motivational interviewing, solution-focused therapy, and trauma-informed care, this program engaged IPV survivors in creating health and safety goals. Goal attainment scaling was used to track progress after each health advocacy encounter. Clients could set their own goals for healthcare, self-care, and safety. The program served 419 clients and 648 goals were set by clients at the first visit. Among all goals, 89% selected goals focused on healthcare, with 47% of those selecting obtaining health insurance or coverage as a need. These results demonstrate the need for an enhanced healthcare response for this population. The remaining goals selected were self-care (7%) and safety (3%). The design of the health advocacy intervention shows promise towards filling the gaps between IPV and healthcare service delivery systems.