Browsing by Author "Livingston, Melvin D."

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    Human Papillomavirus Vaccine Initiation for Adolescents Following Rhode Island’s School-Entry Requirement, 2010–2016
    (American Public Health Association, 2018-10-01) Thompson, Erika L.; Livingston, Melvin D.; Daley, Ellen M.; Zimet, Gregory D.; Pediatrics, School of Medicine
    Objectives. To assess changes in human papillomavirus (HPV) vaccine initiation for adolescent girls and boys in Rhode Island compared with all other states. Methods. We estimated the gender-specific effects of Rhode Island’s school-entry HPV vaccination policy on self-reported HPV vaccination initiation by using a difference-in-differences design with the National Immunization Survey–Teen from 2010 through 2016. Results. Compared with boys in other states, boys in Rhode Island increased their HPV vaccine initiation rate by 11% (b = 0.11; 95% confidence interval [CI] = 0.05, 0.18) after enactment of the requirement. No difference was seen in the probability of HPV vaccine initiation among girls in Rhode Island compared with girls in the multistate control (b = −0.01; 95% CI = −0.08, 0.05). Conclusions. Our analysis identified an 11% increase in HPV vaccine initiation rate among boys in Rhode Island after the school-entry requirement was enacted, whereas no significant change was observed for girls. Public Health Implications. Given suboptimal vaccine uptake rates in the United States, continued pursuit of state-level public policy to improve HPV vaccination is needed. School-entry requirements for HPV vaccination may be a strategy for closing the gap in HPV vaccine uptake for boys and girls.
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    Increasing awareness and uptake of the MenB vaccine on a large university campus
    (Taylor & Francis, 2021) Richardson, Eric; Ryan, Kathleen A.; Lawrence, Robert M.; Harle, Christopher A.; Desai, Shivani M.; Livingston, Melvin D.; Rawal, Amit; Staras, Stephanie A. S.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: At a large public university, we aimed to evaluate an intervention designed to increase serogroup B meningococcal (MenB) vaccine uptake and awareness. Methods: Using a pretest-posttest design with a double posttest, we evaluated an intervention conducted by a local foundation and the Florida Department of Health that distributed MenB vaccine on campus and conducted an educational campaign. Prior to intervention activities, we recruited students to complete a survey about their MenB knowledge and attitudes. For survey participants who provided contact information, we sent two follow-up surveys and assessed MenB vaccine records. We used chi-square tests, adjusted for nonindependence, to compare preintervention to postintervention (three-month and one-year) vaccination and attitudes. Results: Among the 686 students with accessible vaccine records, MenB vaccine initiation increased 9% (from 24% to 33%) and completion increased 8% (from 13% to 21%) from before the intervention to one year after the intervention. When restricting to students who completed the relevant follow-up surveys, the percentage of students who heard of the MenB vaccine increased by 15% (p > .001) from before the intervention to three months after (n = 188 students) and maintained a 10% increase (p > .001) one year after the intervention (n = 261 students). Among students that heard of the MenB vaccine, the percentage of students who thought they needed the MenB vaccine even though they received the MenACWY increased 14% (p = .03) by the three-month postintervention survey and up to 18% by the one-year follow-up (p = .002). Conclusions: A university-wide, on-campus vaccination and educational campaign increased college students’ MenB vaccine initiation, completion, and knowledge.
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    Perceptions and Knowledge About the MenB Vaccine Among Parents of High School Students
    (Springer, 2021) Richardson, Eric; Ryan, Kathleen A.; Lawrence, Robert M.; Harle, Christopher A.; Young, Alyson; Livingston, Melvin D.; Rawal, Amit; Staras, Stephanie A. S.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents and young adults. Yet, MenB vaccine coverage among adolescents remains below 10%. Since parents are the primary medical decision makers for adolescents, we examined MenB vaccination rates and parent attitudes about meningitis and the MenB vaccine. In 2018, in conjunction with a county-wide, school-based immunization campaign, we conducted a mixed methods study among parents of 16- to 17-year-olds. We facilitated focus groups asking parents about their knowledge of meningitis and reactions to educational materials and sent behavioral surveys based on Health Belief Model constructs to parents through the county high school system. Parents in three focus groups (n = 8; participation rate = 13%) expressed confusion about their child's need to receive the MenB vaccine in addition to the meningococcal conjugate vaccine (MenACWY), but conveyed strong trust in their physicians' recommendation. Among survey participants (n = 170), 70 (41%) had heard of the MenB vaccine. Among those 70 parents, the most common barriers to vaccination were concerns about side effects (55%) and uncertainty of susceptibility due to receipt of the MenACWY vaccine (30%). The percentage of teens that received at least one dose of the MenB vaccine was 50% (n = 35) by parent report and 23% (n = 16) by state vaccination records. Parents demonstrated uncertainty and confusion about the MenB vaccine particularly due to the existence of another meningitis vaccine and limited health care provider recommendations. Confirmatory studies of parent confusion about the MenB vaccine are needed to develop interventions.
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    Rhode Island Human Papillomavirus Vaccine School Entry Requirement Using Provider-Verified Report
    (Elsevier, 2020-08) Thompson, Erika L.; Livingston, Melvin D.; Daley, Ellen M.; Saslow, Debbie; Zimet, Gregory D.; Pediatrics, School of Medicine
    Introduction Human papillomavirus vaccine school entry requirements may be an opportunity to improve the low rates of human papillomavirus vaccination among adolescents. This study evaluates changes in provider-verified human papillomavirus vaccine uptake by age 13 years for adolescents in Rhode Island compared with all other states from 2011 to 2017. Methods The National Immunization Survey-Teen 2011–2017, a population-based cross-sectional survey, was analyzed in 2019. The survey included telephone interviews and provider-verified reports of vaccination among U.S. adolescents aged 13–17 years. The sample was subset to participants with provider-verified human papillomavirus vaccination reports (n=145,153). A difference-in-differences approach evaluated the Rhode Island human papillomavirus vaccination school entry requirement enacted in 2015. The main outcome was provider-verified human papillomavirus vaccine uptake by age 13 years. Results Compared with boys in other states, boys in Rhode Island had an increase of 14 percentage points in the probability of uptake of human papillomavirus vaccination by age 13 years (β=0.139, 95% CI=0.073, 0.205). No such differences were observed on comparing girls in Rhode Island with girls in other states (β=0.009, 95% CI= −0.068, 0.086). Conclusions The Rhode Island school entry requirement for human papillomavirus vaccination improved rates of vaccine uptake among boys and may be a useful option for improving human papillomavirus vaccination nationally.