Browsing by Author "Sturm, Lynne"

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    The association between maternal human papillomavirus (HPV) experiences and HPV vaccination of their children
    (Taylor & Francis, 2021-04-03) Biederman, Erika; Donahue, Kelly; Sturm, Lynne; Champion, Victoria; Zimet, Gregory; School of Nursing
    HPV vaccination prevents most HPV-related cancers yet vaccination rates remain low. In this cross-sectional study, we examined the association between maternal HPV experiences and HPV vaccination uptake among children and whether this association may be explained by perceived benefits of vaccination. We used logistic regression models to estimate the effect of (1) maternal history of abnormal Pap smear, (2), family/friend history of cervical cancer, and (3) maternal history of cervical cancer on HPV vaccination uptake among children. Separate mediation analyses were conducted to determine if perceived benefits mediated the relationship between each maternal HPV experience and HPV vaccination uptake. History of abnormal Pap smear (OR = 1.50, 95% CI = 1.15, 1.97), family history of cervical cancer (OR = 1.72, CI = 1.26, 2.35), and personal history of cervical cancer (OR = 3.00, CI = 1.82, 4.95) predicted HPV vaccination of children. Perceived benefits mediated the relationship between history of abnormal Pap smear (indirect effect =.146, SE =.069, 95% CI =.014, .289), family history of cervical cancer (indirect effect =.228, SE =.079, CI =.080, .387), and personal history of cervical cancer (indirect effect =.298, SE =.116, CI =.082, .533) on HPV vaccination. Our results suggest that personal experiences with HPV-related disease may influence maternal HPV vaccine decision-making.
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    Influenza vaccination in the time of COVID-19: A national U.S. survey of adults
    (Elsevier, 2021) Sturm, Lynne; Kasting, Monica L.; Head, Katharine J.; Hartsong, Jane A.; Zimet, Gregory D.; Pediatrics, School of Medicine
    Introduction Decisions about influenza vaccination for fall-winter 2020 were made against the backdrop of the COVID-19 pandemic. During May 2020, the authors examined intended vaccination in the next 12 months in relationship to demographic variables, healthcare attitudes, and personal COVID-19 experiences for two samples of adults--those who did not receive influenza vaccine during the prior 12 months, and those who did. Methods In May 2020, a cross-sectional online survey was conducted with a national US sample. Participants reported prior influenza vaccination (yes/no during prior 12 months) and anticipated vaccination (yes/no during next 12 months). Covariates included demographic characteristics (e.g., gender, race-ethnicity, political ideology), general beliefs (e.g., benefits of vaccines, altruistic attitudes), and COVID-19 health beliefs and experiences (COVID-19 worry and severity, perception of COVID-19 as a community threat, knowing someone with COVID-19). For each group, hierarchical multivariable logistic regression was conducted with intent to vaccinate as the outcome. Results Among participants (n = 3502), 47% did not receive influenza vaccine in the prior 12 months and 53% had; 25.5% of non-vaccinators and 91.9% of vaccinators intended future vaccination. For non-vaccinators, odds of intending vaccination was associated with race/ethnicity (Hispanics were more likely to intend than white-NH; AOR = 1.74; 95% CI = 1.23–2.4), greater perceived benefits of vaccination (AOR = 2.19; 95% CI = 1.88–2.54), and perception of COVID-19 as a community threat (AOR = 1.91; 95% CI = 1.49–2.45). For vaccinators, odds of intending vaccination was associated with age (AOR = 1.04; 95% CI = 1.03–1.05), race/ethnicity (Black-NH and Other-NH were less likely to intend than white-NH, AOR = 0.60; 95% CI = 0.36–0.999; and AOR = 0.45; 95% CI = 0.24–0.84, respectively), greater perceived benefits of vaccination (AOR = 1.88; 95% CI = 1.45–2.45) and greater perception of collective benefits of vaccines (AOR = 1.48; 95% CI = 1.15–1.90). Conclusions The COVID-19 pandemic may have served as a cue to action for influenza vaccination intention among some prior non-vaccinators whereas intention among prior vaccinators is more related to positive attitudes toward vaccination.
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    Pediatrician-Parent Conversations about Human Papillomavirus Vaccination: An Analysis of Audio-Recordings
    (Elsevier, 2017-08) Sturm, Lynne; Donahue, Kelly; Kasting, Monica; Kulkarni, Amit; Brewer, Noel T.; Zimet, Gregory D.; Pediatrics, School of Medicine
    Purpose We sought to establish which human papillomavirus (HPV) vaccine communication approaches by pediatricians were associated with same-day HPV vaccination of 11- to 12-year-olds by evaluating audio recordings of visits. Methods Verilogue, a market research company maintaining a panel of primary care pediatricians, provided audio recordings and transcriptions of well-child visits for 11- to 12-year-old patients from January through June 2013. Seventy-five transcripts from 19 pediatricians were coded for use of presumptive language (i.e., words conveying assumption of vaccine delivery), offer of delay, recommendation strength, and information provision. Using logistic regression, we evaluated the association between pediatrician communication approaches and agreement to same-day HPV vaccination. Generalized estimating equations accounted for clustering of patients within pediatricians. Results Same-day agreement to HPV vaccination occurred in 29% of encounters. Pediatricians in the sample often provided parents with inconsistent, mixed messages and sometimes offered information about HPV or HPV vaccination that was inaccurate. Pediatricians used presumptive language in only 11 of 75 encounters; when used, presumptive language was associated with higher odds of accepting HPV vaccine (73% vs. 22%; odds ratio = 8.96; 95% confidence interval = 2.32–34.70). Pediatricians offered or recommended delay in most encounters (65%). HPV vaccine acceptance occurred far more often when pediatricians did not mention delaying vaccination (82% vs. 6%; odds ratio = 80.84; 95% confidence interval = 15.72–415.67). Same-day vaccination was not associated with strength of recommendation or pediatrician reference to vaccinating their own children. Conclusions Our findings highlight the need to develop and evaluate physician-focused trainings on using presumptive language for same-day HPV vaccination.
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    Perceptions of the ethical permissibility of strict travel restrictions to mitigate transmission of SARS-CoV-2
    (Elsevier, 2022) Hartsock, Jane A.; Head, Katharine J.; Kasting, Monica L.; Sturm, Lynne; Zimet, Gregory; Communication Studies, School of Liberal Arts
    Although there has been extensive exploration of public opinion surrounding many non-pharmaceutical interventions (NPIs) aimed at mitigating transmission of SARS-CoV-2 (e.g. mask-wearing and social distancing), there has been less discussion of the public's perception of the ethical appropriateness other NPIs. This paper presents the results of a survey of U.S. adults' opinions of the ethical permissibility of both state-to-state and international travel restrictions to mitigate transmission of SARS-CoV-2. Our research revealed overall high agreement with the ethical permissibility of both state-to-state and international travel restrictions, though we saw significant difference across political party affiliation and conservative/liberal ideologies. Other factors associated with agreement with state-to-state travel restrictions included increasing education, increasing income, and both high and low commitment altruism. When considering international travel restrictions, income, education, and low commitment altruism were associated with increased agreement with the ethical permissibility of international travel restrictions. Ethical analysis and implications are explored.
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    Provider Communication and Mothers’ Willingness to Vaccinate Against HPV and Influenza: A Randomized Health Messaging Trial
    (Elsevier, 2017) Donahue, Kelly; Hendrix, Kristin; Sturm, Lynne; Zimet, Gregory; Department of Pediatrics, School of Medicine
    Objective Understand the effect of a health messaging intervention focused on provider communication about vaccination on mothers’ willingness to vaccinate children against HPV and seasonal influenza. Methods 2,476 mothers of 9-13-year-olds in the U.S. completed a Web-based survey in August 2014. Mothers were randomized to one of two groups targeting HPV or influenza vaccine. Mothers whose child had not received the target vaccine (i.e., zero doses of HPV vaccine/no prior-year administration of influenza vaccine) were randomized to the intervention. The study used a 3x2 between-subjects design; illustrated vignettes depicted one of three levels of provider recommendation strength (brief mention of vaccination, strong recommendation of vaccination, or personal disclosure of vaccination of own children), and presence or absence of information comparing safety of vaccination to the safety of a common daily activity. Outcome was mothers’ willingness to have their child receive the target vaccine (0-100.) Perceived benefits of vaccination were assessed prior to viewing the intervention and included as a covariate in analyses, along with child gender. Results For HPV vaccine, there was a main effect of safety information, F(1,684)=7.99, p=.005, and perceived benefits of vaccination, F(1,684)=221.64, p<.001) on mothers’ willingness to vaccinate. For influenza, perceived benefits of vaccination significantly related to willingness, F(1,462)=105.78, p<.001). Child gender was not associated with willingness. Conclusions Provider communication about vaccination may need to be tailored to the vaccine in question. A next step to increasing coverage for both HPV and influenza vaccines may be an intervention aimed at increasing mothers’ perceived benefits of vaccination.
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    Public perceptions of the effectiveness of recommended non-pharmaceutical intervention behaviors to mitigate the spread of SARS-CoV-2
    (PloS, 2020) Kasting, Monica L.; Head, Katharine J.; Hartsock, Jane A.; Sturm, Lynne; Zimet, Gregory D.; Pediatrics, School of Medicine
    Background The COVID-19 pandemic is an unprecedented public health threat, both in scope and response. With no vaccine available, the public is advised to practice non-pharmaceutical interventions (NPI) including social distancing, mask-wearing, and washing hands. However, little is known about public perceptions of the effectiveness of these measures, and high perceived effectiveness is likely to be critical in order to achieve widespread adoption of NPI. Methods In May 2020, we conducted a cross-sectional survey among U.S. adults (N = 3,474). The primary outcome was a six-item measure assessing perceived effectiveness of recommended behaviors to prevent SARS-CoV-2 infection from 1 (not at all effective) to 5 (extremely effective). The sample was divided into “higher” and “lower” perceived effectiveness groups. Covariates included demographics, healthcare characteristics, and health beliefs. Variables that were significant at p<0.01 in bivariate analyses were entered into a multivariable logistic regression and a best-fit model was created using a cutoff of p<0.01 to stay in the model. Results Mean age was 45.5 years and most participants were non-Hispanic White (63%) and female (52.4%). The high perceived effectiveness group was slightly larger than the low perceived effectiveness group (52.7% vs. 47.3%). Almost all health belief variables were significant in the best-fit regression model. COVID-19-related worry (aOR = 1.82; 95% CI = 1.64–2.02), and perceived threat to physical health (aOR = 1.32; 95% CI = 1.20–1.45) were positively associated with perceived effectiveness while perceived severity of COVID-19 (0.84; 95% CI = 0.73–0.96) and perceived likelihood of infection (0.85; 95% CI = 0.77–0.94) switched directions in the adjusted model and were negatively associated with perceived effectiveness. Conclusions This research indicates people generally believe NPI are effective, but there was variability based on health beliefs and there are mixed rates of engagement in these behaviors. Public health efforts should focus on increasing perceived severity and threat of SARS-CoV-2-related disease, while promoting NPI as effective in reducing threat.
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    Public perceptions of the effectiveness of recommended non-pharmaceutical intervention behaviors to mitigate the spread of SARS-CoV-2
    (Public Library of Science (PLOS), 2020-11-04) Kasting, Monica L.; Head, Katharine J.; Hartsock, Jane A.; Sturm, Lynne; Zimet, Gregory D.; Medicine, School of Medicine
    Background: The COVID-19 pandemic is an unprecedented public health threat, both in scope and response. With no vaccine available, the public is advised to practice non-pharmaceutical interventions (NPI) including social distancing, mask-wearing, and washing hands. However, little is known about public perceptions of the effectiveness of these measures, and high perceived effectiveness is likely to be critical in order to achieve widespread adoption of NPI. Methods: In May 2020, we conducted a cross-sectional survey among U.S. adults (N = 3,474). The primary outcome was a six-item measure assessing perceived effectiveness of recommended behaviors to prevent SARS-CoV-2 infection from 1 (not at all effective) to 5 (extremely effective). The sample was divided into "higher" and "lower" perceived effectiveness groups. Covariates included demographics, healthcare characteristics, and health beliefs. Variables that were significant at p<0.01 in bivariate analyses were entered into a multivariable logistic regression and a best-fit model was created using a cutoff of p<0.01 to stay in the model. Results: Mean age was 45.5 years and most participants were non-Hispanic White (63%) and female (52.4%). The high perceived effectiveness group was slightly larger than the low perceived effectiveness group (52.7% vs. 47.3%). Almost all health belief variables were significant in the best-fit regression model. COVID-19-related worry (aOR = 1.82; 95% CI = 1.64-2.02), and perceived threat to physical health (aOR = 1.32; 95% CI = 1.20-1.45) were positively associated with perceived effectiveness while perceived severity of COVID-19 (0.84; 95% CI = 0.73-0.96) and perceived likelihood of infection (0.85; 95% CI = 0.77-0.94) switched directions in the adjusted model and were negatively associated with perceived effectiveness. Conclusions: This research indicates people generally believe NPI are effective, but there was variability based on health beliefs and there are mixed rates of engagement in these behaviors. Public health efforts should focus on increasing perceived severity and threat of SARS-CoV-2-related disease, while promoting NPI as effective in reducing threat.
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    Reflection in Home Visiting: The What, Why, and a Beginning Step Toward How
    (Wiley, 2016-11) Tomlin, Angela M.; Hines, Elesia; Sturm, Lynne; Department of Pediatrics, School of Medicine
    The work of home visitors in early childhood fields may include addressing many challenges to achieving curricular outcomes, including issues such as maintaining boundaries and managing one’s own reactions to children, parents, and overall family situations. Increasingly, reflective supervision and consultation are recognized as a way for workers in home visiting early intervention and early care fields to address these personal and professional challenges and build competence (Watson, Gatti, Cox, Harrison, & Hennes, 2014). The features of home visiting that make reflective supervision/consultation essential are discussed. Next, results of a pilot project in which a sample of Part C early intervention providers respond to a vignette portraying a challenging parent-child interaction are briefly presented and discussed. Despite often stating the importance of relationships, participants did not identify concrete methods of supporting relationship or demonstrate recognition of parallel process. In addition, providers seldom endorsed the use of reflective skills, such as observing, listening, wondering, or reflecting (Weatherston, 2013) and no providers discussed a need for reflective supervision/consultation. We suggest that these findings illustrate some of the areas in which early intervention home visitors could benefit from participation in reflective supervision/consultation to move from identifying reflective skills as important to actually being able to use such skills in their work with families.
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    Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings
    (Oxford, 2016-11) Hoffses, Kathryn W.; Ramirez, Lisa Y.; Berdan, Louise; Honaker, Sarah Morsbach; Meadows, Tawnya J.; Shaffer, Laura; Tunick, Rachel; Robins, Paul M.; Stancin, Terry; Sturm, Lynne; Pediatrics, School of Medicine
    Objectives In the midst of large-scale changes across our nation’s health care system, including the Affordable Care Act and Patient-Centered Medical Home initiatives, integrated primary care models afford important opportunities for those in the field of pediatric psychology. Despite the extensive and growing attention, this subspecialty has received in recent years, a comprehensive set of core professional competencies has not been established. Methods A subset of an Integrated Primary Care Special Interest Group used two well-established sets of core competencies in integrated primary care and pediatric psychology as a basis to develop a set of integrated pediatric primary care-specific behavioral anchors. Conclusions The current manuscript describes these behavioral anchors and their development in the context of professional training as well as with regard to Triple Aim goals and securing psychology’s role in integrated pediatric primary care settings.