Browsing by Author "Sutton, Steven K."

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    Florida physicians' reported use of AFIX-based strategies for human papillomavirus vaccination
    (Elsevier, 2018-11) Kasting, Monica L.; Christy, Shannon M.; Sutton, Steven K.; Lake, Paige; Malo, Teri L.; Roetzheim, Richard G.; Schechtman, Tommy; Zimet, Gregory D.; Walkosz, Barbara J.; Salmon, Daniel; Kahn, Jessica A.; Giuliano, Anna R.; Vadaparampil, Susan T.; Pediatrics, School of Medicine
    HPV vaccination rates in Florida are low. To increase rates, the CDC recommends clinics adhere to components of their evidence-based quality improvement program, AFIX (Assessment, Feedback, Incentives, and eXchange of information). We explored factors associated with engaging in HPV-specific AFIX-related activities. In 2016, we conducted a cross-sectional survey of a representative sample of 770 pediatric and family medicine physicians in Florida and assessed vaccination practices, clinic characteristics, and HPV-related knowledge. Data were analyzed in 2017. The primary outcome was whether physicians' clinics engaged in ≥1 AFIX activity. We stratified by physician specialty and developed multivariable models using a backward selection approach. Of the participants in the analytic sample (n = 340), 52% were male, 60% were White of any ethnicity, and 55% were non-Hispanic. Pediatricians and family medicine physicians differed on: years practicing medicine (p < 0.001), HPV-related knowledge (p < 0.001), and VFC provider status (p < 0.001), among others. Only 39% of physicians reported engaging in ≥1 AFIX activity. In the stratified multivariable model for pediatricians, AFIX activity was significantly associated with HPV-related knowledge (aOR = 1.33;95%CI = 1.08–1.63) and provider use of vaccine reminder prompts (aOR = 3.61;95%CI = 1.02–12.77). For family medicine physicians, HPV-related knowledge was significant (aOR = 1.57;95%CI = 1.20–2.05) as was majority race of patient population (non-Hispanic White vs. Other: aOR = 3.02;95%CI = 1.08–8.43), daily patient load (<20 vs. 20–24: aOR = 9.05;95%CI = 2.72–30.10), and vaccine administration to male patients (aOR = 2.98;95%CI = 1.11–8.02). Fewer than half of Florida pediatric and family medicine physicians engaged in any AFIX activities. Future interventions to increase AFIX engagement should focus on implementing and evaluating AFIX activities in groups identified as having low engagement in AFIX activities.
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    Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs
    (Taylor & Francis, 2017-11) Christy, Shannon M.; Gwede, Clement K.; Sutton, Steven K.; Chavarria, Enmanuel; Davis, Stacy N.; Abdulla, Rania; Ravindra, Chitra; Schultz, Ida; Roetzheim, Richard; Meade, Cathy D.; Psychology, School of Science
    The current study examined the sociodemographic and psychosocial variables that predicted being at risk for low health literacy among a population of racially and ethnically diverse patients accessing primary care services at community-based clinics. Participants (N = 416) were aged 50-75 years, currently not up-to-date with colorectal cancer (CRC) screening, at average CRC risk, and enrolled in a randomized controlled trial (RCT) aimed at promoting CRC screening. Participants completed a baseline interview that assessed health literacy as measured by Rapid Estimate of Adult Literacy in Medicine-Revised, sociodemographic factors, and psychosocial variables (e.g., health beliefs) prior to randomization and receipt of an intervention. Thirty-six percent of the participants were found to be at risk for low health literacy. Sociodemographic and psychosocial variables were assessed as predictors of being at risk for low health literacy using logistic regression. In the final model, predictors were male gender, being from a racial/ethnic minority group, being unable to work, having higher social influence scores, and having higher religious belief scores. These findings suggest several patient characteristics that may be associated with low health literacy, and highlight the importance of supporting all patients through simplified and clear communications and information to improve understanding of CRC screening information.
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    Missing the Target for Routine Human Papillomavirus Vaccination: Consistent and Strong Physician Recommendations Are Lacking for 11- to 12-Year-Old Males
    (American Association for Cancer Research, 2016-10) Vadaparampil, Susan T.; Malo, Teri L.; Sutton, Steven K.; Ali, Karla N.; Kahn, Jessica A.; Casler, Alix; Salmon, Daniel; Walkosz, Barbara; Roetzheim, Richard G.; Zimet, Gregory D.; Giuliano, Anna R.; Pediatrics, School of Medicine
    BACKGROUND: Rates of routine human papillomavirus (HPV) vaccination of adolescent males in the United States are low. Leading health organizations advocate consistent and strong physician recommendations to improve HPV vaccine dissemination. This study describes the prevalence and correlates of consistent and strong physician recommendations for HPV vaccination of adolescent males. METHODS: We surveyed pediatric and family medicine physicians in Florida about their HPV vaccine recommendations for male vaccine-eligible age groups (11-12, 13-17, 18-21 years). Descriptive statistics compared consistency and strength of HPV recommendations across age groups. Multivariable logistic regression examined factors associated with consistent and strong recommendations for 11- to 12-year-olds. RESULTS: We received 367 completed surveys (51% response rate). Physicians most often consistently and strongly recommended HPV vaccine to males ages 13 to 17 (39%) compared with ages 11 to 12 (31%) and 18 to 21 (31%). Consistent and strong recommendation for 11- to 12-year-old males was more likely to be delivered by Vaccine for Children providers and less likely among physicians who reported more personal barriers to vaccination, particularly concerns about vaccine safety, concerns about adding vaccines to the vaccine schedule, and difficulty in remembering to discuss HPV vaccination. CONCLUSIONS: Physicians' current consistency and strength of HPV vaccine recommendations do not align with national recommendations. Interventions to improve HPV vaccine recommendations must also consider the influence of physicians' personal barriers to HPV vaccine delivery. IMPACT: As one of the first studies to examine both consistency and strength of physicians' HPV vaccine recommendations for males, our findings can inform future interventions focused on facilitating physicians' recommendations. Cancer Epidemiol Biomarkers Prev; 25(10); 1435-46. ©2016 AACR.