Browsing by Author "Turner, Kea"

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    Impact of the COVID-19 pandemic on human papillomavirus (HPV) vaccination among a national sample of United States adults ages 18-45: A cross-sectional study
    (Elsevier, 2022-11-21) Turner, Kea; Brownstein, Naomi C.; Whiting, Junmin; Arevalo, Mariana; Vadaparampil, Susan; Giuliano, Anna R.; Islam, Jessica Y.; Meade, Cathy D.; Gwede, Clement K.; Kasting, Monica L.; Head, Katharine J.; Christy, Shannon M.; Communication Studies, School of Liberal Arts
    To assess how the COVID-19 pandemic affected catch-up HPV vaccination among age-eligible adults (ages 18-45). The current study leverages a national, cross-sectional sample of US adults ages 18-45 years to assess the prevalence and determinants of COVID-19 pandemic-related disruptions to catch-up HPV vaccination in 2021. The sample was restricted to adults intending to receive the HPV vaccine. Multinomial logistic regression analysis was conducted to assess the probability of 1) pandemic-related HPV vaccination disruption and 2) uncertainty about pandemic-related HPV vaccination disruption. Report of 'no pandemic-related HPV vaccination disruption' served as the reference category. Among adults intending to get the HPV vaccine (n = 1,683), 8.6 % reported pandemic-related HPV vaccination disruption, 14.7 % reported uncertainty about vaccination disruption, and 76.7 % reported no disruption. Factors associated with higher odds of pandemic-related vaccination disruption included non-English language preference (OR: 3.20; 95 % CI: 1.99-5.13), being a parent/guardian (OR: 1.77; 95 % CI: 1.18-2.66), having at least one healthcare visit in the past year (OR: 1.97; 95 % CI: 1.10-3.53), being up-to-date on the tetanus vaccine (OR: 1.81; 95 % CI: 1.19-2.75), and being a cancer survivor (OR: 2.57; 95 % CI: 1.52-4.34). Catch-up HPV vaccination for age-eligible adults is a critical public health strategy for reducing HPV-related cancers. While a small percentage of adults reported pandemic-related disruptions to HPV vaccination, certain adults (e.g., individuals with a non-English language preference and cancer survivors) were more likely to report a disruption. Interventions may be needed that increase accessibility of catch-up HPV vaccination among populations with reduced healthcare access during the pandemic.
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    Impact of the COVID-19 Pandemic on Women's Health Care Access: A Cross-Sectional Study
    (Mary Ann Liebert, 2022-12-13) Turner, Kea; Brownstein, Naomi C.; Whiting, Junmin; Arevalo, Mariana; Islam, Jessica Y.; Vadaparampil, Susan T.; Meade, Cathy D.; Gwede, Clement K.; Kasting, Monica L.; Head, Katharine J.; Christy, Shannon M.; Communication Studies, School of Liberal Arts
    Background: There has been limited study of how the COVID-19 pandemic has affected women's health care access. Our study aims to examine the prevalence and correlates of COVID-19-related disruptions to (1) primary care; (2) gynecologic care; and (3) preventive health care among women. Materials and Methods: We recruited 4,000 participants from a probability-based online panel. We conducted four multinomial logistic regression models, one for each of the study outcomes: (1) primary care access; (2) gynecologic care access; (3) patient-initiated disruptions to preventive visits; and (4) provider-initiated disruptions to preventive visits. Results: The sample included 1,285 women. One in four women (28.5%) reported that the pandemic affected their primary care access. Sexual minority women (SMW) (odds ratios [OR]: 1.67; 95% confidence intervals [CI]: 1.19–2.33) had higher odds of reporting pandemic-related effects on primary care access compared to women identifying as heterosexual. Cancer survivors (OR: 2.07; 95% CI: 1.25–3.42) had higher odds of reporting pandemic-related effects on primary care access compared to women without a cancer history. About 16% of women reported that the pandemic affected their gynecologic care access. Women with a cancer history (OR: 2.34; 95% CI: 1.35–4.08) had higher odds of reporting pandemic-related effects on gynecologic care compared to women without a cancer history. SMW were more likely to report patient- and provider-initiated delays in preventive health care. Other factors that affected health care access included income, insurance status, and having a usual source of care. Conclusions: The COVID-19 pandemic disrupted women's health care access and disproportionately affected access among SMW and women with a cancer history, suggesting that targeted interventions may be needed to ensure adequate health care access during the COVID-19 pandemic.
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    Primary care physicians’ electronic health record proficiency and efficiency behaviors and time interacting with electronic health records: a quantile regression analysis
    (Oxford University Press, 2022) Nguyen, Oliver T.; Turner, Kea; Apathy, Nate C.; Magoc, Tanja; Hanna, Karim; Merlo, Lisa J.; Harle, Christopher A.; Thompson, Lindsay A.; Berner, Eta S.; Feldman, Sue S.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR. Materials and methods: We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR. Results: Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting. Discussion: Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study. Conclusions: A nuanced association exists between physician EHR proficiency and time spent in the EHR.