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Eat better live longer : understand what your body needs to stay healthy
\"Ever wondered what's going on in your body as you age? Can you really eat to beat cancer or prevent heart disease? These questions and more are answered in this food-led approach to future-proofing your life.\"-- Publisher's description.
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Emergency care utilization by refugee children compared to controls: A statewide database analysis
Refugees face barriers to accessing healthcare despite provision of short-term services after arrival. Limited access to sustained primary care may lead to increased emergency department (ED) utilization and little is known regarding how refugee children access emergency care.
To compare the proportion of ED claims and median level of service (LOS) between refugee children and general population controls in a statewide claims database.
We conducted a retrospective cohort study of medical claims for patients aged 0 to 18 years old in a statewide claims database from 2014-2019. Refugee claims were identified using deterministic linkage of children with known refugee status. Procedure and diagnosis ICD9/10, Healthcare Common Procedure Coding System, and Current Procedural Terminology codes were obtained from the statewide database to indicate type of claim (ED vs outpatient) and LOS. Demographics were extracted from a data warehouse. Primary outcome was the number of ED claims per 1000 combined ED and outpatient claims. LOS was measured as a proxy for ED visit complexity. We compared demographics, frequency of claims, and median LOS using chi-square.
There were 5,590,808 total claims with 1,235,476 ED claims. Median number of ED claims per individual patient was the same between groups, however the proportion of claims related to an ED visit was significantly higher in the refugee population than the general population controls (244 vs 221, p = 0.001). Median LOS for ED claims was Level 3 (99283) and there was no difference between groups.
Proportion of ED claims was higher in a refugee population compared to controls with no differences in LOS, indicating higher ED utilization among refugees for all acuity levels. Further study is needed to determine if healthcare disparities account for this difference and if population specific services may support the care of the refugee children.
Journal Article
Patterns of Primary Care Use Among Young Adult Refugees Resettled in Colorado
Little is known about the prevalence of young adult refugees’ primary care use following resettlement in Colorado. Among a sample of Bhutanese and Burmese young adult refugees resettled in Colorado, proportions with a primary care provider (PCP), physical exam in the last 12 months, and knowledge to make an appointment were calculated across 4 years and compared within the refugee population by demographics using Pearson’s Chi-Squared tests and compared to older refugees and to the general population using two-tailed tests of proportions. Greater than 70% of young adult refugees reported a physical exam in the last 12 months during the 4 years after arrival. Disparities were identified within young adult refugees by sex, marital status and country of origin. Young adult refugees were significantly different than both refugees over 55 and the general population in terms of their primary care use. Young adult refugees need support to identify PCPs earlier in resettlement and maintain primary care use years after resettlement.
Journal Article
Correction: Factors in COVID-19 vaccine uptake in five racial/ethnic Colorado communities: A report from the Colorado CEAL project
[This corrects the article DOI: 10.1371/journal.pone.0305160.].
Journal Article
Factors in COVID-19 vaccine uptake in five racial/ethnic Colorado communities: A report from the Colorado CEAL project
To understand motivators, concerns, and factors associated with COVID-19 vaccine initiation for adults in five racial/ethnic communities across Colorado.
Community-based data collectors surveyed participants from five Colorado communities (urban and rural Latina/o/x, urban Black, rural African American immigrant, and urban American Indian) about vaccine attitudes, intentions, and uptake from September to December 2021. Bivariate and multivariable logistic regression models were used to examine factors associated with the primary outcome of COVID-19 vaccine \"initiation.\"
Most participants (71.1%) reported having initiated COVID-19 vaccination; vaccine series completion was 65.1%. Both motivators and concerns about COVID-19 vaccines were prevalent. Vaccine hesitancy (OR: 0.41, 95% CI:0.32-0.53; p < .001) and low perceptions of COVID-19 vaccination social norms (OR: 0.48, 95% CI:0.27-0.84; p = .01) were associated with vaccine initiation.
Despite the limitation of a moderate sample size, our findings support the need for further interventions to increase vaccination against COVID-19 by reducing vaccine hesitancy and improving perceived social norms of vaccination in underserved Colorado communities.
To improve trust in vaccines and promote vaccine uptake, community messaging should be tailored to vaccination motivators and concerns and demonstrate COVID-19 vaccination as the community default.
Journal Article
Engaging Communities in Preventing Human Papillomavirus-Related Cancers: Two Boot Camp Translations, Colorado, 2017–2018
Since 2006, a vaccine to prevent human papillomavirus (HPV) infection has been available; however, uptake is suboptimal. To encourage HPV vaccine uptake, we employed Boot Camp Translation (BCT) to develop locally relevant materials in 2 Colorado communities, Mesa County and the Denver metropolitan area (Denver metro). The Mesa County group focused on 2 populations, parents of vaccine-eligible children and young adults. The group identified posters, social media, and educational materials for pediatric primary care settings as venues to deliver their messages. The Denver metro group focused on parents of children with low health literacy. Four messages explain the vaccine and call the selected audience to action. Delivery tactics for that group are social media venues and print education materials, including refrigerator magnets, to remind parents about follow-up dosing. BCT can be adapted to develop locally relevant messages and intervention strategies to address HPV vaccination. Future studies should evaluate the effectiveness of community-derived messages to increase HPV vaccination rates.
Journal Article
Evaluation of possible human papillomavirus (HPV) type replacement after vaccine introduction, overall and by race/ethnicity, United States
Investigations of type replacement after human papillomavirus (HPV) vaccine introduction have found increases in some non-vaccine types, but findings have been inconsistent. National Health and Nutrition Examination Survey data were used to explore potential type replacement through 12 years after introduction of the U.S. HPV vaccination program. We determined weighted prevalences of 14 individual high-risk (HR) types (HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68), HPV16/18, and other type categories and compared prevalences among 14–29-year-old females in 2015–2018 compared with the prevaccine era (2003–2006), overall and among non-Hispanic Black (NHB) and non-Hispanic White (NHW) females. Overall, HPV16/18 prevalence decreased; no non-vaccine-HR types increased. There were similar decreases in HPV16/18 prevalence among NHB and NHW females. Type replacement was not seen overall, although there were increases of specific types in two racial/ethnic groups; HPV68 increased among NHB but not NHW females; HPV35 increased among NHW but not NHB females, although the 2003–2006 prevalence estimate for HPV35 was unstable.
Journal Article