Hussain R. Yusuf

Bio: Hussain R. Yusuf is an academic researcher from Centers for Disease Control and Prevention. The author has contributed to research in topics: Public health & Vaccination. The author has an hindex of 28, co-authored 59 publications receiving 3986 citations.

Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study.

Abstract: We identified the prevalence of adults who met the 1993 Centers for Disease Control and Prevention and the American College of Sports Medicine moderate physical activity recommendation and the 1996 Surgeon General's Report on Physical Activity and Health energy expenditure guideline for leading a moderately active lifestyle. Participants were 16,890 women and 12,272 men at least 18 years old who were asked in the 1990 National Health Interview Survey about their leisure-time physical activities. About one third of US adults met either recommendation for moderate activity; 32% met the Centers for Disease Control and Prevention and the American Association of Sports Medicine recommendation and 38% met the surgeon general's guideline. Women, ethnic minorities, adults with lower educational attainment, and older adults were least active. Public health efforts are needed to address the issues related to physical inactivity and to provide organized programs to increase moderate physical activity levels in US adults.

Comparison of E-mail, Fax, and Postal Surveys of Pediatricians

Abstract: Objectives. To compare 3 communication modes (postal, fax, and e-mail) in a rotavirus vaccine physician survey. Methods. We used 3 communication modes to distribute a survey to physicians listed in the membership directory of the Georgia Chapter of the American Academy of Pediatrics. The directory listed 1391 members; however, 404 were deemed ineligible on the basis of their listing as a specialist, retiree, resident in training, or government public health employee. Of the 987 members expected to administer vaccines, 150 were selected randomly to receive the postal survey (postal group). Of the remaining listings, 488 (58%) of 837 listed a fax number; 150 members were selected randomly and faxed a survey (fax group). Of the remaining members, 266 (39%) of 687 had e-mail addresses listed; 150 members were selected randomly for the e-mail survey (e-mail group). A follow-up survey was sent by the same mode at 2 weeks. A final survey was sent via another mode (mixed mode) at 1 month: by fax to e-mail and postal nonresponders and by post to fax nonresponders and those without fax. Results. Eligible respondents in the 3 survey groups were similar in their practice setting and location. Although the e-mail group had fewer median years (8 years) since medical school graduation than the fax group (19 years) and postal group (17 years), a similar percentage of responders in all groups had computers (>85%) and Internet access (≥70%) at work. However, only 39% of members listed an e-mail address in the directory. In the 2 weeks after the first mailing, 39 surveys were completed via postal mail, 50 via fax, and 16 via e-mail. In the 2 weeks after the second contact (sent at 2 weeks), 20 surveys were completed via postal mail, 15 via fax, and 17 via e-mail. The response rate after the first 2 mailings was 41% (59 of 143) for postal, 47% (65 of 137) for fax, and 26% (33 of 125) for e-mail surveys. The third and final survey (sent 1 month after the first mailing) was sent by a different (ie, mixed) mode and elicited an additional 73 responses: 19 responses (15 postal, 4 fax) from the postal group, 19 responses (18 postal, 1 fax) from the fax group, and 35 responses (15 postal, 13 fax, 7 e-mail) from the e-mail group. Twenty-three percent (9 of 40) of the e-mail and 18% (15 of 83) of the fax surveys completed were returned on the same or subsequent day they were sent, compared with none of the postal surveys. There were significant differences among the 3 groups for invalid addresses/numbers (4% postal, 8% fax, and 16% e-mail) listed in the directory. Using mixed modes as the third contact, the overall response rate increased from 39% before mixed mode to a final of 53%. On the basis of the 3 initial groups, responses to 1 of 12 rotavirus questions differed significantly. Conclusions. Future use of e-mail surveys in selected circumstances is promising, because the majority of providers have Internet access and acknowledged interest in participating in e-mail surveys. E-mail surveys could be especially useful if rapid response time is necessary. There were fewer incomplete questions by participants who completed the e-mail survey compared with postal or fax participants. Updating membership e-mail addresses and routinely using e-mail as a communication tool should improve the ability to use e-mail surveys. There may need to be ongoing evaluations that critically evaluate providers’ responses to e-mail surveys compared with other survey modes before e-mail surveys can become a standard survey tool. In the meantime, mixed-mode surveys may be an option.

Underimmunization Among Children: Effects of Vaccine Safety Concerns on Immunization Status

Abstract: Objective. To examine the attitudes, be- liefs, and behaviors of parents whose children were un- derimmunized with respect to >2 vaccines that have recently received negative attention, compared with par- ents whose children were fully immunized with respect to the recommended vaccines. Design. Case-control study. Setting. A sample of households that participated in the National Immunization Survey were recontacted in 2001. Main Outcome Measure. Vaccination status was as- sessed. Case subjects were underimmunized with respect to >2 of 3 vaccines (diphtheria-tetanus-pertussis or diph- theria-tetanus-acellular pertussis, hepatitis B, or measles- containing vaccines), and control subjects were fully im- munized. Results. The response rate was 52.1% (2315 of 4440 subjects). Compared with control households, case households were more likely to make $0 to $30 000 (ad- justed odds ratio (OR): 2.7; 95% confidence interval (CI): 1.5- 4.6) than at least $75 000, to have >2 providers (OR: 2.0; 95% CI: 1.3-3.1) than 1, and to have >4 children (OR: 3.1; 95% CI: 1.5- 6.3) than 1 child. With control for demo- graphic and medical care factors, case subjects were more likely than control subjects to not want a new infant to receive all shots (OR: 3.8; 95% CI: 1.5-9.8), to score vac- cines as unsafe or somewhat safe (OR: 2.0; 95% CI: 1.2- 3.4), and to ask the doctor or nurse not to give the child a vaccine for reasons other than illness (OR: 2.7; 95% CI: 1.2- 6.1). Among case subjects, 14.8% of underimmuniza- tion was attributable to parental attitudes, beliefs, and behaviors. Conclusions. Attitudes, beliefs, and behaviors indic- ative of vaccine safety concerns contribute substantially to underimmunization in the United States. Although concerns were significantly more common among par- ents of underimmunized children, many parents of fully immunized children demonstrated similar attitudes, be- liefs, and behaviors, suggesting a risk to the currently high vaccination levels. Efforts to maintain and improve immunization coverage need to target those with atti- tudes/beliefs/behaviors indicative of vaccine safety con- cerns, as well as those with socioeconomic and health care access problems. Pediatrics 2004;114:e16 -e22. URL:

Compendium of physical activities: an update of activity codes and MET intensities.

Abstract: We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.

Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial.

Abstract: Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes. The MIRACL study : A randomized controlled trial.