Melissa B. Gilkey

Bio: Melissa B. Gilkey is an academic researcher from University of North Carolina at Chapel Hill. The author has contributed to research in topics: Vaccination & Medicine. The author has an hindex of 30, co-authored 90 publications receiving 2951 citations. Previous affiliations of Melissa B. Gilkey include Johns Hopkins University & Georgetown University Medical Center.

Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial.

Abstract: OBJECTIVE: Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. Thus, we sought to determine the effectiveness of training providers to improve their recommendations using either presumptive “announcements” or participatory “conversations.” METHODS: In 2015, we conducted a parallel-group randomized clinical trial with 30 pediatric and family medicine clinics in central North Carolina. We randomized clinics to receive no training (control), announcement training, or conversation training. Announcements are brief statements that assume parents are ready to vaccinate, whereas conversations engage parents in open-ended discussions. A physician led the 1-hour, in-clinic training. The North Carolina Immunization Registry provided data on the primary trial outcome: 6-month coverage change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years. RESULTS: The immunization registry attributed 17 173 adolescents aged 11 or 12 to the 29 clinics still open at 6-months posttraining. Six-month increases in HPV vaccination coverage were larger for patients in clinics that received announcement training versus those in control clinics (5.4% difference, 95% confidence interval: 1.1%–9.7%). Stratified analyses showed increases for both girls (4.6% difference) and boys (6.2% difference). Patients in clinics receiving conversation training did not differ from those in control clinics with respect to changes in HPV vaccination coverage. Neither training was effective for changing coverage for other vaccination outcomes or for adolescents aged 13 through 17 ( n = 37 796). CONCLUSIONS: Training providers to use announcements resulted in a clinically meaningful increase in HPV vaccine initiation among young adolescents.

Provider communication about HPV vaccination: A systematic review.

Abstract: Background. Improving HPV vaccination coverage in the US will require healthcare providers to recommend the vaccine more effectively. To inform quality improvement efforts, we systematically reviewed studies of provider communication about HPV vaccination. Methods. We searched MEDLINE, CINAHL, EMBASE, and POPLINE in August 2015 to identify studies of provider communication about HPV vaccination. Results. We identified 101 qualitative and quantitative studies. Providers less often recommended HPV vaccine if they were uncomfortable discussing sex, perceived parents as hesitant, or believed patients to be low risk. Patients less often received recommendations if they were younger, male, or from racial/ethnic minorities. Despite parents' preference for unambiguous recommendations, providers often sent mixed messages by failing to endorse HPV vaccine strongly, differentiating it from other vaccines, and presenting it as an “optional” vaccine that could be delayed. Conclusion. Interventions are needed t...

Quality of physician communication about human papillomavirus vaccine: findings from a national survey.

Abstract: Background: Improving the quality of physicians' recommendations for human papillomavirus (HPV) vaccination is critical to addressing low coverage. Thus, we sought to describe HPV vaccine communication practices among primary care physicians. Methods: Pediatricians and family physicians ( n = 776) completed our national online survey in 2014. We assessed the quality of their HPV vaccine recommendations on strength of endorsement (i.e., saying the vaccine is important), timeliness (recommending it by ages 11–12), consistency (recommending it routinely vs. using a risk-based approach), and urgency (recommending same-day vaccination). Results: A sizeable minority of physicians reported that they do not strongly endorse HPV vaccine (27%) or deliver timely recommendations for girls (26%) or boys (39%). Many physicians (59%) used a risk-based approach to recommending HPV vaccine, and only half (51%) usually recommended same-day vaccination. Overall recommendation quality was lower among physicians who were uncomfortable talking about HPV vaccine or who believed parents did not value it. Quality was higher among physicians who began discussions by saying the child was due for HPV vaccine versus giving information or eliciting questions. Conclusion: Many physicians in our national sample reported recommending HPV vaccine inconsistently, behind schedule, or without urgency. These practices likely contribute to under-immunization among adolescents, and may convey ambivalence to parents. Impact: As one of the first studies to assess multiple aspects of recommendation quality, these findings can inform the many state and national initiatives that aim to improve communication about HPV vaccine so as to address the persistent underuse of a powerful tool for cancer prevention. Cancer Epidemiol Biomarkers Prev; 24(11); 1673–9. ©2015 AACR . See related commentary by Zimet, [p. 1643][1] . This article is featured in Highlights of This Issue, [p. 1641][2] [1]: /lookup/volpage/24/1643?iss=11 [2]: /lookup/volpage/24/1641?iss=11

Anticipated regret and health behavior: A meta-analysis.

Abstract: OBJECTIVE Risk beliefs are central to most theories of health behavior, yet many unanswered questions remain about an increasingly studied risk construct, anticipated regret. The authors sought to better understand anticipated regret's role in motivating health behaviors. METHOD The authors systematically searched electronic databases for studies of anticipated regret and behavioral intentions or health behavior. They used random effects meta-analysis to synthesize effect sizes from 81 studies (n = 45,618). RESULTS Anticipated regret was associated with both intentions (r+ = .50, p < .001) and health behavior (r+ = .29, p < .001). Greater anticipated regret from engaging in a behavior (i.e., action regret) predicted weaker intentions and behavior, whereas greater anticipated regret from not engaging in a behavior (i.e., inaction regret) predicted stronger intentions and behavior. Anticipated action regret had smaller associations with behavioral intentions related to less severe and more distal hazards, but these moderation findings were not present for inaction regret. Anticipated regret generally was a stronger predictor of intentions and behavior than other anticipated negative emotions and risk appraisals. CONCLUSIONS Anticipated inaction regret has a stronger and more stable association with health behavior than previously thought. The field should give greater attention to understanding how anticipated regret differs from similar constructs, its role in health behavior theory, and its potential use in health behavior interventions. (PsycINFO Database Record

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Abstract: www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Internet, phone, mail and mixed-mode surveys: the tailored design method: reseña

Abstract: Resena de la obra de Don A. Dillman, Jolene D. Smyth y Leah Melani Christian: Internet, Phone, Mail and Mixed-Mode Surveys. The Tailored Design Method. New Jersey: John Wiley and Sons

Health Behavior And Health Education Theory Research And Practice

Abstract: Thank you very much for downloading health behavior and health education theory research and practice. Maybe you have knowledge that, people have search numerous times for their favorite readings like this health behavior and health education theory research and practice, but end up in harmful downloads. Rather than enjoying a good book with a cup of tea in the afternoon, instead they cope with some harmful virus inside their desktop computer.

Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation

Abstract: Introduction E-cigarettes are largely unregulated and internet sales are substantial. This study examines how the online market for e-cigarettes has changed over time: in product design and in marketing messages appearing on websites. Methods Comprehensive internet searches of Englishlanguage websites from May–August 2012 and December 2013–January 2014 identified brands, models, flavours, nicotine strengths, ingredients and product claims. Brands were divided into older and newer groups (by the two searches) for comparison. Results By January 2014 there were 466 brands (each with its own website) and 7764 unique flavours. In the 17 months between the searches, there was a net increase of 10.5 brands and 242 new flavours per month. Older brands were more likely than newer brands to offer cigalikes (86.9% vs 52.1%, p<0.01), and newer brands more likely to offer the more versatile eGos and mods (75.3% vs 57.8%, p<0.01). Older brands were significantly more likely to claim that they were healthier and cheaper than cigarettes, were good substitutes where smoking was banned and were effective smoking cessation aids. Newer brands offered more flavours per brand (49 vs 32, p<0.01) and were less likely to compare themselves with conventional cigarettes. Conclusions The number of e-cigarette brands is large and has been increasing. Older brands tend to highlight their advantages over conventional cigarettes while newer brands emphasise consumer choice in multiple flavours and product versatility. These results can serve as a benchmark for future research on the impact of upcoming regulations on product design and advertising messages of e-cigarettes.