Transcript Carissa Lumby - web.biosci.utexas.edu

BIG SHOTS: IDENTIFYING
COMMUNITY GATEKEEPERS
FOR ADULT VACCINATION
OUTREACH EFFORTS
By: Carissa Lumby
Mentors: Isabel Hargrove and Kurt Becker
INTRODUCTION
WHAT IS A VACCINE?



Derived from disease-causing
microorganisms
Provide prophylactic protection
to specific diseases
The body’s immune response is
stimulated and the body can
later identify and destroy the
infectious agent to prevent
disease
POSITIVE IMPACT OF VACCINES
Reduced incidence of vaccine-preventable diseases
 Eradication of disease is possible, as in the case of
smallpox
 High individual vaccination coverage provides
community/herd immunity to protect individuals
who:
 Are too young to be vaccinated
 Cannot be vaccinated

CHILDHOOD AND ADULT
VACCINATIONS
Childhood




Mandatory
Enforced by schools
and daycare
Adult


Higher national
immunization rates

Greater federal
funding

Voluntary
No large scale
immunization
enforcement
Lower national
immunization rates
Lesser federal funding
AUSTIN/TRAVIS COUNTY HHSD
IMMUNIZATION PROGRAM
TOTAL VACCINE DOSES
ADMINISTERED IN SHOTS FOR
TOTS AND BIG SHOTS, 2008-2009
50000
45000
Number of Doses
40000
35000
30000
25000
Total Shots for Tots
20000
Total Big Shots
15000
10000
5000
0
2008
2009
Year
Source: ATCHHSD Immunization Program
VACCINES OFFERED BY BIG SHOTS
Viral


Influenza
Bacterial

Human
papillomavirus
Tetanus,
diphtheria,
pertussis
(Td/Tdap)

Hepatitis A

Hepatitis B

Pneumococcal
Measles,
mumps, rubella
(MMR)

Meningococcal


Varicella

Zoster
ADULT POPULATIONS AT HIGH
RISK FOR VACCINE-PREVENTABLE
DISEASES
THREE TARGET PATHOGENS
 Human
Papillomavirus
 Hepatitis
A virus
 Hepatitis
B virus
HUMAN PAPILLOMAVIRUS
(HPV)


Genital Diseases

Genital warts

Cervical, vaginal, anal, penile cancers
High Risk Populations
Multiple sexual partners
 Young women
 Men who have sex with men (MSM)


Vaccine Type – protein subunit

Gardasil


Protects against serotypes 6, 11, 16, and 18
Cervarix

Protects against serotypes 16 and 18
HEPATITIS A VIRUS
(HAV)

Disease



Acute viral hepatitis
High Risk Populations

Injection and non-injection drug users

MSM

Travelers to endemic HAV areas
Vaccine Type – inactivated viruses
HEPATITIS B VIRUS
(HBV)


Disease

Acute viral hepatitis

Chronic viral hepatitis
High Risk Populations
Multiple sexual partners
 MSM
 Injection drug users
 Travelers to HBV endemic areas


Vaccine

Type: Protein subunit
ORGANIZATIONS SERVING HIGH
RISK POPULATIONS IN
AUSTIN/TRAVIS COUNTY
Substance
Abuse
Rehabilitation
Centers
Violence
Prevention
Programs
Homeless
Shelters
Example
Organizations
Women’s
Centers
Community
Centers
Mental
Health
Centers
PURPOSE



Identify organizations that serve individuals at
high risk for the three target pathogens: HPV,
hepatitis A virus and hepatitis B virus
Survey key leaders within organizations to
determine their willingness to develop
partnerships to promote low/no cost
immunization services to high risk individuals
Make recommendations to Immunization
Program for effective promotion, partnership,
and outreach efforts to these populations
METHODS
METHODOLOGY
Review and develop list
of organizations serving
high risk individuals in
Austin/Travis County
Choose three target
pathogens: Human
papillomavirus, Hepatitis
A, Hepatitis B
Identify organizations in
Austin/Travis County
serving individuals at
high risk for HPV, HAV
and HBV
METHODOLOGY
Develop questionnaire
Administer questionnaire to organization key
leader
Compile results and analyze data
Make partnership recommendations for the
Immunization Program based on findings
ORGANIZATIONS SERVING HIGH
RISK POPULATIONS
QUESTIONNAIRE DESIGN
Eight questions
 5 quantitative
 3 qualitative
 Categories
 Organization
Characteristics
 Partnership
Potential

QUESTIONNAIRE ADMINISTRATION

Administered by phone
DATA ANALYSIS
Entered questionnaire
responses into Microsoft
Excel
 Analyzed results

RESULTS
ORGANIZATIONS THAT AGREED
TO BE INTERVIEWED
Interviewed
Not Interviewed
ORGANIZATION
CHARACTERISTICS
WHAT POPULATIONS DO YOU SERVE?
N=8
HOW MANY CLIENTS DO YOU SERVE
ANNUALLY?
DO YOU CONSIDER YOUR
POPULATION TO BE IN NEED OF
VACCINATION?
8/8 organizations responded yes!
HOW DO YOU THINK THESE GROUPS
WILL RESPOND TO VACCINATION
INFORMATION?
WHAT IS THE BEST METHOD FOR
INFORMING HIGH RISK INDIVIDUALS
ABOUT VACCINE PRIORITY AND
AVAILABILITY?
PARTNERSHIP
POTENTIAL
HOW WILLING ARE YOU TO BE INVOLVED IN
THE PROMOTION OF VACCINES?
HOW ABLE ARE YOU TO BE INVOLVED
IN THE PROMOTION OF VACCINES?
DO YOU KNOW OF OTHER
ORGANIZATIONS WORKING WITH THE
SAME POPULATIONS THAT WOULD BE
INTERESTED IN VACCINATION
EFFORTS?
Organizations Referred
Organizations To Be Contacted
Yes
4
4
No
(Previously
Contacted)
CONCLUSIONS
CONCLUSIONS: ORGANIZATION
CHARACTERISTICS

Populations served: Substance abuse (3),
LGBTQ (2), Women (2), Youth (1)

Number of clients?

87.5% served less than 5000 clients

Clients in need of vaccines: 100%

Receptive to vaccine information: 62.5%

Method of informing? 62.5% indicated direct
verbal communication
CONCLUSIONS: PARTNERSHIP
POTENTIAL

Willingness to inform clients?
75% willing or very willing


62.5% able or very able to actively
promote vaccines

82.5% provided names of additional
potential partners
FINAL ORGANIZATION PARTNERSHIP
RECOMMENDATIONS
Organization
High-risk
Population
Recommendation
Austin Recovery
Substance Abuse
Yes
Addiction and
Psycotherapy Services
Substance Abuse
Maybe
Austin Harm Reduction
Coalition
Substance Abuse
Yes
YWCA of Greater Austin
Women
No
Safeplace
Women
Yes
Metropolitan Community
Church of Austin
GLBTQ
Yes
Waterloo Counseling
GLBTQ
Maybe
Youth
Yes
Lifeworks
LIMITATIONS
 Time
period
 Small
sample size
FUTURE DIRECTIONS



Form partnership relations with recommended
organizations
Measure the impact of partnership by determining
the number of patients referred by each organization
Follow-up with the additional organizations that
were referred by the key leaders
ACKNOWLEDGMENTS
My mentors at the
ATCHHSD Immunization
Program, Isabel Hargrove
and Kurt Becker
 Dr. Leanne Field,
Dr. Diane Kneeland,
Ms. Nancy Elder and the
Public Health Internship
Program

ACKNOWLEDGEMENTS
Funding generously provided by an
Association of Schools of Public Health/
Association of Public Health Laboratories
“Pathways to Public Health Careers and Internship Grant”
from
The Centers for Disease Control and Prevention