CONCLUSIONS: Minimally trained PCPs can administer the M-CHAT/F reliably and efficiently during regular well-child visits, increasing PPV without compromising detection.
Key Points
Question
Is the Johns Hopkins Community Health Partnership, a broad care coordination program inclusive of acute care and community interventions, associated with improved health outcomes?
Findings
This quality improvement study found that the community intervention was associated with a statistically significant reduction in admissions, readmissions, and emergency department visits for Medicaid, but the utilization results were mixed for the acute care intervention. In terms of cost of care, there were statistically significant cost savings totaling $113.3 million.
Meaning
A care coordination model in an urban academic center environment can be associated with improved outcomes, including substantial cost reduction.
BACKGROUND
In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates.
METHODS
We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues.
RESULTS
Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives.
CONCLUSIONS
If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students.
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