Errors and Correlates in Parental Recall of Child Immunizations: Effects on Vaccination Coverage Estimates

Suarez, Lucina; Simpson, Diane M.; Smith, David R.

doi:10.1542/peds.99.5.e3

Cited by 147 publications

(107 citation statements)

References 10 publications

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“…Research has demonstrated the important effect of different methodologies on the measurement of immunization coverage. [23][24][25][26][27] In particular, the limitations of using parental report have been well documented for immunization assessments, and a similar issue probably exists for lead screening. The use of medical record audits in this study overcomes that limitation and may partially explain the higher screening rates.…”

Section: Discussionmentioning

confidence: 99%

A Statewide Assessment of Lead Screening Histories of Preschool Children Enrolled in a Medicaid Managed Care Program

et al. 2001

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ABSTRACT. Objectives. Despite the prominence of lead poisoning as a public health problem, recent Government Accounting Office reports indicate that only one fifth of children who are covered by Medicaid have been screened for lead poisoning. The purpose of this study was to examine the lead screening histories of children who were enrolled in a statewide, Medicaid managed care plan to determine the relative impact of the type of primary care provider site and family sociodemographic characteristics on the likelihood of being screened. The study also examined the prevalence of and risk factors for lead poisoning of children who had been screened.Methods. A random sample of 2000 preschool-age children was chosen from those who were enrolled continuously in the statewide, expanded, Medicaid managed care program for a 1-year period and between the ages of 19 and 35 months at the end of that year. Sociodemographic characteristics and lists of primary care providers were obtained from administrative data sets. Medical record audits at primary care provider sites were performed to obtain the lead screening histories of the children, including test dates and results.Results. Data on 1988 children were used for study analyses, and 80% of these children had at least 1 documented blood lead level. Children whose primary care provider was an office-based physician were less likely to be screened as compared with patients of health centers, hospital-based clinics, and staff model health maintenance organizations (68%, 86%, 89%, and 91% respectively). Variation in screening rates persisted in a multivariate analysis controlling for family sociodemographic characteristics and practice level variation. Of the 1587 children who had a documented blood lead test, 467 children (29%) had a blood lead level of >10 mg/dL on at least 1 test.Conclusions. Blood lead screening rates in Rhode Island's Medicaid managed care program are dramatically higher than national estimates for children who are enrolled in Medicaid. Potential explanations for this finding are 1) a high sensitization to the problem of lead poisoning in Rhode Island, 2) the primary care focus of the Medicaid program in Rhode Island facilitates the delivery of preventive services, and 3) the medical record audit approach used in this study was more comprehensive in identifying blood lead screens than techniques used in national studies. The high prevalence of elevated blood lead levels found in this study emphasizes the importance of screening among children who are enrolled in Medicaid. Pediatrics 2001;108(2). URL: http://www.pediatrics.org/cgi/content/full/108/2/e29; lead screening, Medicaid managed care.ABBREVIATIONS. NHANES, National Health and Nutrition Examination Survey; HMO, health maintenance organization; MCO, managed care organization; CI, confidence interval; OR, odds ratio.T he deleterious effects of lead poisoning on young children have been well documented. [1][2][3][4][5][6] Blood lead levels as low as 10 g have been associated with negative effects on a ...

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Section: Discussionmentioning

confidence: 99%

A Statewide Assessment of Lead Screening Histories of Preschool Children Enrolled in a Medicaid Managed Care Program

et al. 2001

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“…Os resultados apresentados confirmam aqueles obtidos em Salvador -valores elevados de especificidade, quando houve concordância entre informação do responsável e do cartão, sugerindo que a leitura da cicatriz vacinal é um melhor indicador de história de vacinação com BCG do que a informação do cartão ou da família, no Brasil, sugerindo imperfeição na utilização da informação do responsável em relação ao estado vacinal da criança. 15 Observou-se que a informação obtida através do cartão vacinal é incompleta. Neste aspecto, há algumas particularidades a respeito da forma como esses cartões são preenchidos no Brasil.…”

Section: Discussionunclassified

Sensibilidade e especificidade da leitura da cicatriz vacinal do BCG

et al. 2003

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Resumo ObjetivoValidar a utilização da cicatriz vacinal de BCG como um indicador de vacinação. Métodos Foi realizado um estudo transversal em 52.348 escolares, entre 6 e 14 anos de idade, que possuíam exame de cicatriz vacinal do BCG e que participaram de um ensaio clínico randomizado e controlado na cidade de Manaus, Brasil. Os dados da leitura da cicatriz vacinal foram comparados com a informação sobre a vacinação passada fornecida pelos cartões vacinais ou informação dos responsáveis. Em uma subamostra foi realizada leitura dupla com cálculo do coeficiente Kappa. Para análise dos dados utilizou-se o Stata 7. Resultados Do total de 52.348 escolares estudados, 29.254 possuíam informação sobre cicatriz vacinal coletada por meio de carta aos pais, e 4.947 possuíam história de vacinação coletada pelo cartão de vacinas. Observou-se elevada concordância entre a dupla leitura de cicatriz vacinal (Kappa =0,81). A sensibilidade da leitura de cicatriz vacinal foi 96,6% (95% IC 96,0-97,1) e a especificidade foi 71,1% (95% IC 55,7-83,7) quando o padrão ouro utilizado foi a concordância entre a carta aos pais e a informação do cartão de vacinas. A sensibilidade foi de 96,1%, 97,3% e 95,3% para crianças vacinadas até um mês de idade, até 4 meses e até um ano de idade, respectivamente. Conclusões Os valores encontrados para sensibilidade e especificidade foram independentes da idade da realização da leitura de cicatriz vacinal. O exame da cicatriz vacinal mostrou ser um bom indicador para avaliar a situação vacinal referente ao BCG. Abstract Objective

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“…32 The lack of concordance between respondent reports and provider reports of some children's hepatitis B immunizations raises concerns about the reliability of parental reports, as has been noted elsewhere. [33][34][35] Respondents may have confused notations on the shot record of Haemophilis influenzae type b vaccine immunizations with those for hepatitis B, because the former is usually recorded as Hib and the latter as HBV. Alternatively, provider records may have not included immunization information from a child's other providers.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Immunization Coverage Among Vietnamese-American Children 3 to 18 Years Old

Jenkins¹,

McPhee²,

Wong³

et al. 2000

Pediatrics

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ABSTRACT. Objective. Persons with chronic hepatitis B virus (HBV) infection are at increased risk of chronic hepatitis, cirrhosis, and liver cancer. Although HBV infection is relatively uncommon in the United States, the disease is endemic in persons born in Southeast Asia, including Vietnamese-Americans. Current US infant immunization recommendations and state-mandated school-entry programs have left many nontargeted age-cohorts unvaccinated and at risk of infection. To assess the need for catch-up hepatitis B immunizations, this study reports the hepatitis B immunization rates of Vietnamese-American children 3 to 18 years old living in the metropolitan areas of Houston and Dallas, Texas, and the Washington, DC, area.Design. We conducted 1508 telephone interviews with random samples of Vietnamese households in each of the 3 study sites. We asked for hepatitis B immunization dates for a randomly selected child in each household. Attempts were made to verify immunization dates through direct contact with each child's providers. Low and high estimates of coverage were calculated using reports from providers when reached (n ‫؍‬ 720) and for the entire sample (n ‫؍‬ 1508).Results. Rates of having 3 hepatitis B vaccinations ranged from 13.6% (entire sample) to 24.1% (provider reports, Dallas), 10.3% to 26.4% (Houston), and 18.1% to 37.8% (Washington, DC). Children living in the Texas sites, older children, children whose families had lived in the United States for a longer time, and children whose provider was Vietnamese or who had an institutional provider were less likely to have been immunized. The odds of being immunized were greater, however, for children who had had at least 1 diphtheria, tetanus toxoid, and pertussis shot, and whose parents had heard about HBV infection, and were married.Conclusions. The low rates of hepatitis B vaccine coverage among children and adolescents portend a generation which, too old to benefit from infant programs and school entry laws, will grow into adulthood without the protection of immunization. Increased efforts are needed to design successful catch-up campaigns for this population. Pediatrics 2000;106(6). URL: http://www. pediatrics.org/cgi/content/full/106/6/e78; hepatitis B immunization; Vietnamese-Americans.

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Errors and Correlates in Parental Recall of Child Immunizations: Effects on Vaccination Coverage Estimates

Cited by 147 publications

References 10 publications

A Statewide Assessment of Lead Screening Histories of Preschool Children Enrolled in a Medicaid Managed Care Program

A Statewide Assessment of Lead Screening Histories of Preschool Children Enrolled in a Medicaid Managed Care Program

Sensibilidade e especificidade da leitura da cicatriz vacinal do BCG

Hepatitis B Immunization Coverage Among Vietnamese-American Children 3 to 18 Years Old

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