Referrals for pediatric weight management: the importance of proximity

Ambler, Kathryn A.; Hagedorn, Douglas W J; Ball, Geoff D.C.

doi:10.1186/1472-6963-10-302

Cited by 31 publications

(13 citation statements)

References 17 publications

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“…While these numbers appear small, they are consistent with ICCs found in other observational studies. [34][35][36] In our analyses, the between-state variance in the vaccination outcomes persisted even after adjusting for significant individual-level and state-level determinants. This is demonstrated by the multivariable logistic regression models where the state of residence persisted as an important determinant for completion and compliance.…”

Section: Discussionmentioning

confidence: 56%

Determinants of Meningococcal ACWY vaccination in adolescents in the US: completion and compliance with the CDC recommendations

Cheng

Chang

Novy

et al. 2019

Human Vaccines & Immunotherapeutics

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Since 2011, the Advisory Committee on Immunization Practices (ACIP) guidelines for routine MenACWY vaccination in the US include a primary dose before age 16 y, preferably at ages 11-12 y, with a booster dose at age 16 y. Data on rates and drivers of meningococcal vaccination completion (receipt of both doses) and compliance with recommendations (receipt of primary dose at ages 11-12 y followed by booster at 16 y) down to state-level are limited. This study evaluated rates and determinants of MenACWY vaccination completion and compliance in adolescents aged 17 y based on data from the annual National Immunization Survey-Teen between 2011 and 2016. Individual-and state-level determinants of completion and compliance were assessed using uni-level and multi-level multivariable regression models. Average national rates were 23.2% and 12.1% for completion and compliance, respectively, with large interstate variation observed (completion: 8.7-39.7%; compliance: 3.1-26.2%). Beyond the state of residence, factors significantly associated with a higher likelihood of both completion and compliance included being male, up-to-date on other routine vaccines, having private or hospital-based vaccine providers (vs. public) and having >1 child in the household. Factors specifically associated with completion included having >1 annual health-care visit and presence of a booster-dose vaccine mandate, while a history of asthma and high-risk health conditions had a positive association with compliance. State-level determinants of completion and compliance included pediatricians-to-children ratio and the proportion of Immunization Information System use among adolescents, respectively. Outcomes of this study may help guide clinical, policy and educational interventions to further increase MenACWY completion rates and reduce disparities in vaccination.

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Section: Discussionmentioning

confidence: 56%

Determinants of Meningococcal ACWY vaccination in adolescents in the US: completion and compliance with the CDC recommendations

Cheng

Chang

Novy

et al. 2019

Human Vaccines & Immunotherapeutics

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“…Non-physician controls, excluding other healthcare workers, were selected from a one-million random sample of beneficiaries in 2000. The physicians who suffered from hip fracture between 1997 and 1999 were excluded ( n = 27); the remaining physicians were individually matched (1:1) to non-physician controls based on gender, year of birth, urbanization (including urban, suburban, and rural area), and income level (including high, middle, low, and no income defined by insurance premium) [ 27 ]. These matching variables were considered to select demographically and socio-economically matched controls.…”

Section: Methodsmentioning

confidence: 99%

Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

Shen

Lin

et al. 2015

IJERPH

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Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years) physicians (n = 4303) and matched non-medical persons (control) were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR) of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively), whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively). Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79); by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.

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“…7 Among the many barriers that Latinos face seeking health care, distance is a significant barrier when frequent specialty care visits are warranted. 6,20 Although many tactics have been employed to combat the growing trend of obesity in this clinic, recently there have been higher success rates for decreasing weight and engaging in healthy lifestyle changes by initiating referral to the multidisciplinary pediatric weight management clinic. A commonly expressed barrier described by Latino patients is distance to the weight management clinic.…”

Section: Pediatric Primary Care Clinicmentioning

confidence: 99%