From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
The Influence of Deductible Health Plans on Receipt of the Human Papillomavirus Vaccine Series
Douglas W. Roblin, Ph.D.a, b, Debra P. Ritzwoller, Ph.D.c, Daniel I. Rees, Ph.D.d, Nikki M. Carroll, M.S.c, Anping Chang, M.S.a, Matthew F. Daley, M.D., M.P.H.c–
Journal of Adolescent Health
Volume 54, Issue 3, March 2014, Pages 275–281
To evaluate whether enrollment in deductible health plans (DHP) with higher patient cost-sharing requirements than traditional health maintenance organization plans (HMP) decreased initiation and completion of the human papillomavirus (HPV) vaccine series recommended for prevention of cervical cancer.
This was a retrospective observational study of 9- to 26-year-old females at Kaiser Permanente Georgia and Kaiser Permanente Colorado who were HPV vaccine naive at time of enrollment in a self-pay DHP or HMP in 2007. Estimates of rates of initiation and completion of the HPV vaccine series from plan enrollment in 2007 through December 2009 were obtained using Cox proportional hazards regressions (accounting for censoring) on samples matched on the propensity to enroll in a DHP versus HMP.
Initiation of the HPV vaccine series was 22.2% and 24.4% in the DHP and HMP groups, respectively, at Kaiser Permanente Georgia; completion was 12.3% and 14.4% in the DHP and HMP groups, respectively. Human papillomavirus vaccine series initiation was higher at Kaiser Permanente Colorado, but completion was lower. In the Cox proportional hazards regressions, rates of initiation and completion of the HPV vaccine series did not differ significantly (p ≤ .05) by plan type (DHP vs. HMP) at both sites. The primary care visit rate included in these regressions had a significant, positive association with initiation and completion of the HPV vaccine series.
Enrollment in a DHP versus an HMP did not directly affect initiation or completion of the HPV vaccine series among age-eligible females. Independent of plan type, more frequent primary care visits increased initiation and completion rates.
Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries
Dr Kalipso Chalkidou PhD a, Patricio Marquez MD b, Preet K Dhillon PhD c, Yot Teerawattananon MD d, Thunyarat Anothaisintawee PhD e, Prof Carlos Augusto Grabois Gadelha PhD f, Prof Richard Sullivan MD g
The Lancet Oncology, Early Online Publication, 14 February 2014
Evidence-informed frameworks for cost-effective cancer prevention and management are essential for delivering equitable outcomes and tackling the growing burden of cancer in all resource settings. Evidence can help address the demand side pressures (ie, pressures exerted by people who need care) faced by economies with high, middle, and low incomes, particularly in the context of transitioning towards (or sustaining) universal health-care coverage. Strong systems, as opposed to technology-based solutions, can drive the development and implementation of evidence-informed frameworks for prevention and management of cancer in an equitable and affordable way. For this to succeed, different stakeholders—including national governments, global donors, the commercial sector, and service delivery institutions—must work together to address the growing burden of cancer across economies of low, middle, and high income.
The influence of social norms on the dynamics of vaccinating behaviour for paediatric infectious diseases
Tamer Oraby1, Vivek Thampi1 and Chris T. Bauch1,2
1Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
2Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
Proceedings of the Royal Society B
April 2014 vol. 281 no. 1780 20133172
Mathematical models that couple disease dynamics and vaccinating behaviour often assume that the incentive to vaccinate disappears if disease prevalence is zero. Hence, they predict that vaccine refusal should be the rule, and elimination should be difficult or impossible. In reality, countries with non-mandatory vaccination policies have usually been able to maintain elimination or very low incidence of paediatric infectious diseases for long periods of time. Here, we show that including injunctive social norms can reconcile such behaviour-incidence models to observations. Adding social norms to a coupled behaviour-incidence model enables the model to better explain pertussis vaccine uptake and disease dynamics in the UK from 1967 to 2010, in both the vaccine-scare years and the years of high vaccine coverage. The model also illustrates how a vaccine scare can perpetuate suboptimal vaccine coverage long after perceived risk has returned to baseline, pre-vaccine-scare levels. However, at other model parameter values, social norms can perpetuate depressed vaccine coverage during a vaccine scare well beyond the time when the population’s baseline vaccine risk perception returns to pre-scare levels. Social norms can strongly suppress vaccine uptake despite frequent outbreaks, as observed in some small communities. Significant portions of the parameter space also exhibit bistability, meaning long-term outcomes depend on the initial conditions. Depending on the context, social norms can either support or hinder immunization goals.