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      Pertussis immunization in healthcare workers working in pediatric settings: Knowledge, Attitudes and Practices (KAP) of Occupational Physicians. Preliminary results from a web-based survey (2017)

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          Summary

          Introduction

          The present study aims to characterize knowledge, attitudes and practices in a sample of occupational physicians (OPh) towards pertussis immunization in healthcare workers (HCWs) from pediatric settings.

          Material and methods

          A total of 148 OPh (45.9% males, mean age of 40.3 ± 13.2 years) compiled a web questionnaire including a knowledge test on Italian recommendations for HCWs, epidemiology and pathology of pertussis infection, being then investigated about risk perceptions and vaccination practices. A General Knowledge Score (GKS) and a Risk Perception Score (RPS) were calculated. Multivariate odds ratios (OR) for predictors of vaccine propensity were calculated through regression analysis.

          Results

          78 participants regularly recalled pertussis vaccination status and/or performed pertussis vaccination in HCWs (52.7%). Proactive status was correlated with the aim to avoid pertussis infection in HCWs and its diffusion to other adults (p < 0.001, both statements). GKS was satisfying (72.4% ± 14.9), but participants underestimated the clinical issues of pertussis infection (RPS 60.8% ± 9.5) when confronted with influenza (73.9% ± 10.9) and HBV infection (68.1% ± 10.1). GKS and RPS were well correlated (r = 0.244, p = 0.003). Eventually, a better GKS and the aim to avoid pertussis infection in HCWs were predictive of a proactive status for pertussis vaccination (OR 4.186 95%CI 1.809-9.685 and OR 11.459, 95%CI 3.312-39.651, respectively).

          Conclusions

          Adherence of OPh to HCWs pertussis vaccination was unsatisfying. As knowledge status was predictive for vaccine propensity, information programs for OPh should be more appropriately designed, stressing that HCWs may represent a significant reservoir for pertussis infection in high risk groups (e.g. children/newborns, frail elderly).

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          Most cited references56

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          Advantages and limitations of web-based surveys: evidence from a child mental health survey.

          Web-based surveys may have advantages related to the speed and cost of data collection as well as data quality. However, they may be biased by low and selective participation. We predicted that such biases would distort point-estimates such as average symptom level or prevalence but not patterns of associations with putative risk-factors. A structured psychiatric interview was administered to parents in two successive surveys of child mental health. In 2003, parents were interviewed face-to-face, whereas in 2006 they completed the interview online. In both surveys, interviews were preceded by paper questionnaires covering child and family characteristics. The rate of parents logging onto the web site was comparable to the response rate for face-to-face interviews, but the rate of full response (completing all sections of the interview) was much lower for web-based interviews. Full response was less frequent for non-traditional families, immigrant parents, and less educated parents. Participation bias affected point estimates of psychopathology but had little effect on associations with putative risk factors. The time and cost of full web-based interviews was only a quarter of that for face-to-face interviews. Web-based surveys may be performed faster and at lower cost than more traditional approaches with personal interviews. Selective participation seems a particular threat to point estimates of psychopathology, while patterns of associations are more robust.
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            Measuring people's knowledge about vaccination: developing a one-dimensional scale.

            We propose a new scale to measure people's general knowledge about vaccinations. The scale's psychometric properties and its relationship with people's willingness to vaccinate were examined in two studies. In Study 1, a representative sample of the German- and French-speaking populations in Switzerland (N=1123) responded to a mail survey. In Study 2, members of an online panel answered the same questions (N=233). The results of both studies suggest that people differ considerably in their ability to correctly answer questions related to vaccinations. Mokken scale analyses and a test-retest analysis showed that nine items form a one-dimensional scale with good psychometric properties. In both studies, a substantial correlation between knowledge and willingness to vaccinate was observed. The scale proposed in this study is well suited for research examining group differences. In a time when new media such as the Internet is highly accessible to most people, misconceptions can easily be spread. A good knowledge scale is important for measuring possible knowledge changes.
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              E-health use, vaccination knowledge and perception of own risk: drivers of vaccination uptake in medical students.

              was to improve understanding of mechanisms contributing to healthcare personnel's (HCP) reluctance to get vaccinated against seasonal influenza. We assessed the role of several drivers: vaccination knowledge, vaccination recommendations and the role of the Internet (so-called e-health) in creating vaccination knowledge. The key mechanism under consideration was the perceived own risk (regarding disease and the vaccine). 310 medical students at the Frankfurt University Hospital answered an anonymous questionnaire assessing risk perceptions, intentions to get vaccinated, knowledge, preferences regarding information sources for personal health decisions and search-terms that they would use in a Google-search directed at seasonal influenza vaccination. The key driver of vaccination intentions was the perceived own risk (of contracting influenza and of suffering from vaccine adverse events). The recommendation to get vaccinated was a significant, yet weaker predictor. As an indirect driver we identified one's knowledge concerning vaccination. 32% of the knowledge questions were answered incorrectly or as don't know. 64% of the students were e-health users; therefore, additional information search via the Internet was likely. An analysis of the websites obtained by googling the search-terms provided by the students revealed 30% commercial e-health websites, 11% anti-vaccination websites and 10% public health websites. Explicit searches for vaccination risks led to fewer public health websites than searches without risk as a search term. Content analysis of the first three websites obtained revealed correct information regarding the questions of whether the doses of vaccine additives were dangerous, whether chronic diseases are triggered by vaccines and whether vaccines promote allergies in 58%, 53% and 34% of the websites, respectively. These questions were especially related to own risk, which strongly predicted intentions. Correct information on vaccination recommendations were provided on 85% of the websites. Concentrating on the key drivers in early medical education (own risk of contracting influenza, vaccine safety, vaccination recommendation) promises to be a successful combination to increase vaccination uptake in HCP. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                J Prev Med Hyg
                J Prev Med Hyg
                JPMH
                Journal of Preventive Medicine and Hygiene
                Pacini Editore Srl
                1121-2233
                2421-4248
                02 April 2020
                March 2020
                : 61
                : 1
                : E66-E75
                Affiliations
                [1 ] IRCCS-AUSL di Reggio Emilia; Department of Public Health, Service for Health and Safety in the Workplace ; Reggio Emilia (RE), Italy
                [2 ] Provincial Agency for Health Services of the Autonomous Province of Trento; Department of Prevention, Occupational Health and Safety Unit , Trento (TN), Italy
                [3 ] University of Campania “Luigi Vanvitelli” , Department of Experimental Medicine, Naples (NA), Italy
                [4 ] University of Parma , Department of Medicine and Surgery; School of Medicine, Parma (PR), Italy
                [5 ] Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University , Toronto, Canada
                [6 ] University “Vita e Salute”, San Raffaele Hospital , Milan (MI), Italy
                Author notes
                Correspondence: Matteo Riccò, IRCCS-AUSL di Reggio Emilia, via Amendola 2, 42122 Reggio Emilia (RE), Italy - Tel. +39 0522 837 587 - E-mail: matteo.riccoausl.re.it/mricco2000@ 123456gmail.com
                Article
                10.15167/2421-4248/jpmh2020.61.1.1155
                7225653
                32490271
                9f4cf424-6552-45f0-bc1d-adaafb93168f
                ©2020 Pacini Editore SRL, Pisa, Italy

                This is an open access article distributed in accordance with the CC-BY-NC-ND (Creative Commons Attribution-Non-Commercial-NoDerivatives 4.0 International) license. The article can be used by giving appropriate credit and mentioning the license, but only for non-commercial purposes and only in the original version. For further information: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en

                History
                : 24 December 2018
                : 09 January 2020
                Page count
                Figures: 2, Tables: 4, Equations: 1, References: 64, Pages: 10
                Categories
                Original Article

                healthcare workers,pertussis vaccine,diptheria-tetanus-acellular pertussis vaccines,occupational physicians

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