Massage perceptions and attitudes of undergraduate pre-professional health sciences students: a cross-sectional survey in one U.S. university.

BACKGROUND: Attitudes and beliefs about massage therapy have been explored among health professionals and health profession students, but not for undergraduate preprofessional health sciences students. METHODS: This cross-sectional survey sought to determine pre-professional health students' attitudes and perceptions toward massage therapy and determine the extent demographic variables such as age, gender, race, along with lifetime massage experience are associated with neutral/negative perceptions. RESULTS: N = 129 undergraduate students completed the Attitudes Toward Massage scale and 7 supplemental items pertaining to sexuality and therapist gender preference along with questions regarding lifetime massage utilization. Prevalence of massage therapy utilization was 35.6% (lifetime) and 18.6% (last 12-months). Overall, positive attitudes towards massage therapy was observed with participants reporting massage experience expressing more positive massage attitudes (lifetime; p = 0.0081, the past 12 months; p = 0.0311). Participants with no massage experience were more likely to report neutral/negative attitudes toward massage (p = 0.04). Men were more likely to prefer their massage therapist to be of the opposite sex (38.9%) compared to women (2.1%) (p = < 0.0001). Men were less confident than women in their concern of becoming sexually aroused during massage (p = 0.0001) and in the belief that massage is sexually arousing (p = 0.048). Both genders expressed comfort with female and/or male massage therapists, but if given a choice, both prefer a female massage therapist. CONCLUSIONS: Undergraduate pre-professional health sciences students have generally positive attitudes towards massage therapy however more research is needed regarding implicit gender bias and/or preferences. This work should inform future research designs examining the impact of attitudes and beliefs on patient referrals to massage therapy.

Physician clinical decision support system prompts and administration of subsequent doses of HPV vaccine: A randomized clinical trial.

BACKGROUND: HPV vaccine is effective in preventing several cancers and anogenital warts, yet rates of HPV vaccination series completion in the United States are low. A primary reason identified by parents for vaccinating children against HPV is a health care provider's recommendation. Although most clinicians embrace vaccine recommendations, they are not always carried out evenly and subsequent HPV vaccines are missed. METHODS: Using an electronic health records-based decision support system (CHICA) clinicians were randomized to either usual practice or to receive an automated reminder to recommend the 2nd or 3rd dose of HPV vaccine. The reminder was delivered to clinicians of all intervention group eligible adolescents who had already initiated the vaccine series. Logistic regression models with generalized estimating equations were used for data analysis. RESULTS: A total of 1285 clinical encounters were observed across 29 randomized pediatric providers over a 13-month time frame (50.7% control group, 49.3% intervention group). Overall, patients were 44.9% female, 59.4% Black, 22.1% Hispanic, and 48.8% were ages 11-12 yrs. Within the control group, 421 (64.7%) received a subsequent HPV vaccine, compared to 481 (75.9%) (OR: 1.72, (95% CI 1.35-2.19)). Adjusted analysis showed no difference between the groups (aOR 1.52 (95% CI 0.88-2.62)) or when examined by age (11-12yrs aOR 1.66, (95% CI 0.79-3.48)) and 13-17yrs (aOR 1.19, (95% CI 0.76-1.85)) or gender female (aOR 1.39 (95% CI 0.71-2.72)) and males (aOR 1.67 (95% CI 0.95-2.92)). When results were stratified by both age and gender, there was similarly no statistically significant effect between the two groups. CONCLUSIONS: Automated physician reminders for subsequent 2nd and 3rd doses of HPV vaccination were used. Despite increased rates of vaccination in the intervention group, the differences did not reach the level of statistical significance. Future studies with multifaceted approaches may be needed to examine the efficacy of computer-based reminders. CLINICAL TRIAL REGISTRATION: NCT02558803, "HPV Vaccination: Evaluation of Reminder Prompts for Doses 2 & 3".

An Educational Intervention to Improve HPV Vaccination: A Cluster Randomized Trial.

: media-1vid110.1542/5849572217001PEDS-VA_2018-1457Video Abstract BACKGROUND: Human papillomavirus (HPV) infection can lead to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. METHODS: In a cluster randomized trial, an intervention used to target parents of adolescents (11-17 years) eligible for a dose of HPV vaccine, was tested in pediatric clinics part of an urban health system. Parents watched a digital video outlining the risks and benefits of vaccine using a tablet in the examination room. The primary outcome was change in HPV vaccine status 2 weeks after the clinic visit. An intention-to-treat analysis for the primary outcome used generalized estimating equations to accommodate the potential cluster effect of clinics. RESULTS: A total of 1596 eligible adolescents were observed during the 7-month trial. One-third of adolescents visited an intervention clinic. Adolescents who attended an intervention clinic were more likely to be younger (11-12 years) than those who attended a control clinic (72.4% vs 49.8%; P < .001). No differences in race or sex were observed. The proportion of adolescents with an observed change in vaccine status was higher for those attending an intervention clinic (64.8%) versus control clinic (50.1%; odds ratio, 1.82; 95% confidence interval, 1.47-2.25; P < .001). Adolescents whose parents watched the video had a 3-times greater odds of receiving a dose of the HPV vaccine (78.0%; odds ratio, 3.07; 95% confidence interval, 1.47-6.42; P = .003). CONCLUSIONS: Educational interventions delivered within a clinical setting hold promise to improve vaccination behaviors.

Linkage of Indiana State Cancer Registry and Indiana Network for Patient Care Data.

BACKGROUND: Large automated electronic health records (EHRs), if brought together in a federated data model, have the potential to serve as valuable population-based tools in studying the patterns and effectiveness of treatment. The Indiana Network for Patient Care (INPC) is a unique federated EHR data repository that contains data collected from a large population across various health care settings throughout the state of Indiana. The INPC clinical data environment allows quick access and extraction of information from medical charts. The purpose of this project was to evaluate 2 different methods of record linkage between the Indiana State Cancer Registry (ISCR) and INPC, determine the match rate for linkage between the ISCR and INPC data for patients diagnosed with cancer, and to assess the completeness of the ISCR based on additional validated cancer cases identified in the INPC EHRs. METHODS: Deterministic and probabilistic algorithms were applied to link ISCR cases to the INPC. The linkage results were validated by manual review and the accuracy assessed with positive predictive value (PPV). Medical charts of melanoma and lung cancer cases identified in INPC but not linked to ISCR were manually reviewed to identify true incidence cancers missed by the ISCR, from which the completeness of the ISCR was estimated for each cancer. RESULTS: Both deterministic and probabilistic approaches to linking ISCR and INPC had extremely high PPV (>99%) for identifying true matches for the overall cohort and each subcohort. The combined match rate for melanoma and lung cancer cases identified in the ISCR that matched to any patient occurrence in INPC (not by disease) was 85.5% for the complete cohort, 94.4% for melanoma, and 84.4% for lung cancer. The estimated completeness of capture by the ISCR was 84% for melanoma and 98% for lung cancer. Conclusion: Cancer registries can be successfully linked to patients' EHR data from institutions participating in a regional health information organization (RHIO) with a high match rate. A pragmatic approach to data linkage may apply both deterministic and probabilistic approaches together for the diverse purposes of cancer control research. The RHIO has the potential to add value to the state cancer registry through the identification of additional true incident cases, but more advanced approaches, such as natural language processing, are needed.