Perceptions of Parental Leave Among Ophthalmologists.

Importance: Benchmarking attitudes surrounding parental leave among posttraining North American ophthalmologists may reveal possible areas for intervention. Objective: To evaluate perceptions of current parental leave policy and culture among posttraining North American ophthalmologists. Design, Setting, and Participants: This nonvalidated survey used a 19-item online questionnaire. A convenience sample of 186 self-identified North American-based ophthalmologists who had completed training was obtained using listservs, residency program coordinators, and social media. Data collection occurred from May to July 2022. Main Outcomes and Measures: Descriptive analysis demonstrated response frequencies. Pearson χ2 comparison of means was performed for categorical variables. Two-tailed t tests were performed for continuous variables. Results: Among the 186 surveys completed, 105 respondents (56.5%) identified as female, 76 (40.9%) worked in academia, 133 (71.5%) were 1 to 20 years out of training, and 156 (83.9%) had children. Attitudes toward stop-the-clock policies, or delays in tenure/promotion/partnership review when taking leave, were mixed. Of 171 respondents, 78 (45.6%) thought that stop-the-clock policies should be optional, 39 (22.8%) thought that they should be required, and 31 (18.1%) thought that they should be removed. Of 76 academicians responding, 56 (73.7%) and 49 (64.5%) were unaware if their institution had a stop-the-clock policy for tenure review or promotion review, respectively. Male and female respondents differed in feeling comfortable with taking leave (36 of 66 [54.5%] vs 67 of 90 [74.4%], respectively; P = .04), as well as in their ratings of stress about peer perception on a scale of 0 to 10 (3.70 vs 4.81, respectively; P = .05). Private practitioners and academicians differed in confirmation of leave options for both parents (52 of 101 [51.5%] vs 49 of 69 [71.0%], respectively; P = .02) and ratings of financial stress (7.10 vs 5.43, respectively; P = .004) and research considerations (1.60 vs 3.85, respectively; P < .001). Conclusions and Relevance: Results of this survey study support the hypothesis that demographic factors affect attitudes toward parental leave among posttraining ophthalmologists; policies could be better publicized. Feelings regarding policies and leave were mixed. These findings should be viewed as hypothesis generating because the survey was not validated and the associations provided could be due to confounding factors.

A Peer-Based Strategy to Overcome HPV Vaccination Inequities in Rural Communities: A Physical Distancing-Compliant Approach.

The human papilloma virus (HPV) vaccine is the world's first proven and effective vaccine to prevent cancers in males and females when administered pre-exposure. Like most of the US, barely half of Vermont teens are up-to-date with the vaccination, with comparable deficits in New Hampshire and Maine. The rates for HPV vaccine initiation and completion are as low as 33% in rural New England. Consequently, there is a compelling responsibility to communicate its importance to unvaccinated teenagers before their risk for infection increases. Messaging in rural areas promoting HPV vaccination is compromised by community-based characteristics that include access to appropriate medical care, poor media coverage, parental and peer influence, and skepticism of science and medicine. Current strategies are predominantly passive access to literature and Internet-based information. Evidence indicates that performance-based messaging can clarify the importance of HPV vaccination to teenagers and their parents in rural areas. Increased HPV vaccination will significantly contribute to the prevention of a broadening spectrum of cancers. Reducing rurality-based inequities is a public health priority. Development of a performance-based peer-communication intervention can capture a window of opportunity to provide increasingly effective and sustained HPV protection. An effective approach can be partnering rural schools and regional health teams with a program that is nimble and scalable to respond to public health policies and practices compliant with COVID-19 pandemic-related modifications on physical distancing and interacting in the foreseeable future.

Factors contributing to suboptimal rates of childhood vaccinations in Vermont.

Childhood immunizations are invaluable in preventing contagious diseases. Nonetheless, vaccines have become increasingly controversial with growing numbers of caregivers refusing to vaccinate their children. The percentage of fully vaccinated children in Vermont is one of the lowest nationally. This study set out to determine Vermont caregivers' attitudes toward immunizations to better explain why the percentage of fully vaccinated children has fallen in Vermont. A survey regarding caregivers' health care knowledge about children, their vaccination concerns, and their children's vaccination status was sent to participants in the Vermont Women, Infants and Children's Program from two districts. In total, 83% (n = 379) of respondents reported their children received all recommended vaccinations for their age. Respondents who considered themselves highly knowledgeable regarding their children's health care and confident about the safety of vaccinations were significantly associated with reporting their children as being current on vaccinations and with their intent to continue vaccinations. Respondents indicated highest concern regarding the safety and number of vaccinations administered during one visit. Primary care providers were indicated as important resources for addressing concerns about vaccinations and health care knowledge of children. The results help to understand low vaccination rates in Vermont and can be used for targeting health campaigns to improve vaccination rates.

Improving newborn preventive services at the birth hospitalization: a collaborative, hospital-based quality-improvement project.

OBJECTIVE: The goal was to test the effectiveness of a statewide, collaborative, hospital-based quality-improvement project targeting preventive services delivered to healthy newborns during the birth hospitalization. METHODS: All Vermont hospitals with obstetric services participated. The quality-improvement collaborative (intervention) was based on the Breakthrough Series Collaborative model. Targeted preventive services included hepatitis B immunization; assessment of breastfeeding; assessment of risk of hyperbilirubinemia; performance of metabolic and hearing screens; assessment of and counseling on tobacco smoke exposure, infant sleep position, car safety seat fit, and exposure to domestic violence; and planning for outpatient follow-up care. The effect of the intervention was assessed at the end of an 18-month period. Preintervention and postintervention chart audits were conducted by using a random sample of 30 newborn medical charts per audit for each participating hospital. RESULTS: Documented rates of assessment improved for breastfeeding adequacy (49% vs 81%), risk for hyperbilirubinemia (14% vs 23%), infant sleep position (13% vs 56%), and car safety seat fit (42% vs 71%). Documented rates of counseling improved for tobacco smoke exposure (23% vs 53%) and car safety seat fit (38% vs 75%). Performance of hearing screens also improved (74% vs 97%). No significant changes were noted in performance of hepatitis B immunization (45% vs 30%) or metabolic screens (98% vs 98%), assessment of tobacco smoke exposure (53% vs 67%), counseling on sleep position (46% vs 68%), assessment of exposure to domestic violence (27% vs 36%), or planning for outpatient follow-up care (80% vs 71%). All hospitals demonstrated preintervention versus postintervention improvement of > or = 20% in > or = 1 newborn preventive service. CONCLUSIONS: A statewide, hospital-based quality-improvement project targeting hospital staff members and community physicians was effective in improving documented newborn preventive services during the birth hospitalization.