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Objective: To assess the acceptability of a Tdap vaccination program for partners of pregnant women. Study Design: Pregnant women and their partners were enrolled in a prospective acceptability study. For partners absent during the initial encounter, an introductory letter inviting the partner to participate was sent home. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) was offered to vaccine-eligible partners while vaccine-eligible pregnant women were offered Tdap immediately postpartum, as per national recommendations at the time the study was conducted. Tdap acceptance was defined as vaccination during study participation. Results: A total of 69 pregnant women and 63 partners were enrolled. Excluding the 19 partners reporting prior receipt, 61.4% of partners (27/44) accepted Tdap during the study. Those who enrolled following the introductory letter were more likely to accept Tdap than those enrolled at the initial encounter (84 vs. 44%, p = 0.005). Excluding the 29 pregnant women reporting prior receipt, 65% (26/40) received Tdap postpartum. Demographic factors and vaccine beliefs were not associated with Tdap acceptance. Conclusion: Tdap vaccination for partners of pregnant women during prenatal care is acceptable. Large-scale implementation would require substantial interest and willingness of obstetrician-gynecologists to administer Tdap not only to pregnant women but also to their partners. Such a program would provide improved "cocooning" of vulnerable infants against pertussis. [ABSTRACT FROM AUTHOR]

The objective of this retrospective cohort study was to evaluate the effectiveness of the Duke University Healthy Lifestyles Program (HLP), a primary care–based childhood obesity treatment program. The study population included obese 2- through 19-year-old patients who entered the HLP between October 2006 through December 2008 and who had a visit to the HLP between the sixth and eighth month after entry. Most of the 282 patients were female (57%) and non-Hispanic/non-White (61%). The median age was 11 years. At baseline, the mean body mass index standard deviation score (BMI SDS) was 2.51, and patients achieved a mean reduction in BMI SDS of 0.10 (standard deviation = 0.20). For patients with baseline and follow-up measures of comorbidities, there were improvements in blood pressure, triglycerides, total cholesterol, and insulin resistance (P < .05). The patients in our obesity program demonstrated a small reduction in the severity of obesity. Improvements occurred in some obesity-associated comorbidities. [ABSTRACT FROM PUBLISHER]

Abstract: The aims of this study were to determine the percentage of females who after initiating the human papillomavirus (HPV) vaccine series, both completed it and completed it on-time, as well as to examine factors associated with series completion and on-time completion. Using data from the North Carolina Immunization Registry, of 138,823 females analyzed, 55% completed the series, and 28% completed it on-time. Over 83% of those who initiated the vaccine series in 2006 completed it by the final study date, as compared to 32% of those who initiated the vaccine in 2009. On-time dosing rates, however, are declining, and have been hovering at 25% for the last two years of the study. Factors such as African-American race and public funding were significantly associated with lower rates of on-time dosing as well as series completion when compared to White race and private funding, respectively. Among girls and young women who initiate the HPV vaccination series, overall completion rates are low, but if given enough time most of those who begin the series will complete it. Our results suggest that strategies to improve the timely completion of the HPV vaccination series may be needed. [Copyright &y& Elsevier]

Purpose: To improve adolescent immunization coverage in a rural North Carolina county., Methods: Adolescent immunization coverage rates in an intervention and four comparison counties were compared over 1 year. We introduced practice-based interventions in seven practices centering on immunization registry-driven recall of adolescents for immunizations with postcard reminders (Phase 1), and 6 months later employed nontargeted school-generated telephone reminders to parents of adolescents (Phase 2)., Results: Improvements in the intervention county among 11- to 12-year-olds occurred for first-dose human papillomavirus vaccine in both boys (overall change, 14.2%-32.1%) and girls (27.4%-43.4%) and the meningococcal vaccine (34.6%-49.4%). Improvements among adolescents 13-18 years were limited to human papillomavirus vaccine completion in boys (1.6%-4.2%). Improvements were greater during Phase 1 than Phase 2 and among younger adolescents. Coverage improvements in the comparison counties were smaller than those observed in the intervention county., Conclusions: A resource-light two-phase intervention led to modest improvements in immunization coverage, most notably in the largest adolescent practice in the county, and suggested potential for further gains, particularly among younger adolescents., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

The National Children's Study, a longitudinal cohort study exploring relationships among broadly defined environmental exposures and children's health, is assessing whether these exposures are harmful, harmless, or helpful. The study is presently underway in 37 locations (2 of which are in North Carolina) and will expand to enroll 100,000 children across the United States.

Background: To determine the burden of rotavirus disease before the introduction of rotavirus vaccines., Methods: From February 2005 to June 2006, prospective rotavirus surveillance was conducted in Cincinnati, Ohio, and Durham, North Carolina. Children < 5 years of age presenting at hospitals and outpatient clinics with acute gastroenteritis (AGE) of < 72 hours duration were enrolled. Stool samples were first tested for rotavirus by EIA and the VP7 type was determined by RT-polymerase chain reaction for rotavirus-positive samples. Medical costs were obtained from billing or accounting data., Results: A total of 1998 children were enrolled, with a mean age of 16.9 months. Among 1601 (80%) patients with a stool specimen, 44% were rotavirus positive. The rotavirus detection rate was 38% for patients admitted to hospital, 60% for patients requiring a short-stay hospital visit (< 24 hour hospitalization), 49% for emergency department visits, and 37% for outpatient visits. During the rotavirus season, rotavirus accounted for 56% of all AGE cases. Only 11% of rotavirus-positive children were assigned the rotavirus-specific ICD-9-CM code and this proportion varied considerably by clinical setting. The VP7 genotypes identified were G1, 79%; G2, 14%; G3, 5%; G9, 1%; and G12, 1%. For children hospitalized with rotavirus, the estimated median direct cost was $4565, the average length of stay was 1.9 days, and parents lost 3.4 days of work. For short-stay, emergency department, and outpatient visits, the estimated median costs were $3160, $867, and $75, respectively., Conclusions: Before the widespread use of rotavirus vaccines in the United States, rotavirus was prevalent among children treated in hospital-based and outpatient settings and was associated with a substantial proportion of pediatric medical visits for AGE.