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A MUMPS program called MAILBOX allows information to be more efficiently disseminated in a hospital department of clinical biochemistry. Readily accessible to all staff as the department is equipped with video display units in every laboratory and office, MAILBOX allows laboratory staff to send and read departmental messages; send, read, and save personal messages; sign in to and out of the department; and locate all other staff. Departmental messages containing information of general interest are automatically displayed on signing on to MAILBOX. Personal messages are directed to specific people, who are so informed when signing on; they can only be read by the sender and intended recipient(s). [ABSTRACT FROM PUBLISHER]

The processes of order entry, urinalysis result, and isoenzyme interpretation entry into a laboratory computer system is a time consuming activity. We have designed a series of forms for use with a digitising pad that allow us rapidly to enter orders, urinalysis results, and isoenzyme interpretative comments into our laboratory computer system. We have shown that digitiser entry is always significantly faster than manual entry. Although there are many devices available to facilitate computer entry, we believe that the digitiser technique is an attractive option because of its ease of use, speed, reliability, and low cost. [ABSTRACT FROM PUBLISHER]

Familial involvement has been shown to have a positive impact on children's speech/language development, as well as their social and educational progress. However, what about music? Children with normal hearing (NH) are often involved in informal music activities as part of their upbringing. Parents often incorporate music into everyday routine and in school, NH children are involved in music classes. Music participation for children with a hearing impairment (HI) does not always follow the same path as NH children as often more time is dedicated to speech/ language development, and parental attitudes and perceptions may shift regarding their child's musical potential. Many parents have the perception that their child may be less able at music lessons due to their HI, and do not engage them in musical activities as they would if the child had NH. This study aims to look at the role of music in families of children with and without hearing loss, to provide information for professionals and parents around integrating music into a HI child's day-to-day life. A study-specific questionnaire, the Role of Music in Families Questionnaire (RMFQ) was administered to parents/ guardians of children with 56 NH children and 25 children with a HI (17 with hearing aids, 8 with cochlear implants). The RMFQ included seven subsections covering: General Information, Childhood Music Participation and Experiences, Attitudes and Reactions to Music, Music Resources, Importance of Music in the Family, Child's Music Listening Preferences and Future Perspectives. Children were aged 2-6 years, and yet to start primary school. Results showed that, on average, music held a similar level of importance for NH and HI children's lives, and their family. The attitudes of both groups were overall very positive, with only a few significant differences such as more HI children learning percussive instruments compare to the NH children. There were differences in relation to the child's participation level and enjoyment, but the importance of music's role in the family is not dramatically differed by the presence of a hearing loss. [ABSTRACT FROM AUTHOR]

Abstract Background There is limited information on sleep duration and obesity among Australian children. The objective of the study is to cross-sectionally examine the relationship between sleep duration and obesity in Australian children aged 5 to 15 years. Methods Data were collected using the South Australian Monitoring and Surveillance System between January 2004 and December 2008. Each month a representative random sample of South Australians are selected from the Electronic White Pages with interviews conducted using Computer Assisted Telephone Interviewing (CATI). Within each household, the person who was last to have a birthday was selected for interview. Parents reported the number of hours their children slept each day. Obesity was defined according to the International Obesity Task Force (IOTF) definition based on BMI calculated from reported body weight and height. Results Overall, parents of 3495 children aged 5-15 years (mean 10.7 years, 50.3% boys) were interviewed. The prevalence of obesity was 7.7% (8.9% in boys, 6.6% in girls). In multivariate analysis after adjusting for sociodemographic variables, intake of fruit and vegetables, physical activity and inactivity, the odds ratio (OR) for obesity comparing sleeping Conclusion Short sleep duration is associated with increased obesity in children especially among younger age groups and boys.

Background: Catch-up vaccination is a personalised process through which children with missing recommended vaccinations or incomplete vaccination records are brought up to date with the Australian vaccination schedule. Navigating childhood catch-up vaccination can be difficult for migrant parents with inadequate health system knowledge and competing priorities during settlement. This study aimed to understand the experiences of migrant parents with childhood catch-up vaccination and co-design an intervention to improve the process., Methods: We recruited migrant parents who had attended the City of Melbourne Immunisation Service in Melbourne, Australia to participate in a qualitative co-design study between June and August 2022. Expression of interest emails were sent by the service, and we recruited eligible participants. In Phase One, we conducted group interviews with parents to understand their experiences and preferences for an intervention, these were analysed using inductive and framework analysis. In Phase Two, we designed prototype interventions based on parents' preferences and suggestions. In Phase Three, parents shared their feedback on each prototype., Results: Fourteen migrant parents participated in the study. Most parents did not discover the need for catch-up vaccination until childcare or kindergarten enrolment. The lack of information received about vaccination requirements and difficulty navigating the health system made the process challenging and time-consuming. Based on these Phase One themes, we designed a printout, mobile application, and website prototype. All three were well-received in Phase Three. Overall, parents' top three considerations for any intervention were 1) digital and online accessibility, 2) inclusion of step-by-step processes outlining catch-up vaccination; and 3) inclusion of a checklist., Conclusions: Migrant parents lack information about childhood catch-up vaccination in Australia. A relatively simple intervention could help parents more easily navigate the process, thereby saving time and stress. The next steps are to seek funding to pilot such an intervention to assess practicality and usefulness., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JT is an investigator on a project grant sponsored by Industry. Her institution has received funding from Industry (GlaxoSmithKline) for investigator-led research. She does not receive any personal payments from Industry. All other authors have no conflicts to declare. They declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The aim of this study was to explore the relationship between parental vaccine hesitancy and vaccine coverage for all recommended vaccines for children under five years residing in Statistical Areas Level 3 (SA3). SA3 groupings represent clustering groups of smaller areas, such as regional towns and cities or clusters of related suburbs, which share similar regional characteristics, administrative boundaries or labour markets, and generally have populations between 30,000 and 130,000 persons., Methods: We used parental vaccine hesitancy data from the VBAT (Vaccine Barrier Assessment Tool) study and vaccine coverage by postcode data from the Australian Immunisation Coverage Report 2020/21. Binary logistic regression analysis explored the association., Results: There were complete data for 1110 participants. We found lower vaccine concerns in parents residing in medium coverage (adjusted odds ratio (aOR) 0.36, 95 % confidence interval (CI): 0.22 to 0.59) and high coverage (aOR 0.37, 95 % CI: 0.22 to 0.60) SA3 areas compared to low coverage geographical areas., Conclusions: Developing effective policies to vaccinate children under five in low coverage areas will help reduce vaccine inequity in Australia. Future strategies to improve vaccine coverage should consider ways to address both access and acceptance barriers., Competing Interests: Declaration of competing interest JT is an investigator on a project grant sponsored by Industry. Her institution has received funding from Industry (GlaxoSmithKline) for investigator-led research. She does not receive any personal payments from Industry. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Data on routine childhood vaccination coverage can only tell us who is under-vaccinated; it cannot explain why vaccine coverage is low. Collecting data on the reasons behind under-vaccination is necessary to implement cost-effective strategies that address key barriers and target interventions appropriately. However, no instruments that measure both vaccine acceptance and access factors among parents of children <5 y have been validated in high-income countries. This study aims to develop and validate the Vaccine Barriers Assessment Tool (VBAT) for Australia. We applied three phases of mixed methods data collection and analysis. In Phase 1, we developed a comprehensive list of 80 items reflecting all potential parental barriers to childhood vaccination, derived from published literature and behavioral theory. Through cognitive interviews ( n  = 28), we refined this list to 45 items. In Phase 2, we conducted a two-wave online survey to test the reliability and validity of these items in an Australian sample of parents ( n  = 532) with structural equation modeling, further refining the list to 35 items. In Phase 3, we conducted a final parent survey ( n  = 156), administering these items along with the Parent Attitudes toward Childhood Vaccination (PACV) scale for comparison. We reviewed participants' immunization register data to assess the predictive validity of the proposed models. The final 6-item short form and 15-item long form Vaccine Barriers Assessment Tool assess access, communal benefit, personal risk, equity, commitment, social norms, and trust in health-care workers. It is being applied for national surveillance in Australia and will be adapted for additional populations and vaccines.

Background: Adolescents with disability have lower vaccination rates than the general population, including HPV vaccination. Understanding the multi-level influences on vaccination in specialist schools is crucial to achieve optimal vaccination coverage and vaccination experiences for adolescents living with disability., Objective: To identify and improve understanding of the facilitators and barriers of HPV vaccination among adolescents with intellectual disabilities or autism in Victorian specialist schools to inform strategies to increase vaccination acceptance and uptake., Methods: Qualitative interviews with key stakeholders (adolescents with disabilities, parents, school and council immunisation staff) from six specialist schools in Victoria, Australia. Data were analysed thematically. Inductively derived themes were then deductively mapped across the UNICEF 'Journey to Immunization' model., Results: 32 interviews were conducted with stakeholders (2 adolescents, 7 parents, 13 school staff, 10 council staff). Trust in vaccines was high, but knowledge of the HPV vaccine was limited. Barriers included lack of accessible information for parents, the consent process, behavioural challenges and vaccine-related anxiety among students. The immunisation program in special schools was perceived as convenient, however preparing students for vaccination day and catering to individual student needs were key. Participants expressed a need for more parent information about options and additional support for vaccination outside of the school program., Conclusions: Our study identified a range of facilitators and barriers to the school immunisation program for students with disabilities in specialist schools. The next phase of this work will use co-design workshops to build on the suggestions for improvement and opportunities that could be leveraged to improve vaccination uptake., (© 2024. The Author(s).)

Background: An asymptomatic COVID-19 rapid antigen testing (RAT) screening program was implemented in Victorian schools in January 2022, to support keeping schools open throughout the pandemic. This study explored compliance with the program among caregivers from priority populations in Victorian mainstream and specialist schools., Methods: We conducted semi-structured interviews between 7-31 March 2022 with caregivers of school-aged children participating in the RAT program in Victoria. Participants were asked about awareness, acceptability, compliance, frequency, and barriers to testing. Recordings were transcribed and deductively analysed using a framework approach., Results: Fifty caregivers participated. They expressed confusion about the 'recommended' program, assuming it was mandatory. Caregivers wanted notification from schools of positive cases to increase motivation for compliance. Culturally and linguistically diverse (CALD) families were compliant; however, in-language resources were limited. Aboriginal or Torres Strait Islander (Koori) families tested less regularly and received information from their community rather than school. Caregivers of children living with disabilities reported behavioural challenges to testing, resulting in distress or non-compliance, and received non-specific information for their children., Conclusions: To increase engagement with future surveillance programs, caregivers need clarity about optionality, conducting tests, reporting results, and timely notification of cases. Requirements unique to each priority population include: accurate in-language information for CALD caregivers, community-led communication for Koori caregivers, tailored information, less testing, and flexibility for caregivers of children living with a disability. Keeping schools open and having tailored strategies to ensure equitable access for priority populations are essential for future pandemic management., Competing Interests: MD received funding from the Victorian Department of Health for this and other projects. MD was seconded to the Victorian Department of Health from October 2021 to February 2022. JT received funding from GlaxoSmithKline for investigator-led research. All other authors declare no competing interests.

Introduction: Children with chronic medical diseases are at an unacceptable risk of hospitalisation and death from influenza and SARS-CoV-2 infections. Over the past two decades, behavioural scientists have learnt how to design non-coercive 'nudge' interventions to encourage positive health behaviours. Our study aims to evaluate the impact of multicomponent nudge interventions on the uptake of COVID-19 and influenza vaccines in medically at-risk children., Methods and Analyses: Two separate randomised controlled trials (RCTs), each with 1038 children, will enrol a total of approximately 2076 children with chronic medical conditions who are attending tertiary hospitals in South Australia, Western Australia and Victoria. Participants will be randomly assigned (1:1) to the standard care or intervention group. The nudge intervention in each RCT will consist of three text message reminders with four behavioural nudges including (1) social norm messages, (2) different messengers through links to short educational videos from a paediatrician, medically at-risk child and parent and nurse, (3) a pledge to have their child or themselves vaccinated and (4) information salience through links to the current guidelines and vaccine safety information. The primary outcome is the proportion of medically at-risk children who receive at least one dose of vaccine within 3 months of randomisation. Logistic regression analysis will be performed to determine the effect of the intervention on the probability of vaccination uptake., Ethics and Dissemination: The protocol and study documents have been reviewed and approved by the Women's and Children's Health Network Human Research Ethics Committee (HREC/22/WCHN/2022/00082). The results will be published via peer-reviewed journals and presented at scientific meetings and public forums., Trial Registration Number: NCT05613751., Competing Interests: Competing interests: HM acknowledges support from the National Health and Medical Research Council of Australia: Practitioner Fellowship (APP1155066). CCB acknowledges support from the National Health and Medical Research Council of Australia: Investigator Grant (APP1173163). HM is an independent investigator on clinical trials of investigational vaccines manufactured by pharmaceutical companies including Pfizer, ILiAD Biotechnologies and Merck. The institution at which HM, BW and PA are employed has received funding for investigator-led research from GlaxoSmithKline, Sanofi-Pasteur and Pfizer Vaccines. All authors receive no personal payments from industry. There are no other conflicts of interest to declare., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Objective: This systemic review aimed to evaluate the effectiveness of interventions for increasing the uptake of immunisation in healthcare workers (HCWs) compared to no or alternative interventions., Methods: A systematic review was undertaken (until March 2022) using a search strategy established a priori to capture studies that examined the effect of interventions on vaccination levels in HCWs. We included randomised controlled trials (RCT), cluster RCTs, controlled before-after (CBA) studies and interrupted time-series (ITS) studies. We described studies descriptively and synthesized results with a fixed-effect or random-effects model meta-analysis, where appropriate. The risk of bias was assessed for each study; the quality evidence per comparison was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE)., Results: We identified three RCTs, six cluster RCTs and four ITS studies. There was a diverse range of interventions; many included an educational component. Based on the evidence examined the following may be effective strategies in increasing the proportion of HCWs vaccinated: policy interventions, targeted and multicomponent strategies, tailored programs directed at management, physician delivered education with a vaccine 'champion' and individual decision analysis. Limited eligible studies restricted synthesis and interpretation of findings. No studies evaluated the effectiveness of legislation. Nor did we find studies evaluating the effectiveness of incentives on their own or studies focusing solely on improving access to vaccination. We judged all the studies as either unclear or high risk of bias., Conclusion: Few robust studies that evaluate interventions to increase vaccination in HCWs are available. A limitation of this systematic review is that interventions are diverse, poorly reported and few were sufficiently alike to combine in an evaluation. More research on the effects of interventions to increase vaccination in HCWs is required, this should address a variety of vaccines and not just influenza vaccination., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: KR and HM report no conflict. JT is an investigator on a project grant sponsored by Industry. Her institution has received funding from Industry (GSK) for investigator led research. She does not receive any personal payments from Industry. SS reports funding from the Workers’ Compensation Board of Alberta. MD is supported by an MCRI Clinician Scientist Fellowship and receives funding from the Victorian and Commonwealth Departments of health, NHMRC, WHO, DFAT and philanthropy. HSM is supported by a NHMRC Practitioner fellowship and receives Commonwealth and State health funding for research. She is an investigator on clinical vaccine trials sponsored by Industry (Pfizer, GSK). Her institution receives funding for Investigator led research from GSK, Pfizer, Sanofi-Pasteur., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction: This study aimed to understand barriers and enablers, future strategies, communication approaches and resources needed for COVID-19 vaccination among migrant communities in Melbourne, Australia., Material and Methods: We interviewed 24 immunisation providers who deliver immunisation services to migrant populations in Melbourne. We used the WHO Behavioural and Social Drivers framework (underlined) to organise barriers and enablers to COVID-19 vaccination., Results: Participants believed migrants had concerns about vaccine safety and efficacy and saw vaccines as minimally beneficial in the 'low COVID-19' environment of Australia (what people think and feel). Healthcare providers with established relationships within migrant communities played key roles in vaccine advocacy (social processes). Migrants' vaccine motivation was mediated by health literacy, institutional trust and previous experiences with health services. Practical issues included perceived lack of information on vaccine booking process and accessibility challenges., Conclusions: Strategies to increase migrant vaccine coverage should utilise immunisation providers with community links and trusted local vaccine ambassadors to engage and address community vaccine concerns., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Influenza and COVID-19 infections during pregnancy may have serious adverse consequences for women as well as their infants. However, uptake of influenza and COVID-19 vaccines during pregnancy remains suboptimal. This study aims to assess the effectiveness of a multi-component nudge intervention to improve influenza and COVID-19 vaccine uptake among pregnant women., Methods: Pregnant women who receive antenatal care at five tertiary hospitals in South Australia, Western Australia and Victoria will be recruited to two separate randomised controlled trials (RCTs). Women will be eligible for the COVID-19 RCT is they have received two or less doses of a COVID-19 vaccine. Women will be eligible for the influenza RCT if they have not received the 2023 seasonal influenza vaccine. Vaccination status at all stages of the trial will be confirmed by the Australian Immunisation Register (AIR). Participants will be randomised (1:1) to standard care or intervention group (n = 1038 for each RCT). The nudge intervention in each RCT will comprise three SMS text message reminders with links to short educational videos from obstetricians, pregnant women and midwives and vaccine safety information. The primary outcome is at least one dose of a COVID-19 or influenza vaccine during pregnancy, as applicable. Logistic regression will compare the proportion vaccinated between groups. The effect of treatment will be described using odds ratio with a 95% CI., Discussion: Behavioural nudges that facilitate individual choices within a complex context have been successfully used in other disciplines to stir preferred behaviour towards better health choices. If our text-based nudges prove to be successful in improving influenza and COVID-19 vaccine uptake among pregnant women, they can easily be implemented at a national level., Trial Registration: ClinicalTrials.gov Identifier NCT05613751. Registered on November 14, 2022., (© 2023. Crown.)

Importance: Children with chronic medical conditions are at increased risk of severe influenza. Uptake of influenza vaccination in children and adolescents with these identified special risk medical conditions (SRMCs) is suboptimal., Objective: To assess the effectiveness of Flutext-4U, a parent short message service (SMS) reminder nudge intervention, in increasing influenza immunization in children and adolescents with SRMCs., Design, Setting, and Participants: This randomized clinical trial was conducted at a tertiary pediatric hospital in Adelaide, South Australia, from April 15 to September 30, 2021. Children and adolescents aged 6 months to younger than 18 years with SRMCs and a subspecialist outpatient appointment over a 5-month period during the Australian seasonal influenza vaccination season (April-August 2021) were eligible to participate. Follow-up was until September 30, 2021., Interventions: Participants were randomly assigned (1:1 ratio) to control: clinician nudges (hospital vaccine availability, ease of access, and recommendation from hospital subspecialists) or SMS intervention (control conditions plus an additional SMS reminder nudge to parents), with randomization stratified by age group (<5 years, 5-14 years, or >14 to <18 years)., Main Outcomes and Measures: The primary outcome was influenza vaccination, as confirmed by the Australian Immunisation Register., Results: A total of 600 participants (intervention group: 298 [49.7%]; mean [SD] age, 11.5 [4.6] years; 162 female participants [54.4%]; control group: 302 [50.3%]; mean [SD] age, 11.4 [4.7] years; 155 female participants [51.3%]) were included. Influenza vaccination was 38.6% (113 of 293) in the SMS intervention group compared with 26.2% (79 of 302) in the control group (adjusted odds ratio [aOR], 1.79; 95% CI, 1.27-2.55; P = .001). Time to vaccine receipt was significantly lower among SMS participants (adjusted hazard ratio, 1.67; 95% CI, 1.25-2.22; P < .001). For participants randomly assigned by June 15, a significantly greater proportion receiving the SMS intervention were vaccinated during the optimal delivery period April to June 30 (SMS group: 40.0% [76 of 190] vs 25.4% [50 of 197]; aOR, 1.97; 95% CI, 1.28-3.06; P = .002)., Conclusions and Relevance: Results of this randomized clinical trial suggest that an additional SMS reminder nudge for parents delivered in the tertiary care hospital setting to children and adolescents with SMRCs resulted in higher influenza vaccine uptake compared with clinician nudges alone., Trial Registration: ANZCTR Identifier: ACTRN12621000463875.