1. STOP THE FLU Chaminade University of Honolulu NUR 401: Public Health Nursing By: Alyssa Antonio, Sharlene Daligcon, Joelle Devera, Brittany Fuller, Skye Lam Ho, Satzy Pulido, Jasmine Rapisura, and Jason Savaria, with Professor Anna Motteler BSN, RN-BC 2. Fall 2014: Cohort #1 Clinical assignment: Determine how effective school based flu clinics are in increasing flu vaccine rates versus other alternative flu vaccine providers/clinics available in the community. Literature review and recommendations Conducted a survey at the Children and Youth Day Fair at the Capitol Discussion & matrix of alternative flu vaccine providers in the community 3. Fall 2014: Cohort #2 Clinical assignment Determine how the DOH PHNs and Immunization Branch can target parents and families of school age children to educate them on the importance and benefits of influenza vaccines and to increase influenza vaccine rates. Also, discuss what the literature says about trust, beliefs and safety in the influenza vaccine and what that means to parents. Literature review and recommendations Meta-analysis Designed a mobile application for SFAS including consent, education and VIS forms 4. The Problem/Question The Stop Flu at School (SFAS) Program Flu vaccines for the general public o Costs and coverages Similar programs in the US mainland and other countries Literature reviews related to school-based programs Recommendations for Public Health nurses Literature review with recommendations Performed island wide assessment of community flu vaccine providers Created tool for PHNB containing field research findings 5. Literature Reviews A Survey of Physician-Led Influenza Immunization Programs in Schools How Rural and Urban Parents Describe Convenience in the Context of School-Based Influenza Vaccination: A Qualitative Study School-Based Influenza Vaccination: Parents Perspectives Influenza Vaccination of School Children and Influenza Outbreaks in a School Effect of School Closure on the Incidence of Influenza Among School-Aged Children in Arizona Implementing and Sustaining School-Located Influenza Vaccination Programs: Perspectives From Five Diverse School Districts School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-Like Illness Emergency Care Visits Reaching Children Never Previously Vaccinated for Influenza Through a School-Located Vaccination Program 6. A Survey of Physician-Led Influenza Immunization Programs in Schools Led by Pediatric Physicians TAIV and LIV offered to schools Motivation was need to protect children Continuity has expanded to 13 schools over 2 -3 years Vaccines for Children program supplied vaccines Recommendations Continue to apply for grants for funding Work with smaller schools Utilize nursing schools as volunteers 7. How Rural and Urban Parents Describe Convenience in the Context of School-Based Influenza Vaccination Rural vs. Urban Rural 22.5 vs Urban 366 opportunities for vaccination Transportation: other communities & traffic jams Similarities Reduction in parental scheduling burden Reduction in parental lost time & stress Increased physical access Convenience potentially increases uptake of vaccine 8. School-Based Influenza Vaccination: Parents Perspectives Perceptions of parents of school aged children in Alberta, Canada Parents described advantages, disadvantages, and implications Advantages: o Emotional support o Convenient o Decrease in lost time Disadvantages: o Communication o Feeling pressured o Cost Consulting with parents is essential 9. Influenza Vaccination of School Children and Influenza Outbreaks in a School Aim of Study To demonstrate effectiveness of flu program Investigate flu vaccine coverage rates Total number of class cancellation days Absentee rates in an elementary school Data Collected during 1984-2007 flu seasons Recommendations Moderate increase in vaccinations Continuation of flu vaccines for schoolchildren 10. Effect of School Closure on the Incidence of Influenza Among School-Aged Children in Arizona Study: School-aged children in Arizona Over four year span o 2004-2005, 2005-2006, 2006-2007, 2007-2008 School closure during winter holidays o Lower influenza rates Recommendations o Encourage and recommend flu vaccines o Provide educational pamphlets for parents What is the flu vaccine Why flu vaccine is important Proper hand washing etc. o Ensure community needs are met 11. Implementing and Sustaining School-Located Influenza Vaccination Programs: Perspectives From Five Diverse School Districts Study: five Los Angeles school districts Observed over three influenza seasons o Pilot season: 2007-2008 o Seasons 2 & 3: 2009-2010, 2010-2011 Based on district needs, programs were tailored Recommendations o Look to resources already in place o Utilize available nursing staff and community partnerships o Avoid pressure of creating large-scale programs 12. School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-Like Illness Emergency Care Visits Study conducted in Alachua, Florida Compared against other counties not provided School located influenza Vaccinations Influenza Vaccination made available for all school children (5-17 years old) Reported 70-79% reduction of flu-like illness hospital admissions compared to other counties 13. Reaching Children Never Previously Vaccinated for Influenza Through a School-Located Vaccination Program Summary of in-school immunization clinic article Improving vaccination coverage of children Methods used to advertise vaccination program Data collected based off study Recommendations based off of article data Media implementation for advertisement Automated voice calling to parents of students 14. Matrix By Sections 15. West Honolulu (WHON) Grocery Store Pharmacies Prices (Cheapest to Expensive) Ages/Types of vaccinations offered Insurance Wal-Mart and Costco Prices Ages/Types of vaccinations offered Insurance Clinics Prices Ages/Types of vaccinations offered What insurance is needed 16. East Honolulu (EHON) Grocery Store Pharmacies Times Supermarket Longs Drugs Walgreens Safeway Mina Pharmacy Sams Club Costco Walmart Clinics Wakiki Health Clinic Student Health Services (University of Hawaii-Manoa) Straub Outpatient Clinic Queen Emma Clinic Kapiolani Outpatient Clinic Island Urgent Care & Kahala Urgent Care Shriners Hospital Outpatient Clinic 17. Windward Oahu (WW) Grocery Store Pharmacies Times Supermarket CVS minute Clinic Walgreens Safeway Longs Drug Pharmacy Clinics Kaiser Permanente The Medical Corner Straub Family Clinic Waimanalo Health Center Braun Urgent Care Reis Pediatrics Trade Winds Family Medicine Oahu Medical Group Haleiwa Family Health Center Government Agencies Kaneohe MCBH 18. Central Oahu (CONS) Grocery Store Pharmacies Times Supermarket Longs Drugs Walgreens CVS Minute Clinic Target Sams Club Costco Clinics Straub: Mililani Family Health Center; Pearlridge Kaiser Permanente: Waipio US Med Urgent Care: Pearl City Hospital Pharmacies Pali Momi Medical Center Pharmcare Tripler Army Medical Center (Govt Agency) 19. Leeward Oahu (LONO) Grocery Store Pharmacies Walgreens CVS Minute Clinic Safeway One Minute Clinics Times Pharmacy K-Mart Wal-Mart Target Safeway Clinics Kaiser Permanente: Kapolei; Nanaikeola Waianae Coast Comprehensive Health Center Waianae Kapolei Nanakuli Waiola Waipahu 20. Questions 21. References Hull, H.F. (2010). A survey of physician-led influenza immunization programs in schools. Clinical Pediatrics 49(5), 439-442. doi 10.1177/0009922809346573 Kansagra, S.M., Papadouka, V., Geevarughese, A., Hansen, M.A., Konty, K.J. & Zucker, J.R. (2014). Reaching Children Never Previously Vaccinated for Influenza Through a School-Located Vaccination Program. American Journal of Public Health, 104(1), e45-e49. doi: 10.2015/AJPH.2013.301671 Kawai, S., Nanri, S., Ban, E., Inokuchi, M., Tanaka, T., Tokumura, M., & Sugaya, N. (2011). Influenza vaccination of schoolchildren and influenza outbreaks in a school. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 53(2), 130-136. doi:10.1093/cid/cir336 Lind, C., Russell, M.L., Collins, R., MacDonald, J., Frank, C.J., & Davis, A.E. (2014). School-Based Influenza Vaccination: Parents Perspectives. Plos ONE, 9(3), 1-12. doi:10.1371/journal.pone.0093490 Lind, C., Russell, M.L., Collins, R., MacDonald, J., Frank, C.J., & Davis, A.E. (2015). How rural and urban parents describe convenience in the context of school-based influenza vaccination: a qualitative study. BMC Health Services Research, 15(1), 24. Tran, C. H., Sugimoto, J. D., Pulliam, J. C., Ryan, K. A., Myers, P. D., Castleman, J. B, & Jr.Morris, J. G. (2014).School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-LikeIllness Emergency Care Visits. Plos ONE, 9(12), 1-17. Retrieved from https://ezproxy.chaminade.edu/login?url=http://search.ebscohost.com/login.aspx direct=true&db=aph&AN=100186608&site=ehost-live. Wheeler, C.C., Erhart, L.M., & Jehn, M.L. (2010). Effect of school closure on the incidence of influenza among school-age children in Arizona. Public Health Reports (Washington, D.C.: 1974), 125(6), 851-859. Wilson, D., Sanchez, K. M., Blackwell, S. H., Weinstein, E., & El Amin, A. N. (2013). Implementing and sustaining school-located influenza vaccination programs: Perspectives from five diverse school districts. The Journal of School Nursing, 29(4) , 303-14. doi:http://dx.doi.org/10.1177/1059840513486011