kahperd presentation - blevins, murphy, wells & rathbun

8/14/2019 KAHPERD Presentation - Blevins, Murphy, Wells & Rathbun

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Dispelling MythsDispelling MythsRegardingRegarding

Immunization andImmunization andAutismAutism

Kayla BlevinsKayla Blevins

Scott MurphyScott Murphy

Cindy WellsCindy Wells

Ann RathbunAnn Rathbun


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The Real QuestionThe Real Question

Health of the Public vs. IndividualHealth of the Public vs. IndividualFreedomFreedom

IsolationIsolation

QuarantineQuarantine

Mandatory immunizationsMandatory immunizations


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The ContextThe Context

Consumer HealthConsumer Health

A field of study that assesses what factsA field of study that assesses what factsexist about health & health care and howexist about health & health care and how

people go about distinguishing facts frompeople go about distinguishing facts frommisinformationmisinformation

Parents getting accurate infoParents getting accurate info


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Context - continuedContext - continued

Community HealthCommunity HealthPrivate and public (government) efforts ofPrivate and public (government) efforts of

individuals, groups and organizations toindividuals, groups and organizations to

protect and improve the health of theprotect and improve the health of thecommunity.community.

Public Health & ImmunizationsPublic Health & Immunizations

Re-emergence of diseaseRe-emergence of disease


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Consumer Health ProjectConsumer Health Project

Research Groups (2)Research Groups (2)

Interview GroupInterview Group

Material CreatorsMaterial CreatorsMaterial DistributorsMaterial Distributors

Advocacy GroupAdvocacy Group


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Consumer Health ProjectConsumer Health Project

Parents opting out of vaccination forParents opting out of vaccination forchildren.children.

Discovering why some children are notDiscovering why some children are notgetting immunized.getting immunized.MMRMMR

Chicken PoxChicken Pox

DTPDTP

Hepatitis A/BHepatitis A/B

MeningitisMeningitis


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Background/HistoryBackground/History

Wakefield et al, February 1998Wakefield et al, February 1998

Widely publicized in the British pressWidely publicized in the British press

MMR immunization rates fell fromMMR immunization rates fell from92% to 73%92% to 73%

Resulted in measles outbreakResulted in measles outbreak

First measles death in a decadeFirst measles death in a decadeStudy significantly flawed and discreditedStudy significantly flawed and discredited


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Community Health AssignmentCommunity Health Assignment

Mary Mallon ReadingsMary Mallon Readings

Discussion GuideDiscussion Guide

Class (small-group) DiscussionsClass (small-group) DiscussionsCase study questionsCase study questions


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Case StudiesCase Studies


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History of immunizations and crisesHistory of immunizations and crises

Mary Mallon (Typhoid)Mary Mallon (Typhoid)

Ellen Seigal (Small Pox)Ellen Seigal (Small Pox)

Andrew Speaker (TB)Andrew Speaker (TB)HPV (Factors affecting decision making)HPV (Factors affecting decision making)

SARS (Risk Communication)SARS (Risk Communication)

Smoking BansSmoking Bans


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At IssueAt Issue

Covenant Of TrustCovenant Of TrustDefinedDefined

Violation of Individual Rights Protected by theViolation of Individual Rights Protected by the

ConstitutionConstitution44thth Unreasonable search and seizure Unreasonable search and seizure

88thth No excessive cruel and unusual punishment No excessive cruel and unusual punishment

1010thth Limits the power of the Federal Government Limits the power of the Federal GovernmentReserved powers to the States or to the people.Reserved powers to the States or to the people.


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Typhoid MaryTyphoid Mary

Oyster Bay, New York in 1904Oyster Bay, New York in 1904 First recognized as a carrier of the typhoid bacteriaFirst recognized as a carrier of the typhoid bacteria She worked as a cookShe worked as a cook

1907: North Brother Island, Bronx, New York1907: North Brother Island, Bronx, New York

1910: Health Department released her on one condition; that1910: Health Department released her on one condition; thatshe never accept employment that involved the handling ofshe never accept employment that involved the handling offood.food.

1914: Another outbreak; she was returned to North Brother1914: Another outbreak; she was returned to North BrotherIsland.Island.

1938: Died after a paralytic stroke (6 years)1938: Died after a paralytic stroke (6 years) Fifty-one original cases of typhoid and three deaths wereFifty-one original cases of typhoid and three deaths were

directly attributed to Typhoid Mary.directly attributed to Typhoid Mary. She herself was immune to the typhoid bacillus. (She herself was immune to the typhoid bacillus. (SalmonellaSalmonella

typhityphi).).


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Andrew SpeakerAndrew Speaker

Atlanta man who had spent nearly two weeks traveling in theAtlanta man who had spent nearly two weeks traveling in theUnited States, Canada and EuropeUnited States, Canada and Europe

Extensively drug-resistant" tuberculosis.Extensively drug-resistant" tuberculosis. A rare and often fatal form of the infectionA rare and often fatal form of the infection Killed 52 of 53 South Africans in 2005/2006Killed 52 of 53 South Africans in 2005/2006

The Centers for Disease Control and Prevention imposed anThe Centers for Disease Control and Prevention imposed an"order of isolation" after he had left the U.S."order of isolation" after he had left the U.S.

Passed Canadian BorderPassed Canadian Border He was flown in a government plane on Memorial Day toHe was flown in a government plane on Memorial Day to

Atlanta, where he underwent treatment.Atlanta, where he underwent treatment. States occasionally use their authority to forcibly detain andStates occasionally use their authority to forcibly detain and

treat patients with infections.treat patients with infections. 1963 case1963 case


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Andrew Speaker (Cont.)Andrew Speaker (Cont.)

Ignored advice by Europe healthIgnored advice by Europe healthauthorities not to take a commercial flightauthorities not to take a commercial flight

home.home.

Broke the "Broke the "covenant of trustcovenant of trust"" Health authorities wanted to trace the peopleHealth authorities wanted to trace the people

who sat in his row and two rows in front of andwho sat in his row and two rows in front of and

behind him (transatlantic flights).behind him (transatlantic flights). Officials stated that the man had relatively littleOfficials stated that the man had relatively little

TB bacteria in his phlegm.TB bacteria in his phlegm.


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Ellen SiegelEllen Siegel

Small Pox CaseSmall Pox Case

New York City July 25, 1963New York City July 25, 1963

Ellen Siegel Mother of New York CityEllen Siegel Mother of New York Citylawyer: Helen Minkinlawyer: Helen Minkin

Federal isolation for 14 daysFederal isolation for 14 days

Stockholm small pox infected areaStockholm small pox infected areaNo proof of vaccination (small pox)No proof of vaccination (small pox)


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Factors likely to affect decisionFactors likely to affect decision

making:making: Many factors are likely to affect an immunizationMany factors are likely to affect an immunization

decision (HPV):decision (HPV): Individual beliefs about susceptibilityIndividual beliefs about susceptibility Perceptions of vaccine effectivenessPerceptions of vaccine effectiveness

Family and parental attitudesFamily and parental attitudes Sexual and cultural practicesSexual and cultural practices Provider attitudesProvider attitudes Reactions to qualities of the vaccine or immunizationReactions to qualities of the vaccine or immunization

program (e.g., out-of-pocket costs, mode of vaccineprogram (e.g., out-of-pocket costs, mode of vaccine

delivery).delivery). Fears about getting cervical cancerFears about getting cervical cancer Fairness for who gets the vaccine (poverty and abilityFairness for who gets the vaccine (poverty and ability

to pay)to pay)

Public fears discriminationPublic fears discrimination


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Smoking Bans

Kentucky Law

Prohibits smoking in any public buildingincluding but not limited to:

food service businesses bars

taverns

bingo and bowling centers

pool hall

public areas in hotels/motels

any other building with public access.


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Smoking Ban (Cont.)

Fines$100 for the first offence

$250 for the second offence

$500 for the third and after

ExemptionsPrivately owned homes

Businesses with designated smoking areas

Different for every County in Kentucky


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Solutions

EducationEducationFamilyFamily

PTA or PTOPTA or PTOHome ExtensionHome Extension

The PulpitThe PulpitLocal Health departments actions, publicityLocal Health departments actions, publicity

StudentsStudentsPublic SchoolsPublic Schools

School nursesSchool nurses

Comprehensive Health Education/Consumer healthComprehensive Health Education/Consumer health

http://www.cfah.org/hbns/PreparedPatient/Prepared-Patiehttp://www.cfah.org/hbns/PreparedPatient/Prepared-Patie
http://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfmhttp://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfmhttp://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfm


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Solutions

EducationEducationStudentsStudentsPublic SchoolsPublic Schools

School nursesSchool nursesComprehensive Health Education/ConsumerComprehensive Health Education/Consumer

healthhealth

http://www.cfah.org/hbns/PreparedPatient/Prepared-http://www.cfah.org/hbns/PreparedPatient/Prepared-
http://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfmhttp://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfmhttp://www.cfah.org/hbns/PreparedPatient/Prepared-Patient-Vol1-Issue3.cfm


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Solutions

Education, cont.Education, cont.Providers (doctors, nurses, NPs, PAs,Providers (doctors, nurses, NPs, PAs,

Pharmacists)Pharmacists)Have readable information for patientsHave readable information for patientsKnow your patients (social hx)Know your patients (social hx)

Cultural competence issuesCultural competence issues


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Solutions

Skill buildingSkill buildingCritical thinkingCritical thinking

Problem solvingProblem solving

Media literacyMedia literacy

Health literacyHealth literacy


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Advocacy

Talking, talking, talkingTalking, talking, talking

Letters to the editors, city leaders, countyLetters to the editors, city leaders, countyleadersleaders

The production of radio and televisionThe production of radio and televisionshows and documentariesshows and documentaries


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Advocacy

Radio appearancesRadio appearances

Public service announcementsPublic service announcements

Outreach to media and/or PressOutreach to media and/or Pressconferencesconferences

Lobbying government officialsLobbying government officials

Sponsorship of sporting eventsSponsorship of sporting events

kahperd presentation - blevins, murphy, wells & rathbun

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