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NEWS
Not Getting Through: Vaccination Message Is Ineffective Scare tactics can backfire; subtler messaging might be more useful.
Measles rash on a child’s face and torso. Photo by Dr. M.A. Ansary / Science Photo Library.
O
utbreaks of vaccine- preventable illnesses have made frequent headlines in the news over the past few years.
Some recent, well-publicized outbreaks in the United States include 49 cases of measles in California in the first three months of 2014 and 123 confirmed cases of mumps, as of April 3, in the Columbus, Ohio, area. Driving the outbreaks, in part, is reduced compliance with MMR vaccination requirements. Overall, according to the 2011 National Immunization Survey, U.S. MMR vaccination rates among children 19 to 35 months of age exceeded the target rate of 90%, but 15 states fell below that threshold, with some areas significantly lower as a result of clusters of undervaccinated children. The prevalence of vaccine-safety fears and increasing requests for exemptions make maintaining optimal vaccination rates difficult.
NewsCAPS
A promising decline in early elective deliveries. Early elective deliveries, such as ce-
sarean sections performed for the sake of convenience before 39 weeks of pregnancy, lead to longer hospital stays—including stays in neonatal ICUs—and higher costs to patients and payers. But the number of such deliveries has declined sharply, from 17% in 2010 to 4.6% in 2013, reports the Leapfrog Group. Elective deliveries dropped for the third consecutive year and for the first time hit the target rate of less than 5%. Of the 969 hospitals that participated in the group’s 2013 survey, 71% met that target, compared with 46% of those surveyed in 2012. See the Hospital Safety Scores at www.leapfroggroup.org/cp. Asian Diabetes Prevention Initiative Web site launches. Because Asians—from India
to China to the Middle East—are at higher risk for type 2 diabetes than people of European backgrounds, and because 60% of all people with diabetes in the world live in Asia, experts at the Harvard School of Public Health and the National University of Singapore created the Asian Diabetes Prevention Initiative to educate patients and health care providers on diabetes prevention in this population. Asians are more prone to diabetes because they have more abdominal fat and less muscle, which increases insulin resistance. White rice and refined grains, which have been linked to diabetes risk, form a large part of Asian diets. Urbanization has resulted in lifestyles that involve less physical activity and the consumption of more Western-style fast food. In addition, about half of Asian men smoke, raising their risk of diabetes by 45%. Read more at http://bit.ly/1hNk56L. 16
AJN ▼ June 2014
▼
Vol. 114, No. 6
In an effort to increase compliance, researchers used a nationally representative survey of 1,759 parents of children 17 years old and younger to test four likely interventions: debunking the belief that MMR causes autism; providing information about the symptoms and adverse effects of mumps, measles, and rubella; sharing a story about an infant who almost died from the measles; and showing images of children with the diseases. The first three interventions used language taken almost verbatim from the Centers for Disease Control and Prevention. The researchers found that debunking the autism–MMR link did in fact reduce misperceptions about the connection; even so, it didn’t reduce parents’ concerns about adverse effects and in fact, among those parents with the least favorable attitudes toward vaccination, it reduced the intention to vaccinate. Additionally, emphasizing the risks of the diseases and showing images of sick children only increased the parents’ fears. Because none of the interventions devised by public health authorities appears to increase parents’ intention to vaccinate their children, the study authors conclude that “the best response to false beliefs is not necessarily providing correct information,” and that scare tactics can backfire. What approaches can work remains to be seen; subtler messaging might be effective, and having a trusted source, such as a health care provider, deliver the message could make a difference. —Laura Wallis Nyhan B, et al. Pediatrics 2014;133(4): e835-e842. ajnonline.com
NEWS
Not Getting Through: Vaccination Message Is Ineffective Scare tactics can backfire; subtler messaging might be more useful.
Measles rash on a child’s face and torso. Photo by Dr. M.A. Ansary / Science Photo Library.
O
utbreaks of vaccine- preventable illnesses have made frequent headlines in the news over the past few years.
Some recent, well-publicized outbreaks in the United States include 49 cases of measles in California in the first three months of 2014 and 123 confirmed cases of mumps, as of April 3, in the Columbus, Ohio, area. Driving the outbreaks, in part, is reduced compliance with MMR vaccination requirements. Overall, according to the 2011 National Immunization Survey, U.S. MMR vaccination rates among children 19 to 35 months of age exceeded the target rate of 90%, but 15 states fell below that threshold, with some areas significantly lower as a result of clusters of undervaccinated children. The prevalence of vaccine-safety fears and increasing requests for exemptions make maintaining optimal vaccination rates difficult.
NewsCAPS
A promising decline in early elective deliveries. Early elective deliveries, such as ce-
sarean sections performed for the sake of convenience before 39 weeks of pregnancy, lead to longer hospital stays—including stays in neonatal ICUs—and higher costs to patients and payers. But the number of such deliveries has declined sharply, from 17% in 2010 to 4.6% in 2013, reports the Leapfrog Group. Elective deliveries dropped for the third consecutive year and for the first time hit the target rate of less than 5%. Of the 969 hospitals that participated in the group’s 2013 survey, 71% met that target, compared with 46% of those surveyed in 2012. See the Hospital Safety Scores at www.leapfroggroup.org/cp. Asian Diabetes Prevention Initiative Web site launches. Because Asians—from India
to China to the Middle East—are at higher risk for type 2 diabetes than people of European backgrounds, and because 60% of all people with diabetes in the world live in Asia, experts at the Harvard School of Public Health and the National University of Singapore created the Asian Diabetes Prevention Initiative to educate patients and health care providers on diabetes prevention in this population. Asians are more prone to diabetes because they have more abdominal fat and less muscle, which increases insulin resistance. White rice and refined grains, which have been linked to diabetes risk, form a large part of Asian diets. Urbanization has resulted in lifestyles that involve less physical activity and the consumption of more Western-style fast food. In addition, about half of Asian men smoke, raising their risk of diabetes by 45%. Read more at http://bit.ly/1hNk56L. 16
AJN ▼ June 2014
▼
Vol. 114, No. 6
In an effort to increase compliance, researchers used a nationally representative survey of 1,759 parents of children 17 years old and younger to test four likely interventions: debunking the belief that MMR causes autism; providing information about the symptoms and adverse effects of mumps, measles, and rubella; sharing a story about an infant who almost died from the measles; and showing images of children with the diseases. The first three interventions used language taken almost verbatim from the Centers for Disease Control and Prevention. The researchers found that debunking the autism–MMR link did in fact reduce misperceptions about the connection; even so, it didn’t reduce parents’ concerns about adverse effects and in fact, among those parents with the least favorable attitudes toward vaccination, it reduced the intention to vaccinate. Additionally, emphasizing the risks of the diseases and showing images of sick children only increased the parents’ fears. Because none of the interventions devised by public health authorities appears to increase parents’ intention to vaccinate their children, the study authors conclude that “the best response to false beliefs is not necessarily providing correct information,” and that scare tactics can backfire. What approaches can work remains to be seen; subtler messaging might be effective, and having a trusted source, such as a health care provider, deliver the message could make a difference. —Laura Wallis Nyhan B, et al. Pediatrics 2014;133(4): e835-e842. ajnonline.com
