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Amy B Middleman

Publications and source records attributed to Amy B Middleman.

10 recordsLinked to original sources
PubMed2006

Vaccination: an opportunity to enhance early adolescent preventative services.

New vaccines are being developed that will be recommended for adolescents Adolescence is a time period when adolescent-parent dynamics change and when adolescents may be confronted with increasing opportunities to engage in risk-taking behaviors such as sexual behavior and substance use. Despite clear recommendations regarding preventative counseling, many adolescents do not receive adequate preventive care. In this manuscript, we provide suggestions as to how a new vaccination schedule can be used to enhance preventative services to both adolescents and their parents.

Adolescent↗
PubMed2006

Immunization update: pertussis, meningoccocus, and human papillomavirus.

New vaccines are being recommended for adolescents at a brisk pace. Immunization is an effective preventive measure, and by bringing adolescents in for a medical intervention, the new vaccines promise not only to protect adolescents from the specific diseases they address, but also to enhance other health care services, including screening for other health risk behaviors. This article discusses the newest vaccination recommendations for adolescents pertaining to the meningococcal and tetanus, diphtheria, and acellular pertussis vaccines and reviews the human papillomavirus vaccines developed for use in the United States. With the advent of these new vaccines, the potential exists to improve adolescent health significantly through prevention, adding new incentive to increase adolescent immunization rates for all indicated vaccines.

Adolescent↗
PubMed2006

Adolescent immunizations: a position paper of the Society for Adolescent Medicine.

New vaccines are being targeted to help protect the adolescent population from disease. The Society for Adolescent Medicine strongly urges compliance with adolescent vaccination recommendations provided by the Advisory Committee on Immunization Practices. These vaccines will significantly impact the health and well-being of the adolescent population. To enhance vaccination compliance and access to prevention health care and promotion, the Society supports linking vaccination to the three distinct comprehensive preventive health care visits already recommended by multiple organizations during early, middle, and late adolescence. In addition, multiple provider strategies should be used to increase vaccination rates among adolescents.

Adolescent↗
PubMed2005

An evaluation of school-level factors used in a successful school-based hepatitis B immunization initiative.

PURPOSE: To examine the effect of different school-level factors on the percent return of consent or refusal forms, the percent student participation/enrollment rate, and the percent completion rate of all 3 immunizations in the vaccination series in a school-based hepatitis B immunization initiative. METHODS: The Houston Hepatitis B Immunization Initiative (HBII) was conducted from 1998 through 2001 to provide free hepatitis B immunizations to elementary school students in low socioeconomic areas. At the end of each academic school year, the nurse from each school participating in the initiative was asked to complete a survey evaluating the different strategies utilized in each school to aid in the program's success. The effect of different organizational methods on rate of return of consent/refusal forms, participation rates, and immunization completion rates from the program year 1999-2000 was determined using frequencies, Mann-Whitney analyses, Kruskal-Wallis analyses, and Spearman's correlations. RESULTS: An increase in percent return of signed consent/refusal forms was more likely when teachers helped in publicity/promotion (p = .012) and educational packet distribution (p = .041). Additionally, when teachers assumed responsibility for collecting the forms, the percent return of signed consent/refusal forms (p = .018) and the percent of students receiving all 3 vaccines in the series through HBII (p = .030) were more likely to increase. An increase in signed consent/refusal forms returned was also associated with increased rates of student participation in the program for each school. In schools where students helped specifically with educational packet distribution (p = .039), the percent of students receiving at least 1 vaccine dose from the program was more likely to be higher. CONCLUSIONS: The involvement of teachers in vaccination programs is very important for program success, especially in the enrollment and return of consent/refusal form phases of immunization initiatives. Student involvement may empower the students and encourage other students to participate in the program. Future school-based immunization initiatives can utilize these data to incorporate the most effective school-level factors into their programs to maximize the number of students immunized.

Child↗
PubMed2004

Race/ethnicity and gender disparities in the utilization of a school-based hepatitis B immunization initiative.

OBJECTIVE: To determine if participation and completion rates in a school-based hepatitis B vaccination program differ based on individual demographic factors including insurance status, race, and gender. METHODS: From 1998 through 2001, a school-based adolescent hepatitis B immunization initiative targeted elementary schools with a high percentage of free lunch and "at risk" students and provided free hepatitis B immunization (0,1, and 4 month schedule) during school hours. Demographic data were collected regarding potential enrollees in the project. The rate of return of consent/refusal forms, participation rates, and immunization completion rates were determined. Analyses were completed using the z statistic, frequencies, and stratified Chi-square analyses. RESULTS: Families of female children (p <.0001) and those with insurance or Medicaid were more likely than those with no insurance (p <.0001) to respond by returning a consent or refusal form and were also more likely to participate in the program by receiving at least one immunization dose (p <.0001 for both analyses). Participation rates also varied by race (p <.0001) with black and Hispanic potential enrollees participating more frequently than white and Asian potential enrollees. Females among black (p =.012) and Hispanic (p <.0001) participants and participants of Asian race/ethnicity (p <.0001) were more likely to complete the vaccination series. CONCLUSIONS: Even when access issues are eliminated as a potential barrier to hepatitis B immunization, gender and race disparities exist in the participation in, and completion of, the hepatitis B immunization series given in the schools. Race and gender clearly play separate and distinct roles in health care utilization, unrelated to the traditional variables of socioeconomic status often associated with access to care.

Adolescent↗
PubMed2003

Homeless adolescents: common clinical concerns.

Homeless youth are at alarmingly high risk for a myriad of physical and psychological problems as a result of both the circumstances that prededed their homelessness, and as a direct consequence of life on the streets. Sexually transmitted infections (STIs), pregnancy, trauma, tuberculosis, uncontrolled asthma, and dermatologic infestations are a few of the health problems with which these youth commonly present. These somatic problems are compounded by high rates of drug and alcohol abuse as well as depression and suicide. Despite the obvious need for medical services, homeless youth often do not receive appropriate medical care due to numerous individual and systems barriers impeding health care access by this population. In addition to the barriers experienced by the adult homeless population, homeless adolescents confront further hurdles stemming from their age and developmental stage. Some of these impediments include a lack of knowledge of clinic sites, fear of not being taken seriously, concerns about confidentiality, and fears of police or social services involvement. Improved access to appropriate health care is necessary if we are to better support and care for this population of young people. To effectively manage and treat homeless youth, individual providers must be aware of the diagnoses associated with homelessness, as well as the community resources available to these youth. Finally, providers need to be the voices advocating for improved services for this disadvantaged and silent population.

Adolescent↗
PubMed2002

Adolescent sexuality and sexual behavior.

PURPOSE OF REVIEW: Adolescence is a time of self-discovery and physical, as well as cognitive, development. It is within this context that adolescent sexual development and sexual behavior occur. While curiosity and experimentation are normal, sexual behaviors, both coital and non-coital, place adolescents at risk for undesired consequences including sexually transmitted disease acquisition and pregnancy. Trends in adolescent sexual behavior are changing, and health care professionals must be aware of these trends to provide necessary medical care and education to this population. RECENT FINDINGS: While the sexual activity of teenagers garners much attention, attention must also be directed at non-coital activities such as masturbation, mutual masturbation and oral sex, as the riskier of these behaviors appear to be increasing. The trends in sexual activity and contraceptive use are encouraging with a decrease in the proportion of adolescents reporting sexual activity, and an increase in the proportion reporting using contraception. These trends, however, are not shared equally among racial groups with the greatest decline reported in the in lowest risk groups. Sexual minority youth continue to report a higher prevalence of high-risk behaviors, both sexual and non-sexual, as compared to their heterosexual peers. SUMMARY: These findings highlight the multiple roles health care professionals can play in caring for this unique population: firstly as health care providers, offering age appropriate, confidential health care; secondly, as reproductive health care educators providing factual, balanced, and realistic information to both teenagers and the community; and thirdly, as advocates lobbying for greater education and services for this at-risk population.

Adolescent↗