Examining measles, mumps, and rubella (MMR) immunization uptake in Saskatoon: Can neighbourhood characteristics predict coverage rates?
Notice bibliographique
Résumé
Immunization programs have proven to be one of the most successful public health initiatives in Canada yet continuous monitoring of coverage rates is essential to ensure high uptake and the continued success of these programs. Prior to this study, Saskatoon Public Health Services (PHS) were limited to manual calculation of coverage rates and trends and were unable to examine immunization uptake by neighbourhood. The purpose of this study was to utilize newly available data from the Saskatchewan Immunization Management System (SIMS) to examine city and neighbourhood uptake of the Measles, Mumps, and Rubella (MMR) vaccine. Once neighbourhood coverage rates were calculated, the project centred on using quantitative neighbourhood level data to determine if the neighbourhood variables of interest could significantly contribute to the explanation in variation of up-todate immunization coverage in Saskatoon. The study looked at 10, 287 two year-olds in Saskatoon between 1999 and 2002. The findings revealed immunization rates were relatively stable during this period. Of the approximately 90% of children who were immunized each year about 70% were considered up-to-date while approximately 20% were considered delayed or incomplete. However, significant disparities were found to exist at the neighbourhood level with areas of social and economic disadvantage having lower rates of total, complete, and up-to-date immunization uptake compared to areas of greater social and economic wealth. A slight downward trend in total immunization uptake was also noted in both the city of Saskatoon and high uptake neighbourhoods. Interestingly, high uptake neighbourhoods were also found to have the highest levels of social and economic advantage. Multivariate linear regression, used in the second phase of the analysis, revealed 80.6% of variation in up-to-date immunization uptake in Saskatoon could be explained by the proportion of single mothers and the proportion of vehicles registered in ,the neighbourhood. These findings are supported by the literature and may indicate the presence of real or perceived barriers to immunization for some families in Saskatoon. Limitations of the study include: the quality of the SIMS data, general limitations of ecologic designs, and problems with child mobility within and outside of the city. The issue of mobility likely resulted in the overestimation of coverage rates in some neighbourhoods and underestimation in others even though measures were taken to mitigate the effects of potential misclassification. Six recommendations were devised in an attempt to identify possible directions for future research and to improve the provision of immunization services for all areas of the city with particular attention focussed on high-risk neighbourhoods. It is hoped the findings of this study and recommendations provided will assist PHS in their continued efforts to improve immunization uptake in Saskatoon and throughout the entire region.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».