Elimination of racial/ethnic Hepatitis B vaccination disparities in the US in the 2007--2008 National Health and Nutrition Examination Survey

Viral hepatitis is a significant public health problem worldwide and is due to viral infections that are classified as Hepatitis A, B, C, D, and E. Hepatitis B is one of the five known hepatic viruses. A safe and effective vaccine for Hepatitis B was first developed in 1981, and became adopted into national immunization programs targeting infants since 1990 and adolescents since 1995. In the U.S., this vaccination schedule has led to an 82% reduction in incidence from 8.5 cases per 100,000 in 1990 to 1.5 cases per 100,000 in 2007. Although there has been a decline in infection among adolescents, there is still a large burden of hepatitis B infection among adults and minorities. There is very little research in regards to vaccination gaps among adults. Using the National Health and Nutrition Examination Survey (NHANES) question "{Have you/Has SP (Study Participant)} ever received the 3-dose series of the hepatitis B vaccine?" the existence of racial/ethnic gaps using a cross-sectional study design was explored. In this study, other variables such as age, gender, socioeconomic variables (federal poverty line, educational attainment), and behavioral factors (sexual practices, self-report of men having sex with men, and intravenous drug use) were examined. We found that the current vaccination programs and policies for Hepatitis B had eliminated racial and ethnic disparities in Hepatitis B vaccination, but that a low coverage exists particularly for adults who engage in high risk behaviors. This study found a statistically significant 10% gap in Hepatitis B vaccination between those who have and those who do not have access to health insurance.^

Teaching safety at a summer camp: Evaluation of a children's fire safety curriculum in an urban community setting

Objectives: The purpose of this study was to evaluate the effectiveness of the Danger Rangers Fire Safety Curriculum in increasing the fire safety knowledge of low-income, minority children in pre-kindergarten to third grade in Austin, TX during a summer day camp in 2007.^ Methods: Data was collected from child participants via teacher and researcher administered tests at pretest, posttest (immediately after the completion of the fire safety module), and at a 3 week follow-up to asses retention. In addition, a self-administered questionnaire was collected from parents pre- and post-intervention to assess home-related fire/burn risk factors. Paired t-tests were conducted using STATA 12.0 to evaluate pretest, posttest, and retention test mean scores as well as mean fire safety rules listed by grade group. McNemar's test was used to determine if there was a difference in fire-related risk factors as reported by the parents of the participants before and after the intervention. Only those who had paired data for the tests/surveys being compared were included in the analysis.^ Results: The first/second grade group and the third grade group scored significantly higher on fire safety knowledge on the posttest compared to the pretest (p<0.0001 for both groups). However, there was no significant change in knowledge scores for the pre-kindergarten to kindergarten group (p=0.14). Among the first/second grade group, knowledge levels did not significantly decline between the posttest and retention test (p=0.25). However, the third grade group had significantly lower fire safety knowledge scores on the retention test compared to the posttest (p<0.001). A similar increase was seen in the amount of fire safety rules listed after the intervention (p<0.0001 between pre and posttest for both the first/second grade and third grade groups), with no decline from the posttest to the retention test (p=0.50) for the first/second grade group, but a significant decline in the third grade group (p=0.001). McNemar's chi-square test showed a significant increase in the percentage of participants' parents reporting smoke detector testing on a regular basis and having a fire escape plan for their family after the intervention (p=0.01 and p<0.0001, respectively). However, there was no significant change in the frequency of reports of the child playing in the kitchen while the parent cooks or the house/apartment having a working smoke detector.^ Conclusion: We found that general fire safety knowledge improved and the number of specific fire safety rules increased among the first to third grade children who participated in the Danger Rangers fire safety program. However, it did not significantly increase general fire safety knowledge among the pre-k/k group. This study also showed that a program targeted towards children has the potential to influence familial risk factors by proxy. The Danger Rangers Fire Safety Curriculum should be further evaluated by conducting a randomized controlled trial, using valid measures that assess fire safety attitudes, beliefs, behaviors, as well as fire/burn related outcomes.^