Lois Crowe - Academia.edu (original) (raw)

Papers by Lois Crowe

Research paper thumbnail of Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study

BMJ Open, 2014

Objective: To understand the perspectives of Ontario parents regarding the advantages and disadva... more Objective: To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes.

Research paper thumbnail of The Good, Bad, and Ugly of Online Recruitment of Parents for Health-Related Focus Groups: Lessons Learned

Journal of Medical Internet Research, 2013

We describe our experiences with identifying and recruiting Ontario parents through the Internet,... more We describe our experiences with identifying and recruiting Ontario parents through the Internet, primarily, as well as other modes, for participation in focus groups about adding the influenza vaccine to school-based immunization programs. Our objectives were to assess participation rates with and without incentives and software restrictions. We also plan to examine study response patterns of unique and multiple submissions and assess efficiency of each online advertising mode. We used social media, deal forum websites, online classified ads, conventional mass media, and email lists to invite parents of school-aged children from Ontario, Canada to complete an online questionnaire to determine eligibility for focus groups. We compared responses and paradata when an incentive was provided and there were no software restrictions to the questionnaire (Period 1) to a period when only a single submission per Internet protocol (IP) address (ie, software restrictions invoked) was permitted and no incentive was provided (Period 2). We also compared the median time to complete a questionnaire, response patterns, and percentage of missing data between questionnaires classified as multiple submissions from the same Internet protocol (IP) address or email versus unique submissions. Efficiency was calculated as the total number of hours study personnel devoted to an advertising mode divided by the resultant number of unique eligible completed questionnaires . Of 1346 submitted questionnaires, 223 (16.6%) were incomplete and 34 (2.52%) did not meet the initial eligibility criteria. Of the remaining 1089 questionnaires, 246 (22.6%) were not from Ontario based on IP address and postal code, and 469 (43.1%) were submitted from the same IP address or email address (multiple submissions). In Period 2 vs Period 1, a larger proportion of questionnaires were submitted from Ontario (92.8%, 141/152 vs 75.1%, 702/937, P<.001), and a smaller proportion of same IP addresses (7.9%, 12/152 vs 47.1%, 441/937, P<.001) were received. Compared to those who made unique submissions, those who made multiple submissions spent less time per questionnaire (166 vs 215 seconds, P<.001), and had a higher percentage of missing data among their responses (15.0% vs 7.6%, P=.004). Advertisements posted on RedFlagDeals were the most efficient for recruitment (0.03 hours of staff time per questionnaire), whereas those placed on Twitter were the least efficient (3.64 hours of staff time per questionnaire). Using multiple online advertising strategies was effective for recruiting a large sample of participants in a relatively short period time with minimal resources. However, risks such as multiple submissions and potentially fraudulent information need to be considered. In our study, these problems were associated with providing an incentive for responding, and could have been partially avoided by activating restrictive software features for online questionnaires.

Research paper thumbnail of Health care worker influenza immunization rates: The missing pieces of the puzzle

American Journal of Infection Control, 2013

Research paper thumbnail of Measuring influenza immunization coverage among health care workers in acute care hospitals and continuing care organizations in Canada

American Journal of Infection Control, 2013

Immunizing health care workers against influenza is important for preventing and reducing disease... more Immunizing health care workers against influenza is important for preventing and reducing disease transmission in health care environments. We describe the ability of Canadian health care organizations to measure influenza immunization coverage among health care workers and identify factors associated with comprehensive influenza immunization measurement. A Web-based survey was distributed to influenza immunization campaign planners responsible for delivering the 2010-2011 influenza vaccine to health care workers working in acute care hospitals or long-term continuing care organizations. The primary outcome was the ability to comprehensively measure influenza immunization coverage. Of the 1,127 health care organizations approached, 721 (64%) responded. Ninety-one percent had incomplete immunization coverage measurement; 7% could not measure coverage among any personnel. After multivariable adjustment, organizations with a written influenza immunization implementation plan (odds ratio, 2.0; 95% confidence interval, 1.1-3.5) or a policy or procedure describing how to calculate or report immunization rates (odds ratio, 2.1; 95% confidence interval, 1.2-3.9) were more likely to have comprehensive measurement of influenza immunization coverage than organizations without these practices. Most organizations demonstrated incomplete measurement of influenza immunization among health care workers. Given the use of influenza immunization coverage as a measure of quality of care, further work is needed to develop a standardized approach to improve its measurement.

Research paper thumbnail of Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory policies

American Journal of Infection Control, 2013

Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents ... more Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of mandatory influenza immunization policies were discussed in key informant interviews with influenza immunization program planners. We conducted telephone interviews with 23 influenza immunization program planners from 21 organizations (7 acute care hospitals, 6 continuing care facilities, and 8 public health organizations) across Canada. We used content analysis to identify themes from the interviews. Participants used a variety of promotional and educational activities, and many vaccine delivery approaches, to support HCW immunization programs. Barriers to achieving high coverage in HCWs included misconceptions about the safety and effectiveness of the influenza vaccine, negative personal experiences associated with the vaccine, and antivaccine sentiments. Participants mentioned mandatory influenza immunizations as a solution to low coverage. However, they identified challenges with this approach such as obtaining support from stakeholders, enforcement, and limiting personal autonomy. Participants believed immunization coverage in health care organizations will continue to be suboptimal using existing program strategies. Although participants discussed mandatory immunization as a way to improve uptake, potential obstacles will need to be addressed for this to be implemented successfully.

Research paper thumbnail of A New Approach to Improving Healthcare Personnel Influenza Immunization Programs: A Randomized Controlled Trial

PLOS ONE, 2015

Healthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies ... more Healthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies and expert consultations, the "Successful Influenza Immunization Programs for Healthcare Personnel: A Guide for Program Planners" was produced. This trial assessed the impact of the Guide with facilitation in improving healthcare personnel influenza immunization rates in Canadian healthcare organizations.

Research paper thumbnail of Parental perceptions of school-based influenza immunisation in Ontario, Canada: a qualitative study

BMJ Open, 2014

Objective: To understand the perspectives of Ontario parents regarding the advantages and disadva... more Objective: To understand the perspectives of Ontario parents regarding the advantages and disadvantages of adding influenza immunisation to the currently existing Ontario school-based immunisation programmes.

Research paper thumbnail of The Good, Bad, and Ugly of Online Recruitment of Parents for Health-Related Focus Groups: Lessons Learned

Journal of Medical Internet Research, 2013

We describe our experiences with identifying and recruiting Ontario parents through the Internet,... more We describe our experiences with identifying and recruiting Ontario parents through the Internet, primarily, as well as other modes, for participation in focus groups about adding the influenza vaccine to school-based immunization programs. Our objectives were to assess participation rates with and without incentives and software restrictions. We also plan to examine study response patterns of unique and multiple submissions and assess efficiency of each online advertising mode. We used social media, deal forum websites, online classified ads, conventional mass media, and email lists to invite parents of school-aged children from Ontario, Canada to complete an online questionnaire to determine eligibility for focus groups. We compared responses and paradata when an incentive was provided and there were no software restrictions to the questionnaire (Period 1) to a period when only a single submission per Internet protocol (IP) address (ie, software restrictions invoked) was permitted and no incentive was provided (Period 2). We also compared the median time to complete a questionnaire, response patterns, and percentage of missing data between questionnaires classified as multiple submissions from the same Internet protocol (IP) address or email versus unique submissions. Efficiency was calculated as the total number of hours study personnel devoted to an advertising mode divided by the resultant number of unique eligible completed questionnaires . Of 1346 submitted questionnaires, 223 (16.6%) were incomplete and 34 (2.52%) did not meet the initial eligibility criteria. Of the remaining 1089 questionnaires, 246 (22.6%) were not from Ontario based on IP address and postal code, and 469 (43.1%) were submitted from the same IP address or email address (multiple submissions). In Period 2 vs Period 1, a larger proportion of questionnaires were submitted from Ontario (92.8%, 141/152 vs 75.1%, 702/937, P<.001), and a smaller proportion of same IP addresses (7.9%, 12/152 vs 47.1%, 441/937, P<.001) were received. Compared to those who made unique submissions, those who made multiple submissions spent less time per questionnaire (166 vs 215 seconds, P<.001), and had a higher percentage of missing data among their responses (15.0% vs 7.6%, P=.004). Advertisements posted on RedFlagDeals were the most efficient for recruitment (0.03 hours of staff time per questionnaire), whereas those placed on Twitter were the least efficient (3.64 hours of staff time per questionnaire). Using multiple online advertising strategies was effective for recruiting a large sample of participants in a relatively short period time with minimal resources. However, risks such as multiple submissions and potentially fraudulent information need to be considered. In our study, these problems were associated with providing an incentive for responding, and could have been partially avoided by activating restrictive software features for online questionnaires.

Research paper thumbnail of Health care worker influenza immunization rates: The missing pieces of the puzzle

American Journal of Infection Control, 2013

Research paper thumbnail of Measuring influenza immunization coverage among health care workers in acute care hospitals and continuing care organizations in Canada

American Journal of Infection Control, 2013

Immunizing health care workers against influenza is important for preventing and reducing disease... more Immunizing health care workers against influenza is important for preventing and reducing disease transmission in health care environments. We describe the ability of Canadian health care organizations to measure influenza immunization coverage among health care workers and identify factors associated with comprehensive influenza immunization measurement. A Web-based survey was distributed to influenza immunization campaign planners responsible for delivering the 2010-2011 influenza vaccine to health care workers working in acute care hospitals or long-term continuing care organizations. The primary outcome was the ability to comprehensively measure influenza immunization coverage. Of the 1,127 health care organizations approached, 721 (64%) responded. Ninety-one percent had incomplete immunization coverage measurement; 7% could not measure coverage among any personnel. After multivariable adjustment, organizations with a written influenza immunization implementation plan (odds ratio, 2.0; 95% confidence interval, 1.1-3.5) or a policy or procedure describing how to calculate or report immunization rates (odds ratio, 2.1; 95% confidence interval, 1.2-3.9) were more likely to have comprehensive measurement of influenza immunization coverage than organizations without these practices. Most organizations demonstrated incomplete measurement of influenza immunization among health care workers. Given the use of influenza immunization coverage as a measure of quality of care, further work is needed to develop a standardized approach to improve its measurement.

Research paper thumbnail of Immunizing health care workers against influenza: A glimpse into the challenges with voluntary programs and considerations for mandatory policies

American Journal of Infection Control, 2013

Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents ... more Vaccination of health care workers (HCWs) is an important patient safety initiative. It prevents influenza infection among patients and reduces staff illness and absenteeism. Despite these benefits, HCW influenza immunization uptake is low. Therefore, strategies to achieve high immunization coverage in HCWs, barriers to uptake, and perceptions of mandatory influenza immunization policies were discussed in key informant interviews with influenza immunization program planners. We conducted telephone interviews with 23 influenza immunization program planners from 21 organizations (7 acute care hospitals, 6 continuing care facilities, and 8 public health organizations) across Canada. We used content analysis to identify themes from the interviews. Participants used a variety of promotional and educational activities, and many vaccine delivery approaches, to support HCW immunization programs. Barriers to achieving high coverage in HCWs included misconceptions about the safety and effectiveness of the influenza vaccine, negative personal experiences associated with the vaccine, and antivaccine sentiments. Participants mentioned mandatory influenza immunizations as a solution to low coverage. However, they identified challenges with this approach such as obtaining support from stakeholders, enforcement, and limiting personal autonomy. Participants believed immunization coverage in health care organizations will continue to be suboptimal using existing program strategies. Although participants discussed mandatory immunization as a way to improve uptake, potential obstacles will need to be addressed for this to be implemented successfully.

Research paper thumbnail of A New Approach to Improving Healthcare Personnel Influenza Immunization Programs: A Randomized Controlled Trial

PLOS ONE, 2015

Healthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies ... more Healthcare personnel influenza immunization rates remain sub-optimal. Following multiple studies and expert consultations, the "Successful Influenza Immunization Programs for Healthcare Personnel: A Guide for Program Planners" was produced. This trial assessed the impact of the Guide with facilitation in improving healthcare personnel influenza immunization rates in Canadian healthcare organizations.