Search

Background: Despite evidence-based recommendations for HPV vaccination, uptake among young adults is suboptimal. Limited research has explored factors that may influence HPV vaccination among young adults, as well as associated promotion and informational preferences in this group. This study aimed to examine factors associated with HPV vaccination among young adults and preferences for HPV vaccine information and promotion., Methodology: This study utilized a cross-sectional design to examine factors related to HPV vaccination among young adults on a university campus in Tennessee. Data were collected via an online survey administered to students, aged 18-26 years, from March-May 2023. Study measures included sociodemographic characteristics, health/healthcare-related factors, and perception-related measures. Data analysis included descriptive statistics and multivariable logistic regression analysis., Results: Out of 402 participants that completed the survey, 209 reported being vaccinated against HPV. In the adjusted model, variables associated with HPV vaccination were perceived risk (adjusted OR [aOR] = 1.12; 95% confidence interval [CI]:1.05, 1.20), perceived barriers (aOR = 0.73; 95% CI: 0.66, 0.81), higher HPV knowledge (aOR = 1.17; 95% CI: 1.03, 1.33), and receipt of healthcare provider recommendations (aOR = 12.90; 95% CI: 7.08, 23.51)., Conclusions: Study findings suggest that those who are vaccinated were more likely to report receiving healthcare provider recommendations, low perceived barriers, higher HPV knowledge and perceived risk. Future HPV vaccination promotion efforts for young adults may consider increasing HPV vaccine knowledge and awareness, addressing barriers, and strengthening provider recommendations., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Justin Gatwood is an employee of GlaxoSmithKline (GSK). Justin Gatwood report grants funding from Merck & Co., GSK, and AstraZeneca for vaccine-related research, and consulting/advising payments from Janssen Pharmaceuticals and Merck & Co. for vaccine-related insight. This does not alter our adherence to al PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Oyedeji et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Central to effective public health policy and practice is the trust between the population served and the governmental body leading health efforts, but that trust has eroded in the years preceding the pandemic. Vaccine hesitancy among adults is also a growing concern across the United States. Recent data suggest that the trustworthiness of information about the coronavirus 2019 (COVID-19) vaccine was a larger concern than the vaccine's adverse effects or risks., Objective: This study aims to describe the methods used to create a public health microinfluencer social media vaccine confidence campaign for the COVID-19 vaccine in underserved Tennessee communities. A secondary objective is to describe how the Social-Ecological Model (SEM) and Social Cognitive Theory may address vaccine hesitancy using community pharmacies., Methods: In late 2020, 50 independent community pharmacies in underserved communities across Tennessee were involved in a public health project with the State of Tennessee Department of Health and the University of Tennessee Health Science Center College of Pharmacy. The project involved a 3-pronged, pharmacy-based COVID-19 vaccination outreach project, including (1) social media messaging (i.e., microinfluencer approach), (2) community partner collaboration, and (3) in-pharmacy promotion. Quantitative and qualitative data will assess the quality and effectiveness of the program. Social media outcomes will also be assessed to measure the impact of the microinfluencer social media training., Results: Project implementation is planned for 6 months (January 2021 to June 2021) after an initial month of planning by the research team (December 2020) and preceding several months of assessment (July 2021 and beyond)., Conclusions: Novel, theory-based approaches will be necessary to improve vaccine confidence. One approach to promoting public health, derived from the SEM, may be to use trusted microinfluencers on social media platforms, such as local community pharmacists and community leaders., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: First investigated in the 1990s, medication therapy management (MTM) is an evidence-based practice offered by pharmacists to ensure a patient's medication regimen is individualized to include the safest and most effective medications. MTM has been shown to a) improve quality of patient care, b) reduces health care costs, and c) lead to fewer medication-related adverse effects. However, there has been limited testing of evidence-based, a-priori implementation strategies that support MTM implementation on a large scale., Methods: The study has two objectives assessed at the organizational and individual level: 1) to determine the adoption, feasibility, acceptability and appropriateness of a multi-faceted implementation strategy to support the MTM pilot program in Tennessee; and 2) to report on the contextual factors associated with program implementation based on the Consolidated Framework for Implementation Research (CFIR). The overall design of the study was a hybrid type 2 effectiveness-implementation study reporting outcomes of Tennessee state Medicaid's (TennCare) MTM Pilot program. This paper presents early stage implementation outcomes (e.g., adoption, feasibility, acceptability, appropriateness) and explores implementation barriers and facilitators using the CFIR. The study was assessed at the (a) organizational and (b) individual level. A mixed-methods approach was used including surveys, claims data, and semi-structured interviews. Interview data underwent initial, rapid qualitative analysis to provide real time feedback to TennCare leadership on project barriers and facilitators., Results: The total reach of the program from July 2018 through June 2020 was 2033 MTM sessions provided by 17 Medicaid credentialed pharmacists. Preliminary findings suggest participants agreed that MTM was acceptable (μ = 16.22, SD = 0.28), appropriate (μ = 15.33, SD = 0.03), and feasible (μ = 14.72, SD = 0.46). Each of the scales had an excellent level of internal (> 0.70) consistency (feasibility, α = 0.91; acceptability, α = 0.96; appropriateness, α = 0.98;). Eight program participants were interviewed and were mapped to the following CFIR constructs: Process, Characteristics of Individuals, Intervention Characteristics, and Inner Setting. Rapid data analysis of the contextual inquiry allowed TennCare to alter initial implementation strategies during project rollout., Conclusion: The early stage implementation of a multi-faceted implementation strategy to support delivery of Tennessee Medicaid's MTM program was found to be well accepted and appropriate across multiple stakeholders including providers, administrators, and pharmacists. However, as the early stage of implementation progressed, barriers related to relative priority, characteristics of the intervention (e.g., complexity), and workflow impeded adoption. Programmatic changes to the MTM Pilot based on early stage contextual analysis and implementation outcomes had a positive impact on adoption., (© 2021. The Author(s).)

Purpose: To examine the vaccine-related beliefs and behaviors associated with likely hesitancy toward vaccination against coronavirus disease 2019 (COVID-19) among nonelderly adults., Methods: A cross-sectional survey was conducted in June 2020. Responses were sought from Tennessee adults 18 to 64 years of age who were not healthcare providers. The survey instrument focused on vaccine-related beliefs, prior and planned influenza and pneumococcal vaccine use, and attitudes toward receiving a COVID-19 vaccination. Inferential statistics assessed survey responses, and logistic regression determined predictors of the likelihood of COVID-19 vaccination., Results: A total of 1,000 completed responses were analyzed (a 62.9% response rate), and respondents were mostly White (80.1%), insured (79.6%), and/or actively working (64.2%); the sample was well balanced by gender, age, income, and political leaning. Approximately one-third (34.4%) of respondents indicated some historical vaccine hesitancy, and only 21.4% indicated always getting a seasonal influenza vaccination. More than half (54.1%) indicated at least some hesitancy toward vaccination against COVID-19, with 32.1% citing lack of evidence of vaccine effectiveness as the leading reason. COVID-19 vaccine hesitancy was more likely among those with more moderate (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.749-3.607) or conservative (OR, 3.01; 95% CI, 2.048-4.421) political leanings, Black Americans (OR, 1.80; 95% CI, 1.182-2.742), and residents of nonmetropolitan areas (OR, 1.99; 95% CI, 1.386-2.865)., Conclusion: Subgroups of the population may prove more challenging to vaccinate against COVID-19, requiring targeted approaches to addressing hesitancy to ensure more-vulnerable populations are adequately covered., (© American Society of Health-System Pharmacists 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: The role of community pharmacists continues to evolve to meet the changing medication-related needs of patients in the United States, requiring a fundamental shift in the pharmacist's workflow and tasks including medication dispensing and medication therapy management (MTM). To compare community pharmacists' current and idealized time allocation. Barriers to, and potential facilitators of, typical and specific pharmacist functions are also reported, with an emphasis on MTM practices. A secondary objective included interpreting how pharmacists perceived the value of social determinants of health to the MTM process., Methods: Community pharmacists practicing in Tennessee were surveyed online with 3 distinct foci: time allocation and delegation, MTM barriers, and the perceived value of health-related and social data to the MTM process. For the first 2 sections, the respondents provided responses in 2 different scenarios: (1) current workflow and (2) an idealized workflow. Paired Wilcoxon signed-rank and chi-square tests compared the responses to workday items, and Spearman correlations assessed the relationships between preferences and perceived barriers., Results: The pharmacists reported spending the largest share of time verifying product (32.8% [SD 19.28]), and most indicated that they spent no time in either point-of-care testing (POCT) or physical patient assessment. In an ideal work environment, more patient-focused roles would be preferred (e.g., health screening, POCT, MTM, and vaccinations), with more than 80% indicating that they would delegate register activities, data entry, and product verification to technicians. In performing MTM, the pharmacists indicated that they would prefer delegating more data collection and patient management activities to technicians to reserve time for patient assessment and care plan creation. Key barriers to MTM included a lack of time, staff support, and patients' willingness to participate., Conclusion: Ideally, pharmacists would prefer to do no prescription filling or selling or register activities. Facilitating community pharmacy practice evolution will require focusing on building teams around support personnel., (Copyright © 2020 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: Pharmacist-led medication therapy management (MTM) programs are considered evidence-based and have clearly defined core components. Despite this, MTM programs are often implemented without fidelity due to notable implementation barriers, such as physician-pharmacist relationships and pharmacist access to patient medical records. To improve MTM implementation, the Tennessee Medicaid program developed a MTM intervention that incorporates implementation strategies to address some of the known barriers to implementation (e.g., formalizing pharmacist-physician relationships through collaborative practice agreements, ensuring pharmacists' access to medical records)., Objectives: The purpose of this hybrid type 2 effectiveness-implementation study is to (1) assess the effectiveness of the MTM pilot program in Tennessee (e.g., medication adherence, healthcare utilization, quality and cost of care) and (2) assess the implementation of the MTM pilot program (e.g., feasibility, appropriateness, acceptability, penetration)., Methods: The Tennessee MTM pilot program is being assessed as a hybrid type 2 effectiveness-implementation study with a quasi-experimental design. A mixed methods approach (QUAN + QUAL) for the purpose of complementarity (e.g., answering related research questions). Data will include surveys, interviews, MTM platform encounter information, and medical and pharmacy claims. Initial analyses will include data between January 2018 and December 2019., Conclusion: The study will further add to the evidence base of MTM interventions by testing an intervention that addresses known barriers to implementation and simultaneously collecting data on effectiveness and implementation to speed up MTM translation. The Tennessee MTM program is expected to serve as a guide to other states seeking to expand pharmacist-delivered clinical services to their Medicaid members, particularly those intending to incorporate MTM into programs seeking to improve primary care delivery. Further, by improving the implementation of MTM, the pilot program is expected to improve the reliability of MTM program benefits including healthcare quality and cost and patient outcomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The emphasis that United States employers are placing on employee wellness continues to grow; however, most attention has been paid to larger firms to gauge return-on-investment from a larger pool of enrollees. With fewer resources available to fund expansive wellness programs, smaller businesses need a cost-effective mechanism to provide such benefits. As the most accessible healthcare provider, community pharmacists are in an ideal position to support certain wellness programs for smaller businesses. This research piloted a community pharmacist-led, employer-sponsored wellness program for a self-insured financial services company in Tennessee. Employees with diabetes, hypertension, hyperlipidemia, asthma, or COPD were recruited from the partnering firm to receive live, one-on-one counseling from a community pharmacist over a calendar year. Each session was tailored to individual employee's needs and goals but generally focused on medication adherence, diet, exercise, and health maintenance strategies. Fifteen employees participated in the program, and improvements in clinical measures were not realized over the course of a year. Some, albeit not statistically significant, improvements were seen in self-reported medication adherence and quality of life; however, a trend toward some weight gain was observed. Results suggest that, similar to Medicare beneficiaries, working-age adults with certain chronic conditions may benefit from pharmacist-led MTM programs but deeper investigation is needed., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective. To compare second-year student pharmacists' perspectives on two approaches for completing a pharmacy practice management business planning project. Methods. A mixed-methods approach was used to compare two options (traditional and experimental) for completing business plan projects that were offered to teams of second-year student pharmacists as part of a required pharmacy management course. Teams who chose the traditional project were required to develop a unique, pharmacy-related business plan while those who chose the experimental concept were paired with a pharmacy-focused firm within Tennessee and tasked with designing a potential service for the firm's consideration. At semester's end, all students were asked to complete a brief survey to provide insight on their experiences with either of the group projects. Students and firm stakeholders were also asked to participate in a group and individual interview, respectively. Results. Student group comparisons indicated that the experimental project provided a more real-world, business planning experience. Additionally, groups that did the experimental project were more likely to report seeing how business and pharmacy practice were connected, indicate a better understanding of the principles of pharmacy management, and be perceived as more marketable for a future pharmacy career. Firm representatives indicated that insight provided by the students was valuable and that they had plans to implement what was proposed. Conclusion. Connecting student pharmacists with a pharmacy-focused firm provided a real-world management experience that better complemented the course's principles, and created a mutually beneficial innovation-focused partnership.

Purpose: Results of a study to determine if disparities in drug pricing, pharmacy services, and community pharmacy access exist in a Tennessee county with a predominantly minority population are reported., Methods: A cross-sectional survey of community pharmacies in Shelby County, a jurisdiction with a total population more than 60% composed of racial and ethnic minority groups, was conducted. Data collection included "out-of-pocket" (i.e., cash purchase) prices for generic levothyroxine, methylphenidate, and hydrocodone-acetaminophen; pharmacy hours of operation; availability of selected pharmacy services; and ZIP code-level data on demographics and crime risk. Analysis of variance, chi-square testing, correlational analysis, and data mapping were performed., Results: Survey data were obtained from 90 pharmacies in 25 of the county's 33 residential ZIP code areas. Areas with fewer pharmacies per 10,000 residents tended to have a higher percentage of minority residents ( p = 0.031). Methylphenidate pricing was typically lower in areas with lower employment rates ( p = 0.027). Availability of home medication delivery service correlated with income level ( p = 0.015), employment rate ( p = 0.022), and crime risk ( p = 0.014)., Conclusion: A survey of community pharmacies in Shelby County, Tennessee, found that areas with a high percentage of minority residents had lower pharmacy density than areas with a high percentage of white residents. Pharmacies located in communities with low average income levels, low employment rates, and high scores for personal crime risk were less likely to offer home medication delivery services., (Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)