Abstract
Exposures to measles in medical settings have contributed to the recent resurgence of the disease in the United States. Following a measles exposure in two pediatric medical facilities serving an inner-city population, we investigated the effectiveness of a disease notification strategy and compliance of the exposed population with recommendations for post-exposure prophylaxis, two requirements of a successful intervention program. Of 106 families with children eligible for a prophylactic vaccination by standard guidelines, 64% were notified of exposure by telephone. Compliance was assessed by a brief telephone questionnaire based upon the Health Belief Model, and verified by medical records. Forty-six families were interviewed regarding their decisions to comply with the recommendations. Most (75%) families were compliant. Compliant parents perceived measles to be severe and their children to be in excellent health. In a multiple logistic regression analysis, only the perceived severity of measles significantly contributed to the model. We conclude that: infection control outreach may need to extend beyond telephone notification for an inner-city population, and that once notified, most people will comply with recommendations. The Health Belief Model explains compliance with infection control measures and may be useful in guiding public health interventions.
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Susan Feigelman, MD, is Assistant Professor of Pediatrics, Bonita Stanton, MD, Professor of Pediatrics; Judith D. Rubin, MD, MPH, is Associate Professor of Pediatrics and Epidemiology and Preventive Medicine; Nancy A. Cartelli, MD, is a former Assistant Professor of Pediatrics, all at the University of Maryland School of Medicine, Baltimore, Maryland.
This study was possible due to the efforts of Maureen Black, Anna Gadomski, Lisa Horton, Virginia Keane, James King, Richard Lichenstein; and the staff of the Pediatric Ambulatory Center and the Pediatric Emergency Room. We wish to also acknowledge the assistance of Edward M. Hirshorn and the Maryland State Department of Health, and the statistical and analytical assistance of Christopher Loffredo, P. David Wilson, Susan Zuravin and Madelene Countess.
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Feigelman, S., Stanton, B., Rubin, J.D. et al. Effectiveness of family notification efforts and compliance with measles post-exposure prophylaxis. J Community Health 18, 83–93 (1993). https://doi.org/10.1007/BF01324417
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DOI: https://doi.org/10.1007/BF01324417