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Karlsson, David
Publications (6 of 6) Show all publications
Timpka, T., Spreco, A., Gursky, E., Eriksson, O., Dahlström, Ö., Strömgren, M., . . . Holm, E. (2014). Intentions to perform non-pharmaceutical protective behaviors during influenza outbreaks in Sweden: a cross-sectional study following a mass vaccination campaign. PLoS ONE, 9(3), e91060
Open this publication in new window or tab >>Intentions to perform non-pharmaceutical protective behaviors during influenza outbreaks in Sweden: a cross-sectional study following a mass vaccination campaign
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2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 3, p. e91060-Article in journal (Refereed) Published
Abstract [en]

Failure to incorporate the beliefs and attitudes of the public into theoretical models of preparedness has been identified as a weakness in strategies to mitigate infectious disease outbreaks. We administered a cross-sectional telephone survey to a representative sample (n = 443) of the Swedish adult population to examine whether self-reported intentions to improve personal hygiene and increase social distancing during influenza outbreaks could be explained by trust in official information, self-reported health (SF-8), sociodemographic factors, and determinants postulated in protection motivation theory, namely threat appraisal and coping appraisal. The interviewees were asked to make their appraisals for two scenarios: a) an influenza with low case fatality and mild lifestyle impact; b) severe influenza with high case fatality and serious disturbances of societal functions. Every second respondent (50.0%) reported high trust in official information about influenza. The proportion that reported intentions to take deliberate actions to improve personal hygiene during outbreaks ranged between 45–85%, while less than 25% said that they intended to increase social distancing. Multiple logistic regression models with coping appraisal as the explanatory factor most frequently contributing to the explanation of the variance in intentions showed strong discriminatory performance for staying home while not ill (mild outbreaks: Area under the curve [AUC] 0.85 (95% confidence interval 0.82;0.89), severe outbreaks AUC 0.82 (95% CI 0.77;0.85)) and acceptable performance with regard to avoiding public transportation (AUC 0.78 (0.74;0.82), AUC 0.77 (0.72;0.82)), using handwash products (AUC 0.70 (0.65;0.75), AUC 0.76 (0.71;0.80)), and frequently washing hands (AUC 0.71 (0.66;0.76), AUC 0.75 (0.71;0.80)). We conclude that coping appraisal was the explanatory factor most frequently included in statistical models explaining self-reported intentions to carry out non-pharmaceutical health actions in the Swedish outlined context, and that variations in threat appraisal played a smaller role in these models despite scientific uncertainties surrounding a recent mass vaccination campaign.

Place, publisher, year, edition, pages
Public Library of Science, 2014
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-105029 (URN)10.1371/journal.pone.0091060 (DOI)000332485800091 ()
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-04-07Bibliographically approved
Timpka, T., Spreco, A., Dahlström, Ö., Eriksson, O., Gursky, E., Ekberg, J., . . . Holm, E. (2014). Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study. Journal of Medical Internet Research, 16(4), e116
Open this publication in new window or tab >>Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study
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2014 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 16, no 4, p. e116-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is abundant global interest in using syndromic data from population-wide health information systems--referred to as eHealth resources--to improve infectious disease surveillance. Recently, the necessity for these systems to achieve two potentially conflicting requirements has been emphasized. First, they must be evidence-based; second, they must be adjusted for the diversity of populations, lifestyles, and environments.

OBJECTIVE: The primary objective was to examine correlations between data from Google Flu Trends (GFT), computer-supported telenursing centers, health service websites, and influenza case rates during seasonal and pandemic influenza outbreaks. The secondary objective was to investigate associations between eHealth data, media coverage, and the interaction between circulating influenza strain(s) and the age-related population immunity.

METHODS: An open cohort design was used for a five-year study in a Swedish county (population 427,000). Syndromic eHealth data were collected from GFT, telenursing call centers, and local health service website visits at page level. Data on mass media coverage of influenza was collected from the major regional newspaper. The performance of eHealth data in surveillance was measured by correlation effect size and time lag to clinically diagnosed influenza cases.

RESULTS: Local media coverage data and influenza case rates showed correlations with large effect sizes only for the influenza A (A) pH1N1 outbreak in 2009 (r=.74, 95% CI .42-.90; P<.001) and the severe seasonal A H3N2 outbreak in 2011-2012 (r=.79, 95% CI .42-.93; P=.001), with media coverage preceding case rates with one week. Correlations between GFT and influenza case data showed large effect sizes for all outbreaks, the largest being the seasonal A H3N2 outbreak in 2008-2009 (r=.96, 95% CI .88-.99; P<.001). The preceding time lag decreased from two weeks during the first outbreaks to one week from the 2009 A pH1N1 pandemic. Telenursing data and influenza case data showed correlations with large effect sizes for all outbreaks after the seasonal B and A H1 outbreak in 2007-2008, with a time lag decreasing from two weeks for the seasonal A H3N2 outbreak in 2008-2009 (r=.95, 95% CI .82-.98; P<.001) to none for the A p H1N1 outbreak in 2009 (r=.84, 95% CI .62-.94; P<.001). Large effect sizes were also observed between website visits and influenza case data.

CONCLUSIONS: Correlations between the eHealth data and influenza case rates in a Swedish county showed large effect sizes throughout a five-year period, while the time lag between signals in eHealth data and influenza rates changed. Further research is needed on analytic methods for adjusting eHealth surveillance systems to shifts in media coverage and to variations in age-group related immunity between virus strains. The results can be used to inform the development of alert-generating eHealth surveillance systems that can be subject for prospective evaluations in routine public health practice.

Place, publisher, year, edition, pages
Journal of Medical Internet Research, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-106758 (URN)10.2196/jmir.3099 (DOI)000336501600017 ()24776527 (PubMedID)
Available from: 2014-05-21 Created: 2014-05-21 Last updated: 2018-04-07Bibliographically approved
Timpka, T., Spreco, A., Dahlström, Ö., Eriksson, O., Gursky, E., Ekberg, J., . . . Holm, E. (2013). Intentions to perform non-pharmaceutical protective behaviors during influenza outbreaks: a cross-sectional study of a representative sample of the Swedish adult population. In: : . Paper presented at Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013.
Open this publication in new window or tab >>Intentions to perform non-pharmaceutical protective behaviors during influenza outbreaks: a cross-sectional study of a representative sample of the Swedish adult population
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2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-105045 (URN)
Conference
Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-04-07
Timpka, T., Spreco, A., Dahlström, Ö., Eriksson, H., Gursky, E., Ekberg, J., . . . Holm, E. (2013). Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study using data from Google Flu Trends, telenursing call centres, health service provider web-pages, and mass media coverage. In: : . Paper presented at Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013.
Open this publication in new window or tab >>Performance of eHealth data sources in local influenza surveillance: a 5-year open cohort study using data from Google Flu Trends, telenursing call centres, health service provider web-pages, and mass media coverage
Show others...
2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-105055 (URN)
Conference
Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-04-07
Timpka, T., Spreco, A., Dahlström, Ö., Eriksson, O., Gursky, E., Ekberg, J., . . . Holm, E. (2013). Predictive value of telenursing complaints in influenza surveillance: a prospective cohort study in Sweden. In: : . Paper presented at Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013.
Open this publication in new window or tab >>Predictive value of telenursing complaints in influenza surveillance: a prospective cohort study in Sweden
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2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-105053 (URN)
Conference
Eight Conference of Options for the Control of Influenza, Cape Town, South Africa, September 5-10, 2013
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2018-04-07
Karlsson, D., Ekberg, J., Spreco, A., Eriksson, H. & Timpka, T. (2013). Visualization of infectious disease outbreaks in routine practice. Studies in Health Technology and Informatics, 192, 697-701
Open this publication in new window or tab >>Visualization of infectious disease outbreaks in routine practice
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2013 (English)In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 192, p. 697-701Article in journal (Refereed) Published
Abstract [en]

Throughout the history of epidemiology, visualizations have been used as the interface between public-health professionals and epidemiological data. The aim of this study was to examine the impact of the level of abstraction when using visualizations on routine infectious disease control. We developed three interactive visualization prototypes at increasing levels of abstraction to communicate subsets of influenza outbreak surveillance information. The visualizations were assessed through workshops in an exploratory evaluation with infectious disease epidemiologists. The results show that despite the potential of processed, abstract, and information-dense representations, increased levels of abstraction decreased epidemiologists understanding and confidence in visualizations. Highly abstract representations were deemed not applicable in routine practice without training. Infectious disease epidemiologists work routines and decision-making need to be further studied in order to develop visualizations that meet both the quality requirements imposed by policy-makers and the contextual nature of work practice.

Place, publisher, year, edition, pages
I O S Press, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100786 (URN)10.3233/978-1-61499-289-9-697 (DOI)000341021700143 ()23920646 (PubMedID)
Available from: 2013-11-12 Created: 2013-11-12 Last updated: 2017-12-06
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