EPIDEMIOLOGY OF INFLUENZA AND ABSENTEEISM IN AN ELEMENTARY SCHOOL SETTING

描述(由申请人提供)：学龄儿童在社区内流感传播中发挥关键作用。因此，学校对流感控制战略至关重要。公共卫生官员广泛使用旷课数据作为社区流感活动的指标；然而，流感和旷课之间的真正关系尚不清楚。这项提案的目的是确定小学旷课是否是学校流感活动的标志，以及小学是否是社区流感活动的哨所。我的具体目标是：1)确定冬季呼吸道疾病季节的小学缺勤率是否因学校特点而异，包括城市或农村、经济状况以及学校的手部卫生政策和将患病学生排除在外；2)通过将旷课数据与以下两种情况相关联来确定小学旷课是否先于社区的其他流感标志物：a)由大型地区性医疗保健提供组织InterMountain Healthcare(IH)收集的病毒流行病学数据，以及b)犹他州卫生部收集的流感样疾病和与流感相关的住院数据，以及3)确定缺课是否反映了学校的流感病毒活动，方法是确定在小学就读的有症状的儿童中流感病毒与其他病毒的比例，并将该数据与学校的缺勤率联系起来。无论是用于流感监测，还是作为流感预防计划效果的结果衡量标准，这些知识都将提高学校缺勤数据的价值。从拟议研究中获得的数据将对为学校制定循证政策至关重要，并将成为进一步干预学校缓解流感的研究的基础。除了我的研究目标，我的具体职业发展目标还包括1)扩大我在研究设计、分析和结果解释方面的现有技能，2)发展流行病学技能，包括封闭人群的生物采样和传染病流行病学，3)了解医疗保健行为理论及其在研究环境中的应用，4)发展调解技能，使我能够促进小组之间的合作，5)与教育工作者合作建立教学工具，使教师能够将公共卫生信息纳入他们的课程，6)发展研究管理技能，以领导未来的项目，7)通过领导力培训发展领导技能。我的首要职业目标是通过理解和应用基础科学在学校环境中实施和评估有效的干预措施来改善弱势儿童及其社区的健康。这项提议的研究和职业发展目标将使我成为一名独立调查员，能够领导地方和全国的流行病规划，以确保安全的学校和健康的社区。

DESCRIPTION (provided by applicant): School-age children play a critical role in influenza transmission within communities. Therefore, schools are critical to strategies for influenza control. School absenteeism data is widely used by public health officials as an indicator of influenza activity in communities; however, the true relationship between influenza and school absenteeism is not clear. The goal of this proposal is to determine whether elementary school absenteeism is a marker for influenza activity in the school and whether elementary schools are sentinels for influenza activity in the community. My specific aims are to: 1) determine whether elementary school absenteeism rates during the winter respiratory illness season vary by school characteristics including urban or rural, economic status, and school policies of hand hygiene and exclusion of ill students, 2) determine whether elementary school absenteeism precedes other markers of influenza in the community by relating absenteeism data to: a) viral epidemiology data collected by a large regional health care delivery organization, Intermountain Healthcare (IH), and b) influenza-like illness and influenza-associated hospitalization data collected by the Utah Department of Health, and 3) determine whether school absenteeism reflects influenza virus activity in the school by determining the proportion of symptomatic children attending an elementary school who are shedding influenza virus versus other viruses and relating this data to the school's absenteeism rates. This knowledge will improve the value of school absenteeism data when used either for influenza surveillance or as an outcome measure of the effect of influenza prevention programs. The data obtained from the proposed studies will be vital for preparing evidence-based policies for schools and will be the basis for further interventional research regarding influenza mitigation in schools. In addition to my research aim, my specific career development aims include 1) expand my existing skills in study design, analysis, and interpretation of results, 2) develop epidemiologic skills including biologic sampling of closed populations and infectious disease epidemiology, 3) learn about theories of health care behavior and their application in a research setting, 4) develop mediation skills to enable me to foster collaboration between groups, 5) work with educators to build teaching tools that allow teachers to incorporate public health messages into their curricula, 6) develop research management skills to lead projects in the future, 7) develop leadership skills through leadership training. My overarching career goal is to improve the health of disadvantaged children and their communities by understanding and applying basic science to implement and evaluate effective interventions in a school setting. The research and career development aims of this proposal will prepare me to be an independent investigator able to lead both locally and nationally in pandemic planning to ensure safe schools and healthy communities.