Edward A. Holt

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Much of the research on determinants of health service utilization has focused on economic and cognitive variables which influence preventative health behavior. Our ethnographic study of maternal perceptions of the barriers and incentives to immunization use in Haiti underscores the importance of 'hidden' social and psychological costs of utilization, such(More)
OBJECTIVE To determine whether financial sanctions to Aid to Families With Dependent Children (AFDC) recipients can be used to improve vaccination coverage of young children. DESIGN Randomized controlled trial. SETTING Six AFDC jurisdictions in Maryland. INTERVENTION Recipients of AFDC were randomized to the experimental or control group of the(More)
Antibodies to herpes simplex virus type 2 (HSV-2), antibodies to hepatitis B virus (HBV) core antigen (anti-HBc), and VDRL antibodies (serologic evidence of syphilis) were evaluated in women known to be infected with human immunodeficiency virus type 1 (HIV-1) (n = 95) or human T lymphotropic virus type I (HTLV-I) (n = 45) and controls (n = 89).(More)
OBJECTIVE To determine whether deaths among Haitian infants born to HIV-1-seronegative women could be distinguished from deaths among children born to HIV-1-seropositive women using the verbal autopsy technique. METHODS Mothers of 315 Haitian children who died were interviewed about events leading to the child's death. Three physicians independently(More)
OBJECTIVE To compare estimates based on vaccination cards, parental recall, and medical records of the percentages of children up-to-date on vaccinations for diphtheria, tetanus, and pertussis; polio; and measles, mumps, and rubella. METHOD The authors analyzed parent interview and medical records data from the Baltimore Immunization Study for 525(More)
OBJECTIVE To provide empirical data on immunization coverage and the receipt of preventive health care to inform policy makers' efforts to improve childhood immunization. DESIGN AND METHODS We surveyed a random sample drawn from a birth cohort of 557 2-year-old children living in the inner-city of Baltimore. Complete information on all their preventive(More)
We enrolled 427 consecutive patients with tuberculosis diagnosed in Cité Soleil, Haiti in a trial of short-course intermittent therapy. All patients received supervised therapy with isoniazid, rifampin, pyrazinamide, and ethambutol thrice weekly for 8 wk, followed by isoniazid and rifampin thrice weekly for 18 wk. At entry, the 177 human immunodeficiency(More)
Pregnant Haitian women (n = 4,474) residing in a periurban slum were interviewed to identify risk factors for sexually transmitted diseases and sera were tested to identify antibodies to HIV-1 and syphilis. The seroprevalence rates for antibodies to HIV-1 increased from 8.9% in 1986 to 9.9% in 1987 and 10.3% in 1988. Sera obtained in 1982 from 533 mothers(More)
This article presents the results of the first large-scale mail survey of non-residential green power customers in the United States. The survey explored the motivations, attitudes, and experiences of 464 business, non-profit, and public-sector customers that have voluntarily opted to purchaseFand frequently pay a premium forFrenewable electricity.(More)
A rapid ethnographic assessment of barriers to health service utilization was conducted to identify maternal factors predicting use of child immunizations in Haiti. Methods included four focus group interviews, four natural group interviews, individual interviews with 14 health care providers and participant observation at vaccination posts. Analysis of(More)