1
|
Garibay KK, Durazo A, Vizcaíno T, Oviedo Y, Marson K, Arechiga C, Prado P, Carrera O, Alvarado MJ, Havlir DV, Rojas S, Chamie G, Marquez C, Sauceda J, Yen IH, De Trinidad Young ME. Lessons from Two Latino Communities Working with Academic Partners to Increase Access to COVID-19 Testing. Prog Community Health Partnersh 2024; 18:1-9. [PMID: 38661822 PMCID: PMC11076150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE We sought to examine the experiences of community partners in a community-academic partnership to promote COVID-19 testing in two majority Latino communities. METHODS We conducted semistructured, in-depth interviews in English and Spanish with community-based organization leaders and community health workers/promotoras (n = 10) from June to July 2021. Interviews focused on identifying partner roles in planning and testing implementation and evaluating communication among partners. Interviews were transcribed and analyzed in ATLAS.ti version 8.4.5. Analyses involved deductive and inductive approaches to identify key themes. RESULTS Participants described both strengths and challenges to the collaborative approach within each of three core themes: building relationships in the time of COVID-19; uplifting existing community leadership; and commitment of the academic partners and community-based organizations to conduct partnership activities in Spanish. CONCLUSION Community-academic partnerships that invest in strong relationships, community leadership, and a commitment to the community's preferred language offer a promising approach to addressing COVID-19 testing barriers. Findings provide direction for future research on how community members and academic partners can come together to inform strategies to continue addressing the COVID-19 pandemic.
Collapse
|
2
|
Thomas CM, Yun K, Mudenge NU, Abudiab S, de Acosta D, Fredkove WM, Garcia Y, Hoffman SJ, Karim S, Mann E, Smith MK, Yu K, Dawson-Hahn E. Experiences of American Health Departments, Health Systems, and Community Organizations in COVID-19 Vaccine Provision for Refugee, Immigrant, and Migrant Communities. Am J Trop Med Hyg 2023; 109:471-479. [PMID: 37429571 PMCID: PMC10397449 DOI: 10.4269/ajtmh.23-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/09/2023] [Indexed: 07/12/2023] Open
Abstract
Effective provision of COVID-19 vaccines could mitigate the disproportionate impact of the COVID-19 pandemic experienced by many immigrant communities. To describe organizational experiences in using COVID-19 vaccination programs, qualitative interviews were conducted from September 2020 to April 2021 with representatives from public health, health system, and community organizations responding to the COVID-19 pandemic among immigrant communities across the United States. Interviews followed a semistructured interview guide and were audio recorded, transcribed, and coded. A latent thematic analysis was facilitated by Dedoose software. Interviews representative of 18 public health departments, 20 healthcare systems, and 18 community organizations were included in the analysis. Five identified themes referenced the importance of 1) appreciating community and individual heterogeneity in health priorities and attitudes; 2) addressing vaccine fears with trustworthy messages; 3) ensuring equitable access to vaccine opportunities; 4) making substantive investments in community partnerships and outreach; and 5) adapting to meet new needs. It is essential that vaccine efforts consider community heterogeneity, communicate in a trustworthy and culturally and linguistically appropriate manner, strive for equitable provision of care, build partnerships, and learn from prior experiences.
Collapse
Affiliation(s)
- Christine M. Thomas
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Katherine Yun
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nadège U. Mudenge
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Community Leadership Board, National Resource Center for Refugees, Immigrants, and Migrants, Minneapolis, Minnesota
| | - Seja Abudiab
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Diego de Acosta
- National Resource Center for Refugees, Immigrants, and Migrants, Minneapolis, Minnesota
| | - Windy M. Fredkove
- National Resource Center for Refugees, Immigrants, and Migrants, Minneapolis, Minnesota
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota
| | - Yesenia Garcia
- Seattle Children’s Research Institute, Seattle, Washington
| | - Sarah J. Hoffman
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Sayyeda Karim
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota
| | - Erin Mann
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota
| | - M. Kumi Smith
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Kimberly Yu
- National Resource Center for Refugees, Immigrants, and Migrants, Minneapolis, Minnesota
| | | |
Collapse
|
3
|
Goode JVR, Cook P, Cuttino S, Pollard S. Evaluation of a team-based quality improvement initiative for influenza vaccination in an underserved population. J Am Pharm Assoc (2003) 2022; 63:667-671. [PMID: 36549933 DOI: 10.1016/j.japh.2022.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Influenza vaccine is the most effective way to prevent influenza. However, low vaccination rates continue especially in underserved populations. OBJECTIVES To increase influenza vaccinations in an underserved population and to evaluate the impact of influenza vaccinations compared to previous year influenza vaccinations. PRACTICE DESCRIPTION Federally-Qualified Health care Center for the Homeless, Richmond, Virginia PRACTICE INNOVATION: Team-based quality improvement initiative led by a pharmacist champion. EVALUATION METHODS Before and after evaluation of the quality improvement initiative was conducted by comparing the total number of vaccines administered to those administered the previous year. RESULTS Influenza vaccinations increased by 42% over the prior influenza vaccination season (1269 vs. 895), respectively. From a population perspective, 31% of patients received an influenza vaccine in 2019-20 and 48% in 2020-21. During the 2019-20 influenza vaccine season, the majority of patients vaccinated were female 56% versus 50.9% in 2020-21. The average age increased from 2019-20 to 2020-21, 37.62 years of age versus 42.71 years of age, respectively. CONCLUSION A team-based quality improvement initiative was successful in improving our influenza vaccination program for adults and has served as a foundation for the delivery of other vaccines. Lessons learned were used to implement a COVID-19 vaccine program.
Collapse
|
4
|
Khorasani S, Zubiago J, Carreiro J, Guardado R, Wurcel AG. Influenza Vaccination in Massachusetts Jails: A Mixed-Methods Analysis. Public Health Rep 2022; 137:936-943. [PMID: 34524903 PMCID: PMC9379841 DOI: 10.1177/00333549211041659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Influenza infects millions of people each year and contributes to tens of thousands of deaths annually despite the availability of vaccines. People most at risk of influenza complications are disproportionately represented in people incarcerated in US prisons and jails. The objectives of this study were to survey health administrators in Massachusetts county jails about institutional influenza vaccine policies and practices and estimate influenza vaccination rates in Massachusetts jails from 2013 to 2020. METHODS In April 2020, we administered surveys to the health services administrators in Massachusetts' 14 county jails to gather information about influenza vaccination policies and delivery practices. To calculate influenza vaccination rates for each facility, we obtained data on influenza vaccine orders from the Massachusetts Department of Public Health for each county in Massachusetts for influenza seasons 2013-2020. We calculated summary statistics for each reporting facility and each year, conducted a Kruskal-Wallis analysis to compare vaccination rates between years, and used a linear regression model to identify predictors of vaccination rates. RESULTS Influenza vaccination rates in Massachusetts jails ranged from 1.9% to 11.8%. We found no significant differences in vaccination rates between years. Influenza vaccine ordering and delivery practices varied by jail, and respondents had high levels of confidence in influenza policies and vaccine delivery practices. CONCLUSIONS Influenza vaccination rates in Massachusetts jails are low, and delivery practices in jails vary. Lack of influenza vaccinations in jails is a gap in health care that needs to be prioritized, especially considering the current COVID-19 pandemic. Further investigations for effective and equitable vaccination in this population should involve people who are incarcerated and people who make influenza vaccine policies in jails.
Collapse
Affiliation(s)
| | - Julia Zubiago
- Division of Geographic Medicine and Infectious Diseases,
Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Jac Carreiro
- Tufts University School of Medicine, Boston, MA, USA
| | - Rubeen Guardado
- Division of Geographic Medicine and Infectious Diseases,
Department of Medicine, Tufts Medical Center, Boston, MA, USA
| | - Alysse G. Wurcel
- Tufts University School of Medicine, Boston, MA, USA
- Division of Geographic Medicine and Infectious Diseases,
Department of Medicine, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
5
|
Fortuna KL, Hudson MF, Myers A, Kadakia A, Rivera J, Nutz T. How can we achieve health equity? Revisit the premise informing the scientific method. Health Expect 2022; 25:1-3. [PMID: 35171530 PMCID: PMC8849369 DOI: 10.1111/hex.13369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- Karen L. Fortuna
- Department of PsychiatryGeisel School of Medicine at DartmouthHanoverNew HampshireUSA
| | | | | | | | | | - Tony Nutz
- National Alliance on Mental IllnessWichitaKansasUSA
| |
Collapse
|
6
|
Rogers JH, Cox SN, Hughes JP, Link AC, Chow EJ, Fosse I, Lukoff M, Shim MM, Uyeki TM, Ogokeh C, Jackson ML, Boeckh M, Englund JA, Mosites E, Rolfes MA, Chu HY. Trends in COVID-19 vaccination intent and factors associated with deliberation and reluctance among adult homeless shelter residents and staff, 1 November 2020 to 28 February 2021 - King County, Washington. Vaccine 2022; 40:122-132. [PMID: 34863618 PMCID: PMC8590934 DOI: 10.1016/j.vaccine.2021.11.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/17/2021] [Accepted: 11/08/2021] [Indexed: 12/01/2022]
Abstract
Introduction Little is known about COVID-19 vaccination intent among people experiencing homelessness. This study assesses surveyed COVID-19 vaccination intent among adult homeless shelter residents and staff and identifies factors associated with vaccine deliberation (responded “undecided”) and reluctance (responded “no”), including time trends. Methods From 11/1/2020–2/28/21, we conducted repeated cross-sectional surveys at nine shelters in King County, WA as part of ongoing community-based SARS-CoV-2 surveillance. We used a multinomial model to identify characteristics associated with vaccine deliberation and reluctance. Results A total of 969 unique staff (n = 297) and residents (n = 672) participated and provided 3966 survey responses. Among residents, 53.7% (n = 361) were vaccine accepting, 28.1% reluctant, 17.6% deliberative, and 0.6% already vaccinated, whereas among staff 56.2% were vaccine accepting, 14.1% were reluctant, 16.5% were deliberative, and 13.1% already vaccinated at their last survey. We observed higher odds of vaccine deliberation or reluctance among Black/African American individuals, those who did not receive a seasonal influenza vaccine, and those with lower educational attainment. There was no significant trend towards vaccine acceptance. Conclusions Strong disparities in vaccine intent based on race, education, and prior vaccine history were observed. Increased vaccine intent over the study period was not detected. An intersectional, person-centered approach to addressing health inequities by public health authorities planning vaccination campaigns in shelters is recommended. Clinical Trial Registry Number: NCT04141917.
Collapse
Affiliation(s)
- Julia H Rogers
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Sarah N Cox
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Amy C Link
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Eric J Chow
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA
| | | | | | - M Mia Shim
- Public Health - Seattle & King County, WA, USA; Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Janet A Englund
- Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - Emily Mosites
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Helen Y Chu
- Department of Medicine, Division of Allergy & Infectious Diseases, University of Washington, Seattle, WA, USA
| |
Collapse
|
7
|
County Social Vulnerability and Influenza Vaccine Rates: National and Local Estimates for Medicare Recipients. Am J Prev Med 2022; 62:e1-e9. [PMID: 34548222 DOI: 10.1016/j.amepre.2021.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Seasonal influenza vaccination among older adults is well below the recommendation of Healthy People 2020. Although geographic disparities in influenza vaccination are well documented, it remains unclear how community attributes correlate with influenza vaccination rates. Social vulnerability measures play an important role in interventions addressing vaccine equity; however, social vulnerability dimensions as corollaries of vaccination are poorly understood. To inform vaccine equity interventions, this analysis investigates spatially varying associations between county social vulnerability and influenza vaccination rate among Medicare recipients. METHODS County-level 2018 data (N=3,105) from the Centers for Disease Control and Prevention's Social Vulnerability Index were merged with the percentage of Medicare recipients vaccinated against influenza. Multilevel linear regression and geographically weighted regression generated global and local estimates, adjusted for potential confounders. Analyses were conducted in November 2020-April 2021. RESULTS A 10-percentile point increase in the overall Social Vulnerability Index was associated with an 0.87-point decrease in percentage vaccinated (p<0.001) with substantial variation by Social Vulnerability Index theme and geography. A 10-percentile point increase in socioeconomic vulnerability was associated with a 1.6-point decrease in vaccination (p<0.001) with stronger associations in higher Social Vulnerability Index quartiles and in parts of the Midwest, South, and coastal Northeast. Other Social Vulnerability Index themes had smaller associations with mixed directions: household composition and disability estimates were negative, whereas estimates for minority status and language and housing and transportation were positive. CONCLUSIONS Medicare recipients in socioeconomically vulnerable counties have low influenza vaccination rates, particularly in select regions of the country. Best practices to improve vaccine access and uptake should be targeted and should explicitly consider local socioeconomic vulnerability.
Collapse
|
8
|
Nguyen AT, Arnold BF, Kennedy CJ, Mishra K, Pokpongkiat NN, Seth A, Djajadi S, Holbrook K, Pan E, Kirley PD, Libby T, Hubbard AE, Reingold A, Colford JM, Benjamin-Chung J. Evaluation of a city-wide school-located influenza vaccination program in Oakland, California with respect to race and ethnicity: A matched cohort study. Vaccine 2021; 40:266-274. [PMID: 34872797 PMCID: PMC8881996 DOI: 10.1016/j.vaccine.2021.11.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/12/2021] [Accepted: 11/23/2021] [Indexed: 11/23/2022]
Abstract
Background: Increasing influenza vaccination coverage in school-aged children may substantially reduce community transmission. School-located influenza vaccinations (SLIV) aim to promote vaccinations by increasing accessibility, which may be especially beneficial to race/ethnicity groups that face high barriers to preventative care. Here, we evaluate the effectiveness of a city-wide SLIV program by race/ethnicity from 2014 to 2018. Methods: We used multivariate matching to pair schools in the intervention district in Oakland, CA with schools in a comparison district in West Contra Costa County, CA. We distributed cross-sectional surveys to measure caregiver-reported student vaccination status and estimated differences in vaccination coverage levels and reasons for non-vaccination between districts stratifying by race/ethnicity. We estimated difference-in-differences (DID) of laboratory confirmed influenza hospitalization incidence between districts stratified by race/ethnicity using surveillance data. Results: Differences in influenza vaccination coverage in the intervention vs. comparison district were larger among White (2017–18: 21.0% difference [95% CI: 9.7%, 32.3%]) and Hispanic/Latino (13.4% [8.8%, 18.0%]) students than Asian/Pacific Islander (API) (8.9% [1.3%, 16.5%]), Black (5.9% [−2.2%, 14.0%]), and multiracial (6.3% [−1.8%, 14.3%)) students. Concerns about vaccine effectiveness or safety were more common among Black and multiracial caregivers. Logistical barriers were less common in the intervention vs. comparison district, with the largest difference among White students. In both districts, hospitalizations in 2017–18 were higher in Blacks (Intervention: 111.5 hospitalizations per 100,00; Comparison: 134.1 per 100,000) vs. other races/ethnicities. All-age influenza hospitalization incidence was lower in the intervention site vs. comparison site among White/API individuals in 2016–17 (DID −25.14 per 100,000 [95% CI: −40.14, −10.14]) and 2017–18 (−36.6 per 100,000 [−52.7, −20.5]) and Black older adults in 2017–18 (−282.2 per 100,000 (−508.4, −56.1]), but not in other groups. Conclusions: SLIV was associated with higher vaccination coverage and lower influenza hospitalization, but associations varied by race/ethnicity. SLIV alone may be insufficient to ensure equitable influenza outcomes.
Collapse
Affiliation(s)
- Anna T Nguyen
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States; Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States.
| | - Benjamin F Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, United States
| | - Chris J Kennedy
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, United States
| | - Kunal Mishra
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Nolan N Pokpongkiat
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Anmol Seth
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Stephanie Djajadi
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Kate Holbrook
- Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, Oakland, CA, United States; Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Erica Pan
- Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, Oakland, CA, United States; California Department of Public Health, Richmond, CA, United States; Department of Pediatrics, Division of Infectious Diseases, University of California, San Francisco, San Francisco, CA, United States
| | - Pam D Kirley
- California Emerging Infections Program, Oakland, CA, United States
| | - Tanya Libby
- California Emerging Infections Program, Oakland, CA, United States
| | - Alan E Hubbard
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Arthur Reingold
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - John M Colford
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States
| | - Jade Benjamin-Chung
- Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, CA, United States; Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States
| |
Collapse
|
9
|
Lambert JF, Stete K, Balmford J, Bockey A, Kern W, Rieg S, Boeker M, Lange B. Reducing burden from respiratory infections in refugees and immigrants: a systematic review of interventions in OECD, EU, EEA and EU-applicant countries. BMC Infect Dis 2021; 21:872. [PMID: 34445957 PMCID: PMC8390210 DOI: 10.1186/s12879-021-06474-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Respiratory diseases are a major reason for refugees and other immigrants seeking health care in countries of arrival. The burden of respiratory diseases in refugees is exacerbated by sometimes poor living conditions characterised by crowding in mass accommodations and basic living portals. The lack of synthesised evidence and guideline-relevant information to reduce morbidity and mortality from respiratory infections endangers this population. METHODS A systematic review of all controlled and observational studies assessing interventions targeting the treatment, diagnosis and management of respiratory infections in refugees and immigrants in OECD, EU, EEA and EU-applicant countries published between 2000 and 2019 in MEDLINE, CINAHL, PSYNDEX and the Web of Science. RESULTS Nine of 5779 identified unique records met our eligibility criteria. Seven studies reported an increase in vaccine coverage from 2 to 52% after educational multilingual interventions for respiratory-related childhood diseases (4 studies) and for influenza (5 studies). There was limited evidence in one study that hand sanitiser reduced rates of upper respiratory infections and when provided together with face masks also the rates of influenza-like-illness in a hard to reach migrant neighbourhood. In outbreak situations of vaccine-preventable diseases, secondary cases and outbreak hazards were reduced by general vaccination strategies early after arrival but not by serological testing after exposure (1 study). We identified evidence gaps regarding interventions assessing housing standards, reducing burden of bacterial pneumonia and implementation of operational standards in refugee care and reception centres. CONCLUSIONS Multilingual health literacy interventions should be considered to increase uptake of vaccinations in refugees and immigrants. Immediate vaccinations upon arrival at refugee housings may reduce secondary infections and outbreaks. Well-designed controlled studies on housing and operational standards in refugee and immigrant populations early after arrival as well as adequate ways to gain informed consent for early vaccinations in mass housings is required to inform guidelines.
Collapse
Affiliation(s)
- Jan-Frederic Lambert
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany.
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Katarina Stete
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Annabelle Bockey
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Winfried Kern
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Berit Lange
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr.7, 38124, Braunschweig, DE, Germany
| |
Collapse
|
10
|
Factors Associated with Influenza Vaccination Uptake among U.S. Adults: Focus on Nativity and Race/Ethnicity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105349. [PMID: 34067932 PMCID: PMC8157050 DOI: 10.3390/ijerph18105349] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 11/21/2022]
Abstract
To support implementation strategies for upcoming influenza (flu) vaccinations for foreign-born and racial/ethnic minority groups, we analyzed the 2018 National Health Interview Survey (NHIS) database and performed logistic regression to examine the factors associated with, and the interaction between nativity and race/ethnicity in directing flu vaccination rates during the past 12 months (n = 25,045). As a result, we found nativity and race/ethnicity were associated with flu vaccination rates; foreign-born and non-Hispanic black respondents were less likely to take the vaccine than U.S.-born and non-Hispanic white respondents. The odds ratios were largest for the elderly, those working in the healthcare industry, those with health insurance, and those with a usual source of care (ORs = 3.058, 2.871, 2.317, and 2.342, respectively), suggesting that access to healthcare resources is critical for the uptake of the flu vaccine. There was a significant interaction effect between nativity and race/ethnicity. For improving flu vaccination rates, more support is necessary for foreign-born people and racial/ethnic minorities who have lower health insurance rates and usual sources of care than U.S.-born people and non-Hispanic whites, and thus are less able to adequately access healthcare resources in a timely manner.
Collapse
|
11
|
Lu PJ, Srivastav A, Santibanez TA, Amaya A, Dever JA, Roycroft J, Kurtz MS, Williams WW. Trends in place of early-season influenza vaccination among adults, 2014-15 through 2018-19 influenza seasons-The importance of medical and nonmedical settings for vaccination. Am J Infect Control 2021; 49:555-562. [PMID: 33038459 PMCID: PMC9077541 DOI: 10.1016/j.ajic.2020.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Annual vaccination is the most effective strategy for preventing influenza. We assessed trends and demographic and access-to-care characteristics associated with place of vaccination in recent years. METHODS Data from the 2014-2018 National Internet Flu Survey were analyzed to assess trends in place of early-season influenza vaccination during the 2014-15 through 2018-19 seasons. Multivariable logistic regression was conducted to identify factors independently associated with vaccination settings in the 2018-19 season. RESULTS Among vaccinated adults, the proportion vaccinated in medical (range: 49%-53%) versus nonmedical settings (range: 47%-51%) during the 2014-15 through 2018-19 seasons were similar. Among adults aged ≥18 years vaccinated early in the 2018-19 influenza season, a doctor's office was the most common place (34.4%), followed by pharmacies or stores (32.3%), and workplaces (15.0%). Characteristics significantly associated with an increased likelihood of receipt of vaccination in nonmedical settings among adults included household income ≥$50,000, having no doctor visits since July 1, 2018, or having a doctor visit but not receiving an influenza vaccination recommendation from the medical professional. CONCLUSIONS Place of early-season influenza vaccination among adults who reported receiving influenza vaccination was stable over 5 recent seasons. Both medical and nonmedical settings were important places for influenza vaccination. Increasing access to vaccination services in medical and nonmedical settings should be considered as an important strategy for improving vaccination coverage.
Collapse
Affiliation(s)
- Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Anup Srivastav
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA; Leidos Inc., Atlanta, GA
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | | - Walter W Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
12
|
Platt L, Elmes J, Stevenson L, Holt V, Rolles S, Stuart R. Sex workers must not be forgotten in the COVID-19 response. Lancet 2020; 396:9-11. [PMID: 32422122 PMCID: PMC7228722 DOI: 10.1016/s0140-6736(20)31033-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 01/12/2023]
Affiliation(s)
- Lucy Platt
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
| | - Jocelyn Elmes
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Luca Stevenson
- International Committee on the Rights of Sex Workers in Europe, Brussels, Belgium
| | - Victoria Holt
- Department of Social Sciences, University of Roehampton, Roehampton, UK
| | | | - Rachel Stuart
- School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, UK
| |
Collapse
|
13
|
Ozawa S, Yemeke TT, Evans DR, Pallas SE, Wallace AS, Lee BY. Defining hard-to-reach populations for vaccination. Vaccine 2019; 37:5525-5534. [PMID: 31400910 PMCID: PMC10414189 DOI: 10.1016/j.vaccine.2019.06.081] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/29/2022]
Abstract
Extending the benefits of vaccination to everyone who is eligible requires an understanding of which populations current vaccination efforts have struggled to reach. A clear definition of "hard-to-reach" populations - also known as high-risk or marginalized populations, or reaching the last mile - is essential for estimating the size of target groups, sharing lessons learned based on consistent definitions, and allocating resources appropriately. A literature review was conducted to determine what formal definitions of hard-to-reach populations exist and how they are being used, and to propose definitions to consider for future use. Overall, we found that (1) there is a need to distinguish populations that are hard to reach versus hard to vaccinate, and (2) the existing literature poorly defined these populations and clear criteria or thresholds for classifying them were missing. Based on this review, we propose that hard-to-reach populations be defined as those facing supply-side barriers to vaccination due to geography by distance or terrain, transient or nomadic movement, healthcare provider discrimination, lack of healthcare provider recommendations, inadequate vaccination systems, war and conflict, home births or other home-bound mobility limitations, or legal restrictions. Although multiple mechanisms may apply to the same population, supply-side barriers should be distinguished from demand-side barriers. Hard-to-vaccinate populations are defined as those who are reachable but difficult to vaccinate due to distrust, religious beliefs, lack of awareness of vaccine benefits and recommendations, poverty or low socioeconomic status, lack of time to access available vaccination services, or gender-based discrimination. Further work is needed to better define hard-to-reach populations and delineate them from populations that may be hard to vaccinate due to complex refusal reasons, improve measurement of the size and importance of their impact, and examine interventions related to overcoming barriers for each mechanism. This will enable policy makers, governments, donors, and the vaccine community to better plan interventions and allocate necessary resources to remove existing barriers to vaccination.
Collapse
Affiliation(s)
- Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | | | - Sarah E Pallas
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Aaron S Wallace
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
14
|
Brandt HM, Vanderpool RC, Curry SJ, Farris P, Daniel-Ulloa J, Seegmiller L, Stradtman LR, Vu T, Taylor V, Zubizarreta M. A multi-site case study of community-clinical linkages for promoting HPV vaccination. Hum Vaccin Immunother 2019; 15:1599-1606. [PMID: 31158042 DOI: 10.1080/21645515.2019.1616501] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human papillomavirus (HPV) vaccination rates in the U.S. are suboptimal, requiring innovative partnerships between community and clinical entities to remedy this issue. A rigorous evaluation of HPV-related community-clinical linkages (CCLs) was conducted to understand their components, processes, and outcomes to increase HPV vaccination. Cancer Prevention and Control Research Network (CPCRN) investigators explored CCLs in their communities employing an iterative, case study approach. Information describing nine CCLs on HPV vaccination was collected from representatives from the community organization and clinical setting. Thematic content analysis was used to analyze and interpret data. Five CCLs included a federally qualified health center as the clinical partner, and five included a non-profit organization as the community partner. Five reflected clinically focused integration wherein engagement occurs in the community but vaccine delivery and follow-up occur in the clinical setting. The main impetus was the need to improve HPV vaccination and a community's strong interest in preventing cancer. Noted critical components were a designated person to support the CCL and funding. Results will guide HPV vaccination promotion, education, and intervention efforts. CCLs provide an opportunity to study the adaption, integration, and enhancement of evidence-based approaches to increase HPV vaccination.
Collapse
Affiliation(s)
- Heather M Brandt
- a Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health , Columbia , SC , USA
| | - Robin C Vanderpool
- b Department of Health, Behavior and Society, University of Kentucky College of Public Health , Lexington , KY , USA
| | - Susan J Curry
- c Department of Health Management and Policy, University of Iowa , Iowa City , USA
| | - Paige Farris
- d Oregon Health and Science University School of Public Health , Portland , QR , USA
| | - Jason Daniel-Ulloa
- e Department of Community & Behavioral Health, University of Iowa College of Public Health , Iowa City , IA , USA
| | - Laura Seegmiller
- e Department of Community & Behavioral Health, University of Iowa College of Public Health , Iowa City , IA , USA
| | - Lindsay R Stradtman
- b Department of Health, Behavior and Society, University of Kentucky College of Public Health , Lexington , KY , USA
| | - Thuy Vu
- f Department of Health Services, University of Washington School of Public Health , Seattle , WA , USA
| | - Victoria Taylor
- f Department of Health Services, University of Washington School of Public Health , Seattle , WA , USA
| | - Maria Zubizarreta
- a Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health , Columbia , SC , USA
| |
Collapse
|
15
|
Hughes MM, Saiyed NS, Chen TS. Local-Level Adult Influenza and Pneumococcal Vaccination Disparities: Chicago, Illinois, 2015-2016. Am J Public Health 2018; 108:517-523. [PMID: 29470113 DOI: 10.2105/ajph.2017.304257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate local-level adult influenza and pneumococcal vaccination disparities to inform targeted interventions. METHODS Questions on influenza and pneumococcal vaccination uptake were included in a door-to-door community-based representative survey conducted in 10 Chicago, Illinois, neighborhoods in 2015 and 2016. A total of 1543 adults completed the survey, including 172 adults aged 65 years or older. We calculated adult influenza (≥ 18 years) and pneumococcal (≥ 65 years) vaccination coverage by community area and respondent characteristics. RESULTS We observed significant differences in pneumococcal vaccination coverage between community areas (range = 18%-91%). Influenza vaccination coverage differed by gender, age, insurance coverage, acculturation, and confidence or trust in physician. Non-Hispanic Blacks were more likely to be vaccinated when they had higher confidence or trust in their physician (45% vs 20%; P < .01). Mexicans who reported less acculturation were more likely to be vaccinated than were Mexicans who were more acculturated (41% vs 27%; P = .02). CONCLUSIONS Striking disparities between neighborhoods and racial/ethnic groups in adult influenza and pneumococcal vaccination coverage highlight the need for improved local-level immunization coverage data.
Collapse
Affiliation(s)
- Michelle M Hughes
- Michelle M. Hughes conducted this research at the Sinai Urban Health Institute, Sinai Health System, Chicago, IL, and Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL. Nazia S. Saiyed is with the Sinai Urban Health Institute. Tiffany S. Chen is with Chicago Medical School, Rosalind Franklin University of Medicine and Science
| | - Nazia S Saiyed
- Michelle M. Hughes conducted this research at the Sinai Urban Health Institute, Sinai Health System, Chicago, IL, and Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL. Nazia S. Saiyed is with the Sinai Urban Health Institute. Tiffany S. Chen is with Chicago Medical School, Rosalind Franklin University of Medicine and Science
| | - Tiffany S Chen
- Michelle M. Hughes conducted this research at the Sinai Urban Health Institute, Sinai Health System, Chicago, IL, and Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL. Nazia S. Saiyed is with the Sinai Urban Health Institute. Tiffany S. Chen is with Chicago Medical School, Rosalind Franklin University of Medicine and Science
| |
Collapse
|
16
|
Quinn SC, Jamison A, An J, Freimuth VS, Hancock GR, Musa D. Breaking down the monolith: Understanding flu vaccine uptake among African Americans. SSM Popul Health 2017; 4:25-36. [PMID: 29349270 PMCID: PMC5769118 DOI: 10.1016/j.ssmph.2017.11.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022] Open
Abstract
Black adults are significantly less likely to be immunized for seasonal influenza when compared to Whites. This persistent disparity contributes to increased influenza-related morbidity and mortality in the African American population. Most scholarship on vaccine disparities has compared Whites and Blacks. Employing Public Health Critical Race Praxis, this study seeks to shift the focus to explore differences within the Black population. Utilizing a nationally-representative 2015 survey of US Black adults (n = 806), we explore differences by gender, age, income, and education across vaccine-related measures (e.g., perceived risk, knowledge, attitudes) and racial factors (e.g. racial salience, racial fairness, perceived discrimination). We also explore differences by vaccine behavior in the past five years among those who vaccinate every year, most years but not all, once or twice, and never. Greater frequency of flu vaccine uptake was associated with better self-reported vaccine knowledge, more positive vaccine attitudes, more trust in the flu vaccine and the vaccine process, higher perceived disease risk, lower perceived risk of vaccine side effects, stronger subjective and moral norms, lower general vaccine hesitancy, higher confidence in the flu vaccine, and lower perceived barriers. Logistic regression results highlighted other significant differences among the groups, emphasizing areas to target for improved vaccination rates. We find great diversity within the Black community related to influenza immunization decisions, highlighting the need to “break down the monolith” in future research. Empirically tested differences within the Black population for flu vaccine behavior. Detected significant differences in past vaccine behavior by age, gender, income, and education. Focus on past behavior to move adults along the continuum to increase vaccination. Highlights diversity within the Black population, often missing from comparative studies.
Collapse
Affiliation(s)
- Sandra Crouse Quinn
- Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1142, College Park, MD 20742, USA.,Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1304, College Park, MD 20742, USA
| | - Amelia Jamison
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1304, College Park, MD 20742, USA
| | - Ji An
- Department of Human Development and Quantitative Methods, University of Maryland,1230 Benjamin Building, College Park, MD 20742, USA
| | - Vicki S Freimuth
- Department of Health Promotion and Behavior, University of Georgia, 100 Foster Road, Athens, GA 30602, USA
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methods, University of Maryland,1230 Benjamin Building, College Park, MD 20742, USA
| | - Donald Musa
- University Center for Social and Urban Research, University of Pittsburgh, 3343 Forbes Avenue, Pittsburgh, PA 15260, USA
| |
Collapse
|
17
|
Abstract
Hidden populations, such as injecting drug users (IDUs), sex workers (SWs) and men who have sex with men (MSM), are considered at high risk of contracting and transmitting infectious diseases such as AIDS, gonorrhea, syphilis etc. However, public health interventions to such groups are prohibited due to strong privacy concerns and lack of global information, which is a necessity for traditional strategies such as targeted immunization and acquaintance immunization. In this study, we introduce an innovative intervention strategy to be used in combination with a sampling approach that is widely used for hidden populations, Respondent-driven Sampling (RDS). The RDS strategy is implemented in two steps: First, RDS is used to estimate the average degree (personal network size) and degree distribution of the target population with sample data. Second, a cut-off threshold is calculated and used to screen the respondents to be immunized. Simulations on model networks and real-world networks reveal that the efficiency of the RDS strategy is close to that of the targeted strategy. As the new strategy can be implemented with the RDS sampling process, it provides a cost-efficient and feasible approach for disease intervention and control for hidden populations.
Collapse
|
18
|
Worasathit R, Wattana W, Okanurak K, Songthap A, Dhitavat J, Pitisuttithum P. Health education and factors influencing acceptance of and willingness to pay for influenza vaccination among older adults. BMC Geriatr 2015; 15:136. [PMID: 26503289 PMCID: PMC4620638 DOI: 10.1186/s12877-015-0137-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 10/19/2015] [Indexed: 11/29/2022] Open
Abstract
Background The influenza vaccine is recommended in older population. However the immunization coverage varies globally. It has been reported as low as 10–20 % in some countries. This study explored the acceptance of and willingness to pay for influenza vaccination, comparing acceptance and willingness to pay before and after health education. Methods The study was conducted with 2693 older people in Bangkok, Thailand. Participants were divided into an education group (n = 1402) and a control group (n = 1291). A validated questionnaire measuring acceptance of and willingness to pay for vaccination was administered during semi-structured interviews before and after education. Data on factors influencing acceptance were analyzed. Results Participants’ mean age was 69.5 years, 80 % were women and 82.1 % had at least one co-morbidity. Of the participants, 43.5 % had previously received vaccination more than once, although 92.8 % expressed acceptance of vaccination. Acceptance was associated with a positive attitude toward vaccination (OR 2.1, 95 % CI 1.5–2.9) and a history of receiving vaccination (OR 4.1, 95 % CI 2.8–6.1). At baseline, there were no differences between the education and control groups in terms of work status (p = 0.457), co-morbidities (p = 0.07), medical status (p = 0.243), and previous vaccination (p = 0.62), except for educational background (p = 0.004). Acceptance of vaccination increased to 95.8 % (p < 0.001) after education and willingness to pay increased to 82.1 % (p < 0.001). Education significantly affected those with primary school-level education and no previous vaccination history, with acceptance increasing from 83.3 to 92.6 % (p < 0.001); more than twice as high as the control group (OR 2.4, 95 % CI 1.2–4.7). Viewing an educational video increased the proportion of participants with a high level of knowledge from 29.2 to 49.2 % (p < 0.001), and increased the proportion of participants with a positive attitude from 52.4 to 70.7 % (p <0.001). No significant difference was found in any parameter between the first and second assessment in the control group. Conclusions The strategies to increase positive attitudes may enhance the acceptance of vaccination. Health education using an educational video demonstrated a significant impact on acceptance, willingness to pay, knowledge and attitude in older people. This may lead to increased sustainability of the immunization program in older people.
Collapse
Affiliation(s)
- Rawipun Worasathit
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Wantanee Wattana
- Bangkok Metropolitan Administration (BMA), Mitmaitree Road, Dindang, Bangkok, 10400, Thailand.
| | - Kamolnetr Okanurak
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Archin Songthap
- Sirindhorn College of Public Health, 89 Moo2 Thanon Trang-Kantang Thambon Kuanthani Amphoe Kantang, Trang Province, 92000, Trang, Thailand.
| | - Jittima Dhitavat
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Punnee Pitisuttithum
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
| |
Collapse
|
19
|
Gany F, Rau-Murthy R, Mujawar I. Increasing influenza vaccination in New York City taxi drivers: A community driven approach. Vaccine 2015; 33:2521-3. [PMID: 25850021 DOI: 10.1016/j.vaccine.2015.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 02/19/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
The Healthy People 2020 influenza immunization goal is 80% for non-institutionalized adults 18-64. However, vaccination rates remain stubbornly low. Culturally tailored approaches to communities with poor vaccine uptake are necessary. Taxi drivers are at risk for influenza and its complications, could serve as vectors for influenza infection, and could be an effective vaccination target to enhance herd immunity of the urban population. To the best of our knowledge, this is the first study related to influenza vaccination among taxi drivers. The NYC Taxi Network surveyed a convenience sample of 53 taxi drivers to understand vaccination barriers. Only 17% had been vaccinated. Results informed a pilot tailored workplace intervention, which resulted in vaccinations for 44% of unvaccinated drivers. The study revealed that older drivers were more likely to be vaccinated than younger drivers, while the most common barrier to immunization was that drivers thought vaccination was 'not necessary'.
Collapse
Affiliation(s)
- Francesca Gany
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 300 East 66th Street, 15th Floor, New York, NY 10065, USA.
| | - Rohini Rau-Murthy
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 300 East 66th Street, 15th Floor, New York, NY 10065, USA.
| | - Imran Mujawar
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 300 East 66th Street, 15th Floor, New York, NY 10065, USA.
| | | |
Collapse
|
20
|
Jarrett C, Wilson R, O'Leary M, Eckersberger E, Larson HJ. Strategies for addressing vaccine hesitancy - A systematic review. Vaccine 2015; 33:4180-90. [PMID: 25896377 DOI: 10.1016/j.vaccine.2015.04.040] [Citation(s) in RCA: 612] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts. METHODS A systematic review of peer reviewed (January 2007-October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager. RESULTS Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
Collapse
Affiliation(s)
- Caitlin Jarrett
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rose Wilson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maureen O'Leary
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Elisabeth Eckersberger
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | | |
Collapse
|
21
|
Young S, Dosani N, Whisler A, Hwang S. Influenza Vaccination Rates Among Homeless Adults With Mental Illness in Toronto. J Prim Care Community Health 2014; 6:211-4. [PMID: 25416307 DOI: 10.1177/2150131914558881] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the incidence of influenza vaccination among homeless individuals with mental illness in Toronto. METHODS A retrospective chart review was carried out using a random sample of homeless individuals with mental illness who were participants of the At Home/Chez Soi Study. Primary care charts were obtained and reviewed for the incidence influenza vaccination within a 1-year period. RESULTS Of the 75 participants for whom charts were reviewed, 5 (6.7%) had documentation indicating receipt of the influenza vaccination in the year prior to study recruitment. CONCLUSION This study raises awareness of the low incidence of homeless adults receiving the influenza vaccination in Toronto. The data are concerning given the high risk of morbidity from communicable respiratory illnesses in this group. Further research into the causes of low influenza vaccination rates among homeless Canadians is needed to develop strategies for increased delivery of the vaccination.
Collapse
Affiliation(s)
- Samantha Young
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Naheed Dosani
- St Michael's Hospital, Toronto, Ontario, Canada Inner City Health Associates, Toronto, Ontario, Canada McMaster University, Hamilton, Ontario, Canada
| | | | - Stephen Hwang
- St Michael's Hospital, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
22
|
Lu PJ, O'Halloran A, Ding H, Williams WW, Bridges CB, Kennedy ED. National and state-specific estimates of place of influenza vaccination among adult populations - United States, 2011-12 influenza season. Vaccine 2014; 32:3198-204. [PMID: 24731815 PMCID: PMC5824644 DOI: 10.1016/j.vaccine.2014.04.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/14/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Annual influenza vaccination has been recommended for all persons ≥6 months since the 2010-11 season. New partnerships between public health agencies and medical and nonmedical vaccination providers have increased the number of vaccination providers and locations where vaccination services are delivered. METHODS Data from the 2011-12 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Point estimates of place of vaccination and 95% confidence intervals were calculated. Multivariable logistic regression and predictive marginal modeling were conducted to identify factors associated with vaccination settings. RESULTS Among adults vaccinated during the 2011-12 influenza season, a doctor's office was the most common place (38.4%) for receipt of influenza vaccination, with stores (e.g., supermarkets or drug stores) (20.1%) the next common, and workplaces (17.6%) the third common. Overall, reported vaccination in nonmedical settings by state ranged from 32.2% in California to 60.4% in Nevada, with a median of 45.8%. Characteristics significantly associated with an increased likelihood of receipt of vaccination in nonmedical settings were higher education, not having certain identified high-risk conditions, not having had a routine checkup in the previous 12 months, and not having a primary doctor for health care. Being a member of a racial/ethnic minority group, unemployed or not in the work force were significantly associated with a decreased likelihood of receipt of vaccination in nonmedical settings. CONCLUSION Doctor's offices were the most common medical setting for adult influenza vaccination; workplaces and stores were important nonmedical settings. Increasing access to vaccination services in medical and nonmedical settings should be considered as important strategies for improving vaccination coverage. These results also can help guide development of strategies for achieving Healthy People 2020 objectives for influenza vaccination of adult populations.
Collapse
Affiliation(s)
- Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
| | - Alissa O'Halloran
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States
| | - Helen Ding
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States
| | - Walter W Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States
| | - Carolyn B Bridges
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States
| | - Erin D Kennedy
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States
| |
Collapse
|
23
|
Resources and interest among faith based organizations for influenza vaccination programs. J Immigr Minor Health 2014; 15:758-63. [PMID: 22623183 DOI: 10.1007/s10903-012-9645-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the United States, annual influenza vaccination rates are suboptimal and are well below the national health objectives. Project VIVA mobilized community members and organizations to implement an influenza vaccination program in Harlem by administering vaccines in "non-traditional" venues, such as community-based organizations, pharmacies, and faith-based organizations (FBOs). FBOs have been recognized as important venues for health promotion initiatives within medically underserved communities. However, data regarding the extent of resources and interest in health promotion programs among FBOs are sparse. We conducted a telephone survey among 115 FBOs in three New York City neighborhoods with histories of low influenza immunization rates to identify the congregation's health concerns, interest in serving as a community-based venue for influenza vaccinations, and existing resources for health programming. Twenty-six percent of the FBOs had an established health ministry, while 45 % expressed interest in developing one. Seven percent included nurses among their health activities and 16.5 % had contact with the local health department. Most FBOs expressed interest in common health promotions programs; 60 % expressed interest in providing on-site influenza vaccination programs within their organization. Health programs within FBOs can be a point of access that may improve the health of their congregants as well as the larger community.
Collapse
|
24
|
Schiavo R, Leung MM, Brown M. Communicating risk and promoting disease mitigation measures in epidemics and emerging disease settings. Pathog Glob Health 2014; 108:76-94. [PMID: 24649867 PMCID: PMC4005587 DOI: 10.1179/2047773214y.0000000127] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This review aims to identify and assess evidence on interventions to communicate risk and promote disease mitigation measures in epidemics and emerging disease outbreak settings. The study focuses on data that are relevant to low and middle-income country (LMIC) settings. METHODS We conducted a comprehensive literature search using five major electronic databases (Pubmed Medline, Biomed Central, EMBASE, Science of Citation Index, and Cochrane Library) and other sources to identify relevant studies published from January 2002 to July 2013. The review was guided by the socio-ecological model/perspective of public health and the ideation theory and focused on interventions at the community, healthcare, and multi-sectoral settings, which also reflect key intervention levels of the Ottawa Charter for Health Promotion. Eligible quantitative studies were selected according to specific study criteria and assessed using the Critical Appraisal Skills Program (CASP) framework. Conversely, qualitative studies, reviews, case studies, and editorials were not included. Studies were selected by two independent reviewers. RESULTS Twenty-nine relevant studies from 16 countries were included. Most studies focused on a single intervention or intervention level, rather than multi-sectoral interventions. The majority of the evidence relates to programs aimed at behavioral and social results (or relevant intermediate steps) within a specific population group. Two studies included implications for improvements in health service delivery, two studies examined the intervention's impact on health systems-related outcomes, and three had also implications for environmental health outcomes. Cost- and health equity-related implications for select evidence were also discussed. CONCLUSIONS The paucity of well-designed quantitative evaluations of interventions to communicate health risk and promote disease control measures in LMICs does not allow for any definitive conclusions. Yet, the review identified several promising interventions and areas for future investigation. Among them, community-based and participatory interventions seemed to be central within epidemic and emerging disease settings, particularly in low-resource settings. Yet, evidence on their effectiveness is not conclusive and needs to be explored by future studies. Other promising areas for future investigation include multi-component and multi-sectoral approaches to intervention design. Major research gaps referred to any evaluation of the impact of these kinds of interventions on health policy adoption and/or implementation, and social determinants of health. Research on cost-effectiveness also needs to be strengthened. This review identified several research gaps and questions, and discusses potential future directions for increasing capacity for future and more rigorous assessments.
Collapse
Key Words
- Behavior change communication,
- Communication preparedness,
- Cost,
- Development communication,
- Emerging diseases,
- Epidemics,
- Global health,
- Health communication,
- Health equity,
- Health promotion,
- Health service delivery,
- Health systems,
- Low and middle-income countries (LMICs),
- Outbreak control,
- Public health,
- Risk communication,
- Social change communication,
- Vulnerable and underserved populations
Collapse
Affiliation(s)
| | - May May Leung
- CUNY School of Public Health, New York, NY, USA
- Hunter College, New York, NY, USA
| | | |
Collapse
|
25
|
Metcalfe SE, Sexton EH. An Academic-Community Partnership to Address the Flu Vaccination Rates of the Homeless. Public Health Nurs 2013; 31:175-82. [DOI: 10.1111/phn.12088] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
Buccieri K, Gaetz S. Ethical Vaccine Distribution Planning for Pandemic Influenza: Prioritizing Homeless and Hard-to-Reach Populations. Public Health Ethics 2013. [DOI: 10.1093/phe/pht005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Jagosh J, Macaulay AC, Pluye P, Salsberg J, Bush PL, Henderson J, Sirett E, Wong G, Cargo M, Herbert CP, Seifer SD, Green LW, Greenhalgh T. Uncovering the benefits of participatory research: implications of a realist review for health research and practice. Milbank Q 2012; 90:311-46. [PMID: 22709390 PMCID: PMC3460206 DOI: 10.1111/j.1468-0009.2012.00665.x] [Citation(s) in RCA: 588] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Context Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes. Methods Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis. Findings From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context. Conclusions We used a realist approach to embrace the heterogeneity and complexity of the PR literature. This theory-driven synthesis identified mechanisms by which PR may add value to the research process. Using the middle-range theory of partnership synergy, our review confirmed findings from previous PR reviews, documented and explained some negative outcomes, and generated new insights into the benefits of PR regarding conflicts and negotiation between stakeholders, program sustainability and advancement, unanticipated project activity, and the generation of systemic change.
Collapse
Affiliation(s)
- Justin Jagosh
- Participatory Research at McGill, McGill University.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Cleary PD, Gross CP, Zaslavsky AM, Taplin SH. Multilevel interventions: study design and analysis issues. J Natl Cancer Inst Monogr 2012; 2012:49-55. [PMID: 22623596 PMCID: PMC3482964 DOI: 10.1093/jncimonographs/lgs010] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Multilevel interventions, implemented at the individual, physician, clinic, health-care organization, and/or community level, increasingly are proposed and used in the belief that they will lead to more substantial and sustained changes in behaviors related to cancer prevention, detection, and treatment than would single-level interventions. It is important to understand how intervention components are related to patient outcomes and identify barriers to implementation. Designs that permit such assessments are uncommon, however. Thus, an important way of expanding our knowledge about multilevel interventions would be to assess the impact of interventions at different levels on patients as well as the independent and synergistic effects of influences from different levels. It also would be useful to assess the impact of interventions on outcomes at different levels. Multilevel interventions are much more expensive and complicated to implement and evaluate than are single-level interventions. Given how little evidence there is about the value of multilevel interventions, however, it is incumbent upon those arguing for this approach to do multilevel research that explicates the contributions that interventions at different levels make to the desired outcomes. Only then will we know whether multilevel interventions are better than more focused interventions and gain greater insights into the kinds of interventions that can be implemented effectively and efficiently to improve health and health care for individuals with cancer. This chapter reviews designs for assessing multilevel interventions and analytic ways of controlling for potentially confounding variables that can account for the complex structure of multilevel data.
Collapse
Affiliation(s)
- Paul D Cleary
- Yale School of Public Health, 60 College St., LEPH 210, PO Box 208034, New Haven, CT 06520-8034, USA.
| | | | | | | |
Collapse
|
29
|
Kumar S, Quinn SC, Kim KH, Musa D, Hilyard KM, Freimuth VS. The social ecological model as a framework for determinants of 2009 H1N1 influenza vaccine uptake in the United States. HEALTH EDUCATION & BEHAVIOR 2011; 39:229-43. [PMID: 21984692 DOI: 10.1177/1090198111415105] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research on influenza vaccine uptake has focused largely on intrapersonal determinants (perceived risk, past vaccine acceptance, perceived vaccine safety) and on physician recommendation. The authors used a social ecological framework to examine influenza vaccine uptake during the 2009 H1N1 pandemic. Surveying an adult population (n = 2,079) in January 2010 with significant oversamples of Blacks and Hispanics, this study found that 18.4% (95% confidence interval = 15.6-21.5) had gotten the 2009 H1N1 vaccine. Variables at each level of the social ecological model were significant predictors of uptake as well as of intent to get the vaccine. The intrapersonal level explained 53%, the interpersonal explained 47%, the institutional level explained 34%, and the policy and community levels each explained 8% of the variance associated with vaccine uptake. The levels together explained 65% of the variance, suggesting that interventions targeting multiple levels of the framework would be more effective than interventions aimed at a single level.
Collapse
Affiliation(s)
- Supriya Kumar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | | | | | | | | | | |
Collapse
|
30
|
Cheng PJ, Huang SY, Shaw SW, Kao CC, Chueh HY, Chang SD, Hsu TY, Kung FT, Hsieh TT. Factors influencing women's decisions regarding pertussis vaccine: A decision-making study in the Postpartum Pertussis Immunization Program of a teaching hospital in Taiwan. Vaccine 2010; 28:5641-7. [DOI: 10.1016/j.vaccine.2010.05.078] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 05/17/2010] [Accepted: 05/19/2010] [Indexed: 11/28/2022]
|
31
|
Farmer GC, Papachristou T, Gotz C, Yu F, Tong D. Does primary language influence the receipt of influenza and pneumococcal immunizations among community-dwelling older adults? J Aging Health 2010; 22:1158-83. [PMID: 20660635 DOI: 10.1177/0898264310373277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine (a) the influence of primary language on the receipt of influenza and pneumococcal immunizations and (b) the feasibility of being immunized in a nontraditional setting. METHOD The population was multiethnic, linguistically diverse, community-dwelling, low income, older adults in California. Face-to-face interviews were conducted with 164 participants (response rate 82%). Questions from BRFSS and CHIS were used.The questionnaire was implemented in six languages. RESULTS Influenza vaccination within the past 12 months was reported by 75.3%, but only 50.6% reported ever receiving the pneumococcal vaccine. Immunization predictors: Influenza-insurance through MediMedi, rating one's health as excellent/good, living with another person, and English as a primary language; pneumococcal-insurance through MediMedi and English as a primary language. Majority were willing to be immunized in nontraditional setting, especially those with limited English proficiency. DISCUSSION Need exists for cultural and linguistically appropriate immunization outreach methods for older adults and practitioners.
Collapse
Affiliation(s)
- Gail C Farmer
- College of Health and Human Services, California State University at Long Beach, 1250 Bellflower Blvd., M/S 4902, Long Beach, CA 90840, USA.
| | | | | | | | | |
Collapse
|
32
|
Abstract
OBJECTIVES To determine the distribution of influenza vaccine coverage in the United States in 2008. DESIGN Cross-sectional analysis. SETTING The 2008 Behavioral Risk Factor Surveillance Survey, which employs random-digit dialing to interview noninstitutionalized adults in the United States and territories. PARTICIPANTS Two hundred forty-nine thousand seven hundred twenty-three persons aged 50 and older. MEASUREMENTS Participants were asked whether they had had an influenza vaccination during the previous 12 months. RESULTS In 2008, 42.0% of adults aged 50 to 64 and 69.5% of adults aged 65 and older reported receiving an influenza vaccination in the past 12 months. Vaccine coverage generally increased with advancing age (P<.001), higher levels of education (P<.001) and total household income (P<.001), and greater morbidity (P<.001). In participants aged 50 to 64, vaccine prevalence was lower in men (39.9%) than in women (44.1%; P<.001), although no significant differences were observed in older adults. Within each 5-year interval of age, non-Hispanic blacks and Hispanics had significantly lower vaccine prevalence than non-Hispanic whites (P<.001 for all comparisons). For participants aged 65 and older, non-Hispanic blacks and Hispanics were 56% (adjusted prevalence ratio (PR)=1.56, 95% confidence interval (CI)=1.48, 1.64) and 44% (adjusted PR=1.44, 95% CI=1.35, 1.54) more likely, respectively, to be unvaccinated than non-Hispanic whites, adjusting for age and sex. Racial and ethnic disparities in vaccine coverage narrowed with increasing number of diseases, although these disparities remained significant in older adults with two or more diseases (P<.05). CONCLUSION There were large disparities in influenza vaccine coverage in 2008, particularly across race and ethnicity and socioeconomic position. Accordingly, more targeted interventions are needed to improve vaccine delivery to disadvantaged segments of the U.S. population.
Collapse
Affiliation(s)
- Shauna T. Linn
- Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, NIH, Bethesda, Maryland
- Johns Hopkins University, Baltimore, Maryland
| | - Jack M. Guralnik
- Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, NIH, Bethesda, Maryland
| | - Kushang V. Patel
- Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, NIH, Bethesda, Maryland
| |
Collapse
|
33
|
Bouye K, Truman BI, Hutchins S, Richard R, Brown C, Guillory JA, Rashid J. Pandemic influenza preparedness and response among public-housing residents, single-parent families, and low-income populations. Am J Public Health 2009; 99 Suppl 2:S287-93. [PMID: 19797740 DOI: 10.2105/ajph.2009.165134] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
During the early stages of an influenza pandemic, a pandemic vaccine likely will not be available. Therefore, interventions to mitigate pandemic influenza transmission in communities will be an important component of the response to a pandemic. Public-housing residents, single-parent families, and low-income populations may have difficulty complying with community-wide interventions. To enable compliance with community interventions, stakeholders recommended the following: (1) community mobilization and partnerships, (2) culturally specific emergency communications planning, (3) culturally specific education and training programs, (4) evidence-based measurement and evaluation efforts, (5) strategic planning policies, (6) inclusion of community members as partners, and (7) policy and program changes to minimize morbidity and mortality.
Collapse
Affiliation(s)
- Karen Bouye
- Office of Minority Health and Health Disparities, Office of the Chief of Public Health Practice, Office of the Director, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail Stop E-67, Atlanta, GA 30333, USA.
| | | | | | | | | | | | | |
Collapse
|
34
|
Truman BI, Tinker T, Vaughan E, Kapella BK, Brenden M, Woznica CV, Rios E, Lichtveld M. Pandemic influenza preparedness and response among immigrants and refugees. Am J Public Health 2009; 99 Suppl 2:S278-86. [PMID: 19461109 PMCID: PMC4504387 DOI: 10.2105/ajph.2008.154054] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2009] [Indexed: 11/04/2022]
Abstract
Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of preexisting health and social disparities, migration history, and living conditions in the United States. Vulnerable populations and their service providers need information to overcome limited resources, inaccessible health services, limited English proficiency and foreign language barriers, cross-cultural misunderstanding, and inexperience applying recommended guidelines. To increase the utility of guidelines, we searched the literature, synthesized relevant findings, and examined their implications for vulnerable populations and stakeholders. Here we summarize advice from an expert panel of public health scientists and service program managers who attended a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008, in Atlanta, Georgia.
Collapse
Affiliation(s)
- Benedict I Truman
- Office of Minority Health and Health Disparities, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop E-67, Atlanta, GA 30333, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Hutchins SS, Fiscella K, Levine RS, Ompad DC, McDonald M. Protection of racial/ethnic minority populations during an influenza pandemic. Am J Public Health 2009; 99 Suppl 2:S261-70. [PMID: 19797739 PMCID: PMC4504373 DOI: 10.2105/ajph.2009.161505] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2009] [Indexed: 11/04/2022]
Abstract
Racial/ethnic minority populations experience worse health outcomes than do other groups during and after disasters. Evidence for a differential impact from pandemic influenza includes both higher rates of underlying health conditions in minority populations, increasing their risk of influenza-related complications, and larger socioeconomic (e.g., access to health care), cultural, educational, and linguistic barriers to adoption of pandemic interventions. Implementation of pandemic interventions could be optimized by (1) culturally competent preparedness and response that address specific needs of racial/ethnic minority populations, (2) improvements in public health and community health safety net systems, (3) social policies that minimize economic burdens and improve compliance with isolation and quarantine, and (4) relevant, practical, and culturally and linguistically tailored communications.
Collapse
Affiliation(s)
- Sonja S Hutchins
- Office of Minority Health and Health Disparities, Office of the Chief of Public Health Practice, Office of the Director, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E-67, Atlanta, GA 30333, USA.
| | | | | | | | | |
Collapse
|