Melissa C. Kuhajda, Department of Community and Rural Medicine, Institute for Rural Health Research, The University of Alabama, 375-D Nott Hall, Box 870326, Tuscaloosa, AL, USA, John C. Higginbotham, Department of Community and Rural Medicine, Director - Institute for Rural Health Research, The University of Alabama, Box 870326, Tuscaloosa, AL, USA, and Karen Wooten, Centers for Disease Control and Prevention, National Immunization Program, Mathematical Statistician, 1600 Clifton Road, NE, Atlanta, Georgia, USA.
KEYWORDS:
Influenza, Pneumococcal, Immunization, Nominal Group Technique, Older African-Americans
BACKGROUND:
Influenza and pneumonia together are the sixth leading cause of death in the United States; most deaths occurring in persons age ³ 65 years. It is recommended that adults age ³ 65 years receive a yearly influenza vaccine and a one-time pneumococcal vaccine. Although senior vaccination rates have steadily increased, they fall short of the Healthy People 2010 90% objective, especially for African-Americans. A comprehensive national education campaign is needed with more effective interventions for African-Americans.
OBJECTIVE:
Identify vaccination predictors of older urban and rural African- and White-Americans by conducting idea-generating sessions using the Nominal Group Technique (NGT). NGT results will inform development of a card sort task in which participants will organize a set of cognitive objects into categories. Card sort task results will inform development of Vaccination Predictors Questionnaire, which will be used to assess prevalence of vaccination predictors.
METHOD:
A comprehensive cognitive mapping strategy, “concept mapping,” consisting of a blend of quantitative and qualitative methodology was used. Analyses involved multidimensional scaling and cluster analysis.
RESULT:
The NGT process was found to be wearisome for some seniors, especially those with low literacy. This caveat aside, preliminary NGT results suggest that fear of needles and becoming ill from the vaccination are among the most frequently identified barriers to adult vaccination. Facilitators include prevention of illness and physician recommendation.
CONCLUSION:
NGT process should not be utilized with low literacy populations. A larger sample size is necessary to test the robustness of the predictors identified thus far by rural and urban African-American seniors.
LEARNING OBJECTIVES:
1. Examine immunization patterns of older African-Americans.
2. Determine most cost-effective measures to increase vaccination coverage.
3. Discover whether previously recommended vaccination strategies effectively improve the acceptance rate in older African-Americans.
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