Melissa C. Kuhajda1, Richard M. Shewchuk
2, John C. Higginbotham
1, H. Russell Foushee
2, Karen Wooten
3, James D. Leeper
1, and Lasonja B. Kennedy
1. (1) Department of Community and Rural Medicine, Institute for Rural Health Research, The University of Alabama, Box 870326, Tuscaloosa, AL, USA, (2) The University of Alabama at Birmingham, Birmingham, AL, USA, (3) Centers for Disease Control and Prevention, National Immunization Program, Atlanta, GA, USA
BACKGROUND:
Together influenza and pneumonia are the sixth leading cause of death in the U.S., accounting for approximately 36,000 and 3,400 deaths, respectively, most of which occur in persons 65 years and older. It is recommended that these older adults 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. According to the 2002 Behavioral Risk Factor Surveillance System, the influenza and pneumococcal vaccination rates for White- Americans is 69% and 65%, whereas for African-Americans the rate is only 51% and 45%. Consequently, 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). Develop a Vaccination Predictors Questionnaire, using NGT results, to assess prevalence of vaccination predictors.
METHOD:
A comprehensive cognitive mapping strategy, “concept mapping,” consisting of a blend of quantitative and qualitative methodology is being used to analyze the data.
RESULT:
African- and White-Americans ranked similar barriers and facilitators as important. One striking difference: African-Americans identified “didn’t know about it” as the most important barrier to receiving the pneumococcal vaccination versus White-Americans “getting ill from the shot.” Urban participants ranked “fear of death” as an important barrier to receiving the influenza vaccine and as an important facilitator to receiving the pneumococcal vaccine. Death was not ranked as an important facilitator or barrier for either vaccine by rural participants.
CONCLUSION:
Demographic differences for prediction of vaccination among the elderly may be clarified by a national telephone survey, which is currently underway in Alabama.
LEARNING OBJECTIVES:
1.Examine immunization patterns of older African-Americans.
2.Discover vaccination strategies to improve acceptance rate in older African-Americans.