Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
Discuss community involvement in flu research and intervention development.
Identify factors associated with Central Brooklyn community members receiving the flu vaccine.
Describe interventions developed to increase vaccination rates


Background:
The NYC Department of Health and Mental Hygiene recently established a “District Public Health Office” in Central Brooklyn to address neighborhood health disparities. Responding to historically low vaccination rates and low demand during the 2004-2005 vaccine shortage in this predominantly Caribbean and African American community, the department initiated a participatory study examining the determinants of adult influenza vaccination.

Setting:
Central Brooklyn medical practices and faith-based institutions

Population:
Convenience sample of medical providers and community members age 50 and older.

Project Description:
The study, guided by a steering committee of faith leaders, included brief interviews with medical providers (n=11), and self-administered surveys (n=337) and focus groups (4) with community residents. The provider interview addressed attitudes and influenza vaccination practices. Community participants were asked about their attitudes and experiences with the vaccine, and trust in the medical profession.

Results/Lessons Learned:
Medical providers believe the vaccine is safe and effective; however, few had systematic methods to ensure patients are vaccinated. There were strong associations for residents between receiving the vaccine and favorable beliefs about vaccine efficacy (OR=2.9, p<.01), doctor's recommendation (OR=3.4, p<.001) and mistrust in the medical profession (OR=0.3, p<.001). Focus group findings further delineated issues of vaccine acceptance in vaccination decision making. The perceived need for vaccination must be strong enough to overcome convention and contrary advice of friends. The decision is influenced by layers of trust: in the vaccine, in home-remedies and in the medical profession and government. These results have shaped neighborhood and citywide strategies, including increased outreach clinics and targeted educational materials to promote adult vaccination.