An Analysis of Community Engagement Strategies to Reduce Influenza Vaccination Coverage Disparities Among Uninsured Populations

Background:  Surveillance data clearly indicate flu coverage disparities continue to exist.  One key strategy to increase flu vaccination uptake for minority communities is the development of partnerships that can support the implementation of a seasonal influenza marketing campaign. The National Influenza Vaccination Disparities Partnership (NIVDP) was created to identify and develop action-oriented long-term partnerships to support promotional activities including the dissemination of materials, organizing educational events and flu vaccine clinics, and identifying local health champions for community mobilization.  

Program background:  Among adults, substantial disparities in flu vaccination coverage have persisted (MMWR, 2010).  The vaccination rate among African Americans, Hispanics, and American Indians remains lower compared with non-Hispanic whites for the last ten years (CDC, 2011).  There is a strong need to engage trusted influencers through local grassroots outreach efforts to reinforce messaging about the safety of the vaccine.  The partners for NIVDP were selected based on the following criteria within the African American, Hispanic and American Indian communities:

• Ability to help drive influenza vaccination uptake
• Respected and trusted within the community
• Health jurisdiction in low level vaccination uptake
• Capacity to implement and sustain outreach activities

Culturally specific models were implemented to engage the partners based on tested messages, the identification of trusted messengers, and reinforcement of campaign objectives.

Evaluation Methods and Results:  Lessons learned from the development and execution of NIVDP alliances and activities will be shared based on a readiness assessment and a results-oriented evaluation that identified barriers to accessing influenza vaccination and cultural factors that inhibit flu vaccination uptake behaviors.  Preliminary data indicate a strong adherence to the objectives of the partnership campaign.  Action steps towards sustainability of the Partnership will be shared in addition to successes for National Influenza Vaccination Week activities.  Successes for the campaign include a 30% increase in partner engagement; a two-fold increase in flu vaccination promotional activities; and 300% increase in flu vaccination uptake among targeted uninsured consumers.

Conclusions:  Lessoned learned include:

• Significance of family focused messaging
• Proximity of flu vaccination promotion to uninsured consumers
• Engagement of high profile trusted messengers
• Localization of personal stories to emphasize salience of uptake

Implications for research and/or practice: 

• Replication of engagement strategies has the potential to close the gap for flu vaccine disparities.
• Partnership strategies need to be tested across subgroups of consumers especially those who continue to face under-vaccination rates.