Predictors of Reported Influenza Vaccination during the 2012-2013 Influenza Season in an Older African American Population Based on Data Collected in a Faith-Based Setting 公开

Abstract

Objectives
Faith-based settings are institutions of social and health support for elderly African Americans. This thesis looks at predictors of reported 2012-2013 influenza vaccination in an older African American population in the context of a faith-based setting.
Methods
A cross-sectional study was conducted collecting data on older congregation members from six churches located in or around the Atlanta area participating in the Dose of Hope study.
Results
Out of 208 study participants, 95 (45.67%) reported receiving the influenza vaccine. Logistic regression showed that relationship with healthcare provider (OR: 14.83 [3.68, 59.83], PR: 4.25 [1.48, 12.22]) and fear of "getting the flu from the flu shot" (OR: 0.1 [0.05, 0.23], PR: 0.29 [0.17, 0.49]) were significant predictors of the vaccination outcome. Not experiencing discrimination in a faith-based setting was associated with a strong healthcare provider relationship. Age, type of medical insurance, and easy access to the influenza vaccine were identified as confounders.
Conclusion
A strong relationship with a healthcare provider and fear of getting influenza from the vaccine were significant predictors of the vaccination outcome. Eliminating negative attitudes towards preventive health behaviors due to mistrust of conventional medicine within the church may strengthen the patient-healthcare provider relationship. This could be done by using medical speakers to disseminate health information in a way that is socioculturally sensitive.

Table of Contents

Literature Review...1

Introduction...9

Thesis Objectives...11

Methods...12
Results...22
Discussion...31
Conclusion...41

References...43

Tables

i. Table 1 - Description of Dose of Hope's study population at the 3-month time point...49

ii. Table 2 - Distribution and bivariate analysis of descriptive variables by vaccination outcome...51

iii. Table 3 - Distribution and bivariate analysis of variables pertaining to participants' relationship with their healthcare provider by vaccination outcome...53

iv. Table 4 - Distribution and bivariate analysis of variables pertaining to participants' attitudes towards immunizations by vaccination

outcome...56

v. Table 5 - Distribution and bivariate analysis of variables pertaining to participants' sources for health information by vaccination

outcome...58

vi. Table 6 - Distribution and bivariate analysis of variables pertaining to participants' attitudes towards discrimination and safety by

vaccination outcome...63

vii. Table 7 - Distribution and bivariate analysis of variables pertaining to transportation issues by vaccination outcome...66

viii. Table 8 - Distribution and bivariate analysis of variables pertaining to spirituality by vaccination outcome...67

ix. Table 9 - Distribution and bivariate analysis of variables pertaining to participants' and their families' vaccine history by vaccination

outcome...68

x. Table 10 - Statistics for the gold standard model describing the association between participants' relationship with their healthcare

provider and vaccination outcome...71

xi. Table 11 - Confounding Analysis for All Possible Subsets of Gold Standard Model (when dc35, dc36, redf10, and dc35xredf10 are

kept)...72

xii. Table 12 - Statistics for model 15 describing the association between participants' relationship with their healthcare provider

and vaccination outcome...74

xiii. Table 13 - Prevalence Ratio estimates for model 15 describing the association between participants' relationship with their

healthcare provider and vaccination outcome...74

Appendices

i. Appendix A - Dose of Hope Consent Forms...75

ii. Appendix B - Dose of Hope Baseline Survey...86

iii. Appendix C - Dose of Hope 3-month Survey...102

iv. Appendix D - Codebook...121

v. Appendix E - SAS code...154

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, General Health Sciences, Epidemiology
关键词	vaccines African American vaccine refusal vaccination vaccination predictors church faith-based setting influenza influenza vaccine older population health disparities
Committee Chair / Thesis Advisor	Sullivan, Kevin M, Emory University
Committee Members	Frew, Paula, Emory University
Partnering Agencies	Religious-based organization Emory University schools, faculty or affiliated programs

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