Influenza Vaccination among Underserved African-American Older Adults.
Influenza Vaccination among Underserved African-American Older Adults.
复制标题
DOI：
10.1155/2020/2160894
复制
发表时间：
2020
影响因子：
--
通讯作者：
Assari S
中科院分区：
文献类型：
--
作者：
Bazargan M;Wisseh C;Adinkrah E;Ameli H;Santana D;Cobb S;Assari S
少数族裔老年人接种流感疫苗的种族差异是一个公共卫生问题。了解影响服务不足的老年非裔美国人流感疫苗接种行为的因素可能会导致更有效的沟通和提供策略。 我们的目的是调查与季节性流感疫苗接种率和相关因素在服务不足的非洲裔美国老年人。我们特别感兴趣的是人口因素，社会经济地位，连续性和患者对医疗服务的满意度，以及身心健康状况的作用。 这项基于社区的横断面研究招募了620名居住在南洛杉矶的非裔美国老年人，南洛杉矶是洛杉矶县资源最匮乏的地区之一，人口超过100万。进行双变量和多元回归分析，以记录流感疫苗接种的独立相关性。 居住在南洛杉矶的65岁及以上的非洲裔美国老年人中，三分之一从未接种过流感疫苗。只有49%的参与者报告在采访前12个月内接种过疫苗。五分之一的参与者承认他们的医疗保健提供者建议接种流感疫苗。然而，只有45%的人遵循了他们提供者的建议。多变量logistic回归显示，老年人（≥75岁），独居的参与者，那些对护理的可及性，可用性和质量满意度较低的人，以及抑郁症状较多的参与者不太可能接种疫苗。正如预期的那样，那些表示他们的医生建议他们接种流感疫苗的参与者更有可能接种疫苗。我们的数据显示，只有性别与被建议接种流感疫苗的自我报告有关。讨论这项研究最引人注目的方面之一是，没有检测到流感疫苗接种与被诊断患有慢性阻塞性肺病或其他主要慢性病之间的关联。我们的研究证实，护理的连续性和对医疗服务的可及性、可用性和质量的满意度与当前的流感疫苗接种密切相关。我们记录了抑郁症状数量较多的参与者不太可能接种疫苗。 这些发现强调了文化上可接受和可获得的常规护理货车作为守门人在服务不足的少数老年人中促进和实施流感疫苗接种的作用。在服务不足的非洲裔美国老年人中，流感疫苗接种的持续差异，加上慢性病的不成比例的负担，使他们处于与流感相关的不良后果的高风险之中。由于抑郁症更慢性/致残，并且在非洲裔美国人中不太可能得到治疗，因此有必要将抑郁症筛查和治疗作为一种策略，以加强预防性护理管理，例如为服务不足的非洲裔美国老年人接种疫苗。对疫苗接种率较低与抑郁症症状以及独居之间的关联进行量化，应使卫生专业人员能够针对服务不足的非洲裔美国老年人，他们被孤立并患有抑郁症，以减少与疫苗相关的不平等。
Racial disparities in influenza vaccination among underserved minority older adults are a public health problem. Understanding the factors that impact influenza vaccination behaviors among underserved older African-Americans could lead to more effective communication and delivery strategies. We aimed to investigate rate and factors associated with seasonal influenza vaccination among underserved African-American older adults. We were particularly interested in the roles of demographic factors, socioeconomic status, and continuity and patient satisfaction with medical care, as well as physical and mental health status. This community-based cross-sectional study recruited 620 African-American older adults residing in South Los Angeles, one of the most under-resources areas within Los Angeles County, with a population of over one million. Bivariate and multiple regression analyses were performed to document independent correlates of influenza vaccination. One out of three underserved African-American older adults aged 65 years and older residing in South Los Angeles had never been vaccinated against the influenza. Only 49% of participants reported being vaccinated within the 12 months prior to the interview. One out of five participants admitted that their health care provider recommended influenza vaccination. However, only 45% followed their provider's recommendations. Multivariate logistic regression shows that old-old (≥75 years), participants who lived alone, those with a lower level of continuity of care and satisfaction with the accessibility, availability, and quality of care, and participants with a higher number of depression symptoms were less likely to be vaccinated. As expected, participants who indicated that their physician had advised them to obtain a flu vaccination were more likely to be vaccinated. Our data shows that only gender was associated with self-report of being advised to have a flu shot. Discussion. One of the most striking aspects of this study is that no association between influenza vaccination and being diagnosed with chronic obstructive pulmonary disease or other major chronic condition was detected. Our study confirmed that both continuity of care and satisfaction with access, availability, and quality of medical care are strongly associated with current influenza vaccinations. We documented that participants with a higher number of depression symptoms were less likely to be vaccinated. These findings highlight the role that culturally acceptable and accessible usual source of care van play as a gatekeeper to facilitate and implement flu vaccination among underserved minority older adults. Consistent disparities in influenza vaccine uptake among underserved African-American older adults, coupled with a disproportionate burden of chronic diseases, places them at high risk for undesired outcomes associated with influenza. As depression is more chronic/disabling and is less likely to be treated in African-Americans, there is a need to screen and treat depression as a strategy to enhance preventive care management such as vaccination of underserved African-American older adults. Quantification of associations between lower vaccine uptake and both depression symptoms as well as living alone should enable health professionals target underserved African-American older adults who are isolated and suffer from depression to reduce vaccine-related inequalities.
登录
查看更多内容
影响因子：
4.5
作者：
Patten, Scott B.;Williams, Jeanne V. A.;Eliasziw, Michael
通讯作者：
Eliasziw, Michael
美国患有慢性疾病的成年人在流感疫苗接种方面的种族和民族差异因年龄而异
影响因子：
3.7
作者：
Lu D;Qiao Y;Brown NE;Wang J
通讯作者：
Wang J
影响因子：
5.1
作者：
Okoro, CA;Strine, TW;Mokdad, AH
通讯作者：
Mokdad, AH
影响因子：
12.6
作者：
Holt-Lunstad, Julianne;Smith, Timothy B.;Stephenson, David
通讯作者：
Stephenson, David
影响因子：
2.7
作者：
Greenberg, Sherry A.
通讯作者：
Greenberg, Sherry A.