The role of attitudes in understanding disparities in adult influenza vaccination
The role of attitudes in understanding disparities in adult influenza vaccination
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DOI：
10.1016/j.amepre.2006.06.025
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发表时间：
2006-10-01
影响因子：
5.5
通讯作者：
Bardenheier, Barbara H.
中科院分区：
文献类型：
--
作者：
Lindley, Megan C.;Wortley, Pascale M.;Bardenheier, Barbara H.
背景：65岁及以上成年人流感疫苗覆盖率的种族/民族差异即使在控制了可及性、医疗保健利用和社会经济地位之后仍然存在。对疫苗接种态度的不同可能有助于解释这些差异。本研究的目的是描述65岁及以上白人和非裔美国人对流感疫苗接种的患者特征和态度，并检查其对疫苗接种覆盖率的种族差异的影响。方法：对美国五个地点的医疗保险受益人进行横断面电话调查，抽样种族/民族和邮政编码。2005年进行了多变量分析，控制人口统计学、医疗保健利用和对流感疫苗接种的态度，以评估2003-2004年疫苗接种季节疫苗覆盖率的种族差异。结果：分析包括1859名白人和1685名非裔美国人受访者；79%的白人和50%的非洲裔美国人报告在过去一年中接种了流感疫苗（p < 0.00001）。接种疫苗和未接种疫苗的非裔美国人对流感疫苗的积极态度都明显低于白人。即使在有提供者建议的答复者中，持积极态度的答复者比持消极态度的答复者更有可能接种疫苗。多因素调整后，非裔美国人接种流感疫苗的几率显著低于白人（优势比=0.55,95%可信区间=0.42-0.72）。结论：非洲裔美国人和白人之间的疫苗接种覆盖率存在显著差距，即使在控制了具体的受访者态度之后。未来的研究应关注其他因素，如寻求疫苗的行为。
Background: Racial/ethnic disparities in influenza vaccine coverage of adults aged 65 years and older persist even after controlling for access, healthcare utilization, and socioeconomic status. Differences in attitudes toward vaccination may help explain these disparities. The purpose of this study was to describe patient characteristics and attitudes toward influenza vaccination among whites and African Americans aged 65 years and older, and to examine their effect on racial disparities in vaccination coverage.Methods: A cross-sectional telephone survey of Medicare beneficiaries in five U.S. sites, sampled on race/ethnicity and ZIP code. Multivariate analysis controlling for demographics, healthcare utilization, and attitudes toward influenza vaccination was conducted in 2005 to assess racial disparities in vaccine coverage during the 2003-2004 season.Results: The analysis included 1859 white and 1685 African-American respondents; 79% of whites versus 50% of African Americans reported influenza vaccination in the past year (p < 0.00001). Both vaccinated and unvaccinated African Americans were significantly less likely than whites to report positive attitudes toward influenza vaccination. Even among respondents with provider recommendations, respondents with positive attitudes were more likely to be vaccinated than those with negative attitudes. After multivariate adjustment, African Americans had significantly lower odds of influenza vaccination than whites (odds ratio=0.55, 95% confidence interval=0.42-0.72).Conclusions: A significant gap in vaccination coverage between African Americans and whites persisted even after controlling for specific respondent attitudes. Future research should focus on other factors such as vaccine-seeking behavior.