Demographics, perceptions, and socioeconomic factors affecting influenza vaccination among adults in the United States.
Demographics, perceptions, and socioeconomic factors affecting influenza vaccination among adults in the United States.
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作者：
Abbas KM;Kang GJ;Chen D;Werre SR;Marathe A
本研究的目的是通过人口统计学因素、疫苗有效性感知、社会影响、群体免疫力、疫苗成本、健康保险状况和美国18岁及以上成年人接种流感疫苗的障碍来分析流感疫苗接种状况。2010-2011年期间，18岁及以上成年人的流感疫苗接种覆盖率为41%，2016-2017年期间增加并稳定在43%。这低于70%成人流感疫苗接种覆盖率的目标，这是2020年健康人倡议的目标。我们对美国18岁及以上具有全国代表性的成年人样本进行了一项关于影响流感疫苗接种的因素的调查。我们使用Rao-Scott卡方检验进行了双变量分析，并使用加权多项logistic回归对该调查数据进行了多变量分析，以确定人口统计学、疫苗有效性感知、社会影响、群体免疫力、疫苗成本、健康保险以及与美国成年人流感疫苗接种相关的障碍的影响。在年龄较大的成年人中，流感疫苗接种率相对较高（75岁以上者占73.3%），具有学士学位或更高教育水平的成年人（45.1%），非西班牙裔白人（41.8%）、收入较高的成年人（收入超过15万美元的成年人中占52.8%），有伴侣的成年人（43.2%），没有工作的成年人（46.2%）和可以上网的成年人（39.9%）。每年有76%的成年人认为疫苗非常有效，64.2%的成年人受到他人的社会影响，41.8%的成年人有健康保险，而72.3%的成年人没有健康保险从未接种过疫苗。成年人每年接种疫苗的促进因素包括年龄较大、疫苗有效性高、收入较高和没有自付费用。与仅几年相比，从未接种疫苗的成年人的障碍包括缺乏健康保险，不喜欢注射，认为疫苗有效性低，对流感感染风险的低认识以及对危险副作用的认识。通过提高对流感疫苗接种的安全性、有效性和必要性的认识，利用商业和社会营销的实践和原则来提高疫苗的信任度、信心和接受度，以及降低自付费用和通过健康保险支付流感疫苗接种费用，美国成年人的流感疫苗接种率可以提高到2020年健康人群目标的70%。
The study objective is to analyze influenza vaccination status by demographic factors, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance status, and barriers to influenza vaccination among adults 18 years and older in the United States. Influenza vaccination coverage among adults 18 years and older was 41% during 2010–2011 and has increased and plateaued at 43% during 2016–2017. This is below the target of 70% influenza vaccination coverage among adults, which is an objective of the Healthy People 2020 initiative. We conducted a survey of a nationally representative sample of adults 18 years and older in the United States on factors affecting influenza vaccination. We conducted bivariate analysis using Rao-Scott chi-square test and multivariate analysis using weighted multinomial logistic regression of this survey data to determine the effect of demographics, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance, and barriers associated with influenza vaccination uptake among adults in the United States. Influenza vaccination rates are relatively high among adults in older age groups (73.3% among 75 + year old), adults with education levels of bachelor’s degree or higher (45.1%), non-Hispanic Whites (41.8%), adults with higher incomes (52.8% among adults with income of over $150,000), partnered adults (43.2%), non-working adults (46.2%), and adults with internet access (39.9%). Influenza vaccine is taken every year by 76% of adults who perceive that the vaccine is very effective, 64.2% of adults who are socially influenced by others, and 41.8% of adults with health insurance, while 72.3% of adults without health insurance never get vaccinated. Facilitators for adults getting vaccinated every year in comparison to only some years include older age, perception of high vaccine effectiveness, higher income and no out-of-pocket payments. Barriers for adults never getting vaccinated in comparison to only some years include lack of health insurance, disliking of shots, perception of low vaccine effectiveness, low perception of risk for influenza infection, and perception of risky side effects. Influenza vaccination rates among adults in the United States can be improved towards the Healthy People 2020 target of 70% by increasing awareness of the safety, efficacy and need for influenza vaccination, leveraging the practices and principles of commercial and social marketing to improve vaccine trust, confidence and acceptance, and lowering out-of-pocket expenses and covering influenza vaccination costs through health insurance.
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DOI：
10.1177/1090198111415105
发表时间：
2012-04
期刊：
Health education & behavior : the official publication of the Society for Public Health Education
影响因子：
--
作者：
Kumar S;Quinn SC;Kim KH;Musa D;Hilyard KM;Freimuth VS
通讯作者：
Freimuth VS
DOI：
10.1016/j.amjmed.2015.10.031
发表时间：
2016-06
期刊：
The American journal of medicine
影响因子：
--
作者：
Lu PJ;O'Halloran A;Ding H;Srivastav A;Williams WW
通讯作者：
Williams WW
影响因子：
5.5
作者：
Nowak, Glen J.;Gellin, Bruce G.;Butler, Robb
通讯作者：
Butler, Robb
影响因子：
5.5
作者：
Kang GJ;Ewing-Nelson SR;Mackey L;Schlitt JT;Marathe A;Abbas KM;Swarup S
通讯作者：
Swarup S
DOI：
10.3122/jabfm.2013.06.130054
发表时间：
2013-11-01
影响因子：
2.9
作者：
Jerant, Anthony;Fiscella, Kevin;Franks, Peter
通讯作者：
Franks, Peter