Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions and Vaccination Behaviors during the 2009-2010 Influenza Pandemic
Identifieur interne : 000856 ( Pmc/Curation ); précédent : 000855; suivant : 000857Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions and Vaccination Behaviors during the 2009-2010 Influenza Pandemic
Auteurs : Jürgen MaurerSource :
- Medical decision making : an international journal of the Society for Medical Decision Making [ 0272-989X ] ; 2015.
Abstract
Influenza vaccination is strongly associated with socioeconomic status, but there is only limited evidence on the respective roles of socioeconomic differences in vaccination intentions vs. corresponding differences in follow through on initial vaccination plans for subsequent socioeconomic differences in vaccine uptake.
Nonparametric mean smoothing, linear regression and Probit models were used to analyze longitudinal survey data on perceived influenza risks, behavioral vaccination intentions and vaccination behavior of adults during the 2009-10 influenza A/H1N1 (“Swine Flu”) pandemic in the United States. Perceived influenza risks and behavioral vaccination intentions were elicited prior to the availability of H1N1 vaccine using a probability scale question format. H1N1 vaccine uptake was assessed at the end of the pandemic.
Education, income and health insurance coverage displayed positive associations with behavioral intentions to get vaccinated for pandemic influenza while employment was negatively associated with stated H1N1 vaccination intentions. Education and health insurance coverage also displayed significant positive associations with pandemic vaccine uptake. Moreover, behavioral vaccination intentions showed a strong and statistically significant positive partial association with later H1N1 vaccination. Incorporating vaccination intentions in a statistical model for H1N1 vaccine uptake further highlighted higher levels of follow through on initial vaccination plans among persons with higher education levels and health insurance.
Sampling bias, misreporting in self-reported data, and limited generalizability to non-pandemic influenza are potential limitations of the analysis.
Closing the socioeconomic gap in influenza vaccination requires multi-pronged strategies that not only increase vaccination intentions by improving knowledge, attitudes and beliefs but also facilitate follow through on initial vaccination plans by improving behavioral control and access to vaccination for individuals with low education, employed persons and the uninsured.
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DOI: 10.1177/0272989X15608379
PubMed: 26416814
PubMed Central: 4809795
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Jürgen Maurer<affiliation><nlm:aff id="A1">Institute of Health Economics and Management (IEMS) and Department of Economics (DEEP), University of Lausanne, Switzerland. The author is also affiliated with the RAND Corporation, Arlington, VA, the Center for Social and Economic Research (CESR), University of Southern California, Los Angeles, CA, the Munich Center for the Economics of Aging (MEA), Munich, Germany, the Health Econometrics and Data Group (HEDG), Centre for Health Economics, University of York, United Kingdom and the Swiss School of Public Health (SSPH+)</nlm:aff>
<wicri:noCountry code="subfield">United Kingdom and the Swiss School of Public Health (SSPH+)</wicri:noCountry>
</affiliation>
Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Influenza vaccination is strongly associated with socioeconomic status, but there is only limited evidence on the respective roles of socioeconomic differences in vaccination intentions vs. corresponding differences in follow through on initial vaccination plans for subsequent socioeconomic differences in vaccine uptake.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Nonparametric mean smoothing, linear regression and Probit models were used to analyze longitudinal survey data on perceived influenza risks, behavioral vaccination intentions and vaccination behavior of adults during the 2009-10 influenza A/H1N1 (“Swine Flu”) pandemic in the United States. Perceived influenza risks and behavioral vaccination intentions were elicited prior to the availability of H1N1 vaccine using a probability scale question format. H1N1 vaccine uptake was assessed at the end of the pandemic.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Education, income and health insurance coverage displayed positive associations with behavioral intentions to get vaccinated for pandemic influenza while employment was negatively associated with stated H1N1 vaccination intentions. Education and health insurance coverage also displayed significant positive associations with pandemic vaccine uptake. Moreover, behavioral vaccination intentions showed a strong and statistically significant positive partial association with later H1N1 vaccination. Incorporating vaccination intentions in a statistical model for H1N1 vaccine uptake further highlighted higher levels of follow through on initial vaccination plans among persons with higher education levels and health insurance.</p>
</sec>
<sec id="S4"><title>Limitations</title>
<p id="P4">Sampling bias, misreporting in self-reported data, and limited generalizability to non-pandemic influenza are potential limitations of the analysis.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Closing the socioeconomic gap in influenza vaccination requires multi-pronged strategies that not only increase vaccination intentions by improving knowledge, attitudes and beliefs but also facilitate follow through on initial vaccination plans by improving behavioral control and access to vaccination for individuals with low education, employed persons and the uninsured.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8109073</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5668</journal-id>
<journal-id journal-id-type="nlm-ta">Med Decis Making</journal-id>
<journal-id journal-id-type="iso-abbrev">Med Decis Making</journal-id>
<journal-title-group><journal-title>Medical decision making : an international journal of the Society for Medical Decision Making</journal-title>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Inspecting the Mechanism: A Longitudinal Analysis of Socioeconomic Status Differences in Perceived Influenza Risks, Vaccination Intentions and Vaccination Behaviors during the 2009-2010 Influenza Pandemic</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Maurer</surname>
<given-names>Jürgen</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
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<aff id="A1"><label>1</label>
Institute of Health Economics and Management (IEMS) and Department of Economics (DEEP), University of Lausanne, Switzerland. The author is also affiliated with the RAND Corporation, Arlington, VA, the Center for Social and Economic Research (CESR), University of Southern California, Los Angeles, CA, the Munich Center for the Economics of Aging (MEA), Munich, Germany, the Health Econometrics and Data Group (HEDG), Centre for Health Economics, University of York, United Kingdom and the Swiss School of Public Health (SSPH+)</aff>
<author-notes><corresp id="FN1">Please address correspondence to Jürgen Maurer, University of Lausanne, Internef, Dorigny, 1015 Lausanne, Switzerland or <email>jurgen.maurer@unil.ch</email>
, Phone: +41 21 692 3664</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>16</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>28</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2017</year>
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<volume>36</volume>
<issue>7</issue>
<fpage>887</fpage>
<lpage>899</lpage>
<pmc-comment>elocation-id from pubmed: 10.1177/0272989X15608379</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Influenza vaccination is strongly associated with socioeconomic status, but there is only limited evidence on the respective roles of socioeconomic differences in vaccination intentions vs. corresponding differences in follow through on initial vaccination plans for subsequent socioeconomic differences in vaccine uptake.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Nonparametric mean smoothing, linear regression and Probit models were used to analyze longitudinal survey data on perceived influenza risks, behavioral vaccination intentions and vaccination behavior of adults during the 2009-10 influenza A/H1N1 (“Swine Flu”) pandemic in the United States. Perceived influenza risks and behavioral vaccination intentions were elicited prior to the availability of H1N1 vaccine using a probability scale question format. H1N1 vaccine uptake was assessed at the end of the pandemic.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Education, income and health insurance coverage displayed positive associations with behavioral intentions to get vaccinated for pandemic influenza while employment was negatively associated with stated H1N1 vaccination intentions. Education and health insurance coverage also displayed significant positive associations with pandemic vaccine uptake. Moreover, behavioral vaccination intentions showed a strong and statistically significant positive partial association with later H1N1 vaccination. Incorporating vaccination intentions in a statistical model for H1N1 vaccine uptake further highlighted higher levels of follow through on initial vaccination plans among persons with higher education levels and health insurance.</p>
</sec>
<sec id="S4"><title>Limitations</title>
<p id="P4">Sampling bias, misreporting in self-reported data, and limited generalizability to non-pandemic influenza are potential limitations of the analysis.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Closing the socioeconomic gap in influenza vaccination requires multi-pronged strategies that not only increase vaccination intentions by improving knowledge, attitudes and beliefs but also facilitate follow through on initial vaccination plans by improving behavioral control and access to vaccination for individuals with low education, employed persons and the uninsured.</p>
</sec>
</abstract>
<kwd-group><kwd>Influenza Vaccination</kwd>
<kwd>Influenza Pandemic</kwd>
<kwd>Socioeconomic Disparities</kwd>
<kwd>Medical Decision Making</kwd>
<kwd>Behavioral Economics</kwd>
<kwd>Behavioral Intentions</kwd>
<kwd>Vaccination Behavior</kwd>
</kwd-group>
</article-meta>
</front>
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