Factors influencing adults' immunization practices: a pilot survey study of a diverse, urban community in central Ohio.
BACKGROUND
Adult vaccination rates in the United States are well below recommendations with disparities in race, ethnicity, and education level resulting in even lower rates for these populations. This study aimed to identify the barriers to and perceptions of immunizations in adults in an urban, underserved, multicultural community. Understanding the factors that influence adults' decisions to receive routinely recommended vaccines will aid health care providers and public health officials to design programs to improve vaccination rates.


METHODS
This cross-sectional, survey-based study was conducted in January 2014 in Columbus, Ohio. Participants were recruited from four urban federally-qualified health centers and four grocery stores affiliated with those clinics. The survey gathered self-reported receipt of immunizations, knowledge about indications for immunizations, and factors influencing decisions to receive an immunization. Data was analyzed in 2014. Descriptive statistics were generated for all survey items and Chi-Square or Fisher's Exact tests were used as appropriate to test for associations between demographic characteristics and factors influencing immunization decisions.


RESULTS
The top five factors likely to affect the decision to receive an immunization among the 304 respondents were: "doctor's recommendation" (80.6 %), "knowing why I should get a vaccine" (78.2 %), "knowing which vaccines I need" (75.5 %), cost (54.2 %), and "concern about getting sick if I get a vaccine" (54.0 %). Significant differences in factors influencing the immunization decision exist among respondents based on ethnicity and education level. For those participants with self-identified diabetes, heart disease, or asthma, less than half were aware that certain immunizations could reduce the risk of complications associated with their disease(s).


CONCLUSIONS
Data from this study may inform and shape patient education programs conducted in clinics, retailers, and communities, as well as advocacy efforts for adult immunizations. Results from this study suggest that patients would respond to programs for promoting vaccine uptake if they focused on benefits and indications for vaccines. The results also highlighted the need for education regarding immunizations for patients with chronic diseases and special indications. The differences in perceptions found between groups can be used to create targeted interventions based on the needs of those patient populations.
['Sevin|Alexa M|AM|', 'Romeo|Cristina|C|', 'Gagne|Brittany|B|', 'Brown|Nicole V|NV|', 'Rodis|Jennifer L|JL|']
D000293:Adolescent D000328:Adult D000368:Aged D003430:Cross-Sectional Studies D005006:Ethnicity D005260:Female D007722:Health Knowledge, Attitudes, Practice D006801:Humans D017589:Immunization Programs D008297:Male D008875:Middle Aged D009820:Ohio D010342:Patient Acceptance of Health Care D010465:Perception D010865:Pilot Projects D011634:Public Health D044469:Racial Groups D014505:Urban Population D014611:Vaccination D014612:Vaccines D055815:Young Adult
Adults Immunizations Survey Disparities Perceptions Health behavior