Impact of Community Healthcare Workers’ Knowledge, Attitude and Practice on the Influenza Vaccination among Elderly People_Chinese Journal of Evidence-Based Medicine

Authors：

ZHU Xiaofeng ¹ , HUANG Ting ² , ZHU Xiaoping ² , TNAG Xuefeng ² , YU Hongjie ³ , XU Zhen ³ , FENG Ao ⁴ , LIU Lei ² , LUAN Rongsheng ¹ ,  YANG Weizhong ³

1. Teaching Section of Epidemiology of West China School of Public Health, Sichuan University, Chengdu 610041, China;2. Sichuan Center for Disease Control and Prevention, Chengdu 610041, China;3. Chinese Center for Disease Control and Prevention, Beijing 102206, China;4. Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China;

Corresponding author：

YANG Weizhong, Email: yangwz@chinacdc.cn

Keywords：

Influenza vaccination; Elderly; Healthcare worker; Community healthcare

DOI：

10.7507/1672-2531.20130096

Video：

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Objective 　To explore the impact of community healthcare workers’ (CHWs) knowledge, attitude and practice (KAP) on the influenza vaccination among elderly people.
Methods 　By means of simple random sampling, 1 residential quarter of each communities, 2 communities of each districts, 5 districts of Chengdu city were randomly selected, and the elderly equal to or more than 60-year-old were on-site investigated. Meanwhile, the questionnaire survey was conducted among healthcare workers in the selected communities.
Results 　There were 4 KAP factors played a positive role in influenza vaccination among elderly people: CHWs’ affirmation of the effectiveness of influenza vaccine, explicitly knowing the focus groups for influenza vaccination, recommendation of vaccination in flu season when the elderly visits, and participation in flu-related education activities. When the accuracy rate of each factor got improved by 1%, the influenza vaccination rate would improve by 2.747%, 1.299%, 0.864%, 0.602%, respectively.
Conclusion 　The knowledge, attitude and practice of HCWs have impacts on the influenza vaccination rates of elderly people. They are significant to improve the influenza vaccination rates of the elderly.

Citation： ZHU Xiaofeng,HUANG Ting,ZHU Xiaoping,TNAG Xuefeng,YU Hongjie,XU Zhen,FENG Ao,LIU Lei,LUAN Rongsheng,YANG Weizhong. Impact of Community Healthcare Workers’ Knowledge, Attitude and Practice on the Influenza Vaccination among Elderly People. Chinese Journal of Evidence-Based Medicine, 2013, 13(5): 543-547. doi: 10.7507/1672-2531.20130096 Copy

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2.	Forleo-Neto E, Halker E, Santos VJ, et al. Influenza. Rev Soc Bras Med Trop, 2003, 36(2): 267-274.
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5.	Derber CJ, Shankaran S. Health-Care Worker Vaccination for Influenza: Strategies and Controversies. Curr Infect Dis Rep, 2012, 14(6): 627-632.
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12.	Orosi P, Borbely A, Szidor J, et al. Factors affecting influenza vaccine uptake among health care workers at the Medical and Health Sciences Center of Debrecen University, Hungary. Orv Hetil, 2012, 153(13): 505-513.
13.	Liu X, Guo J, Han S, et al. Enhanced immune response induced by a potential influenza A vaccine based on branched M2e polypeptides linked to tuftsin. Vaccine, 2012, 30(46): 6527-6533.
14.	Perez LE, Merrill GA, Delorenzo RA, et al. Evaluation of the specificity and sensitivity of a potential rapid influenza screening system. Diagn Microbiol Infect Dis, 2013, 75(1): 77-80.
15.	Lambert ND, Ovsyannikova IG, Pankratz VS, et al. Understanding the immune response to seasonal influenza vaccination in older adults: a systems biology approach. Expert Rev Vaccines, 2012, 11(8): 985-994.
16.	Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med, 2008, 121(4): 258-264.
17.	Bergsaker M, Hungnes O, Iversen B. Vaccination against influenza--why, for whom and with which vaccine? Tidsskr Nor Laegeforen, 2006, 126(21): 2814-2817.
18.	Domínguez A, Castilla J, Godoy P, et al. Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization. Vaccine, 2012, 30(38): 5644-5650.
19.	Goka E, Vallely P, Mutton K, et al. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respi Viruses, 2012 Oct 19. doi: 10.1111/irv.12020. [Epub ahead of print].
20.	Brydak L, Roiz J, Faivre P, et al. Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig, 2012, 32(2): 73-85.
21.	Toplak N, Avcin T. Influenza and autoimmunity. Ann N Y Acad Sci. 2009, 1173: 619-626. doi: 10.1111/j.1749-6632.2009.04759.x.
22.	刘长暖节译. 流感疫苗（WHO 最新立场性文件）. 中国生物制品学杂志, 2007, 20(1): 69-72.
23.	中国流行性感冒疫苗预防接种指导意见. 中国卫生部, 2005.
24.	Kositanont U, Assantachai P, Wasi C, et al. Kinetics of the Antibody Response to Seasonal Influenza Vaccination Among the Elderly. Viral Immunol, 2012, 25(6): 471-476.
25.	Chen J, Li YT, Gu BK, et al. Estimation of the Direct Cost of Treating People Aged More Than 60 Years Infected by Influenza Virus in Shanghai. Asia Pac J Public Health, 2012 Oct 2. [Epub ahead of print].
26.	Mannino S, Villa M, Apolone G, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol, 2012, 176(6): 527-533.
27.	Gilbert SC. Advances in the development of universal influenza vaccines. Influenza Other Respi Viruses, 2012 Sep 24. doi: 10.1111/irv.12013. [Epub ahead of print].
28.	董振英, 王全意, 吴疆, 等. 北京市城区流感和流感疫苗知识、态度和行为调查. 中华流行病学杂志, 2005, 26(2): 152.
29.	Li HY, Wu SS, Yang P, et al. Influenza vaccination coverage rates and factors associated with vaccine use among the elderly in Beijing during 2008-2010. Zhonghua Liu Xing Bing Xue Za Zhi, 2012, 33(2): 247-248.
30.	李永成, 王淑惠, 杨雪莹, 等. 天津市城区老年人流感疫苗及影响因素分析. 中国公共卫生, 2007, 23(3): 264-266.
31.	张小平, 许二萍, 刘艳, 等. 杭州市城区老年人流感疫苗接种情况及其影响因素分析. 浙江预防医学, 2011, 23(9): 31-32.
32.	Takahashi O, Noguchi Y, Rahman M, et al. Influence of family on acceptance of influenza vaccination among Japanese patients. Fam Pract, 2003, 20(2): 162-166.
33.	Burns VE, Ring C, Carroll D. Factors influencing influenza vaccination uptake in an elderly, community-based sample. Vaccine, 2005, 23(27): 3604-3608.
34.	Kohlhammer Y, Schnoor M, Schwartz M, et al. Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health, 2007, 121(10): 742-751.
35.	Zimmerman RK, Santibanez TA, Janosky JE, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med, 2003, 114(1): 31-38.
36.	Kwong EW, Lam IO, Chan TM. What factors affect influenza vaccine uptake among community-dwelling older Chinese people in Hong Kong general outpatient clinics? J Clin Nurs, 2009, 18(7): 960-971.
37.	Avelino-Silva VI, Avelino-Silva TJ, Miraglia JL, et al. Campaign, counseling and compliance with influenza vaccine among older persons. Clinics (Sao Paulo), 2011, 66(12): 2031-2035.
38.	Blank PR, Bonnelye G, Ducastel A, et al. Attitudes of the General Public and General Practitioners in Five Countries towards Pandemic and Seasonal Influenza Vaccines during Season 2009/2010. PLoS One, 2012, 7(10): e45450.

1. Michael M, Helm E, Van Graafeiland B, et al. Influenza vaccination with a live attenuated vaccine. Am J Nurs, 2009, 109(10): 44-48.
2. Forleo-Neto E, Halker E, Santos VJ, et al. Influenza. Rev Soc Bras Med Trop, 2003, 36(2): 267-274.
3. 中华人民共和国卫生部. 中国流行性感冒疫苗预防接种指导意见. 国际呼吸杂志, 2006, 26(1): 3, 7.
4. Mato Chaín G, Mariano Lázaro A, Alcudia Pérez F, et al. Flu vaccination in the elderly. Rev Esp Geriatr Gerontol, 2011, 46(2): 89-95.
5. Derber CJ, Shankaran S. Health-Care Worker Vaccination for Influenza: Strategies and Controversies. Curr Infect Dis Rep, 2012, 14(6): 627-632.
6. Maggi S. Vaccination and healthy aging. Expert Rev Vaccines, 2010, 9(3 Suppl): 3-6.
7. Lang PO, Mendes A, Socquet J, et al. Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence. Clin Interv Aging, 2012, 7(1): 55-64.
8. Kasten MJ, Poland GA. Influenza vaccination and the elderly: pandemic preparedness. Drugs Aging, 2008, 25(3): 179-186.
9. Booy R, Lindley RI, Dwyer DE, et al. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial. PLoS One, 2012, 7(10): e46509.
10. Biagi E, Candela M, Turroni S, et al. Ageing and gut microbes: Perspectives for health maintenance and longevity. Pharmacol Res, 2013, 69(1): 11-20.
11. Monto AS, Ansaldi F, Aspinall R, et al. Stephenson I Influenza control in the 21st century: Optimizing protection of older adults. Vaccine, 2009, 27(37): 5043-5053.
12. Orosi P, Borbely A, Szidor J, et al. Factors affecting influenza vaccine uptake among health care workers at the Medical and Health Sciences Center of Debrecen University, Hungary. Orv Hetil, 2012, 153(13): 505-513.
13. Liu X, Guo J, Han S, et al. Enhanced immune response induced by a potential influenza A vaccine based on branched M2e polypeptides linked to tuftsin. Vaccine, 2012, 30(46): 6527-6533.
14. Perez LE, Merrill GA, Delorenzo RA, et al. Evaluation of the specificity and sensitivity of a potential rapid influenza screening system. Diagn Microbiol Infect Dis, 2013, 75(1): 77-80.
15. Lambert ND, Ovsyannikova IG, Pankratz VS, et al. Understanding the immune response to seasonal influenza vaccination in older adults: a systems biology approach. Expert Rev Vaccines, 2012, 11(8): 985-994.
16. Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med, 2008, 121(4): 258-264.
17. Bergsaker M, Hungnes O, Iversen B. Vaccination against influenza--why, for whom and with which vaccine? Tidsskr Nor Laegeforen, 2006, 126(21): 2814-2817.
18. Domínguez A, Castilla J, Godoy P, et al. Effectiveness of pandemic and seasonal influenza vaccines in preventing pandemic influenza-associated hospitalization. Vaccine, 2012, 30(38): 5644-5650.
19. Goka E, Vallely P, Mutton K, et al. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respi Viruses, 2012 Oct 19. doi: 10.1111/irv.12020. [Epub ahead of print].
20. Brydak L, Roiz J, Faivre P, et al. Implementing an influenza vaccination programme for adults aged ≥65 years in Poland: a cost-effectiveness analysis. Clin Drug Investig, 2012, 32(2): 73-85.
21. Toplak N, Avcin T. Influenza and autoimmunity. Ann N Y Acad Sci. 2009, 1173: 619-626. doi: 10.1111/j.1749-6632.2009.04759.x.
22. 刘长暖节译. 流感疫苗（WHO 最新立场性文件）. 中国生物制品学杂志, 2007, 20(1): 69-72.
23. 中国流行性感冒疫苗预防接种指导意见. 中国卫生部, 2005.
24. Kositanont U, Assantachai P, Wasi C, et al. Kinetics of the Antibody Response to Seasonal Influenza Vaccination Among the Elderly. Viral Immunol, 2012, 25(6): 471-476.
25. Chen J, Li YT, Gu BK, et al. Estimation of the Direct Cost of Treating People Aged More Than 60 Years Infected by Influenza Virus in Shanghai. Asia Pac J Public Health, 2012 Oct 2. [Epub ahead of print].
26. Mannino S, Villa M, Apolone G, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol, 2012, 176(6): 527-533.
27. Gilbert SC. Advances in the development of universal influenza vaccines. Influenza Other Respi Viruses, 2012 Sep 24. doi: 10.1111/irv.12013. [Epub ahead of print].
28. 董振英, 王全意, 吴疆, 等. 北京市城区流感和流感疫苗知识、态度和行为调查. 中华流行病学杂志, 2005, 26(2): 152.
29. Li HY, Wu SS, Yang P, et al. Influenza vaccination coverage rates and factors associated with vaccine use among the elderly in Beijing during 2008-2010. Zhonghua Liu Xing Bing Xue Za Zhi, 2012, 33(2): 247-248.
30. 李永成, 王淑惠, 杨雪莹, 等. 天津市城区老年人流感疫苗及影响因素分析. 中国公共卫生, 2007, 23(3): 264-266.
31. 张小平, 许二萍, 刘艳, 等. 杭州市城区老年人流感疫苗接种情况及其影响因素分析. 浙江预防医学, 2011, 23(9): 31-32.
32. Takahashi O, Noguchi Y, Rahman M, et al. Influence of family on acceptance of influenza vaccination among Japanese patients. Fam Pract, 2003, 20(2): 162-166.
33. Burns VE, Ring C, Carroll D. Factors influencing influenza vaccination uptake in an elderly, community-based sample. Vaccine, 2005, 23(27): 3604-3608.
34. Kohlhammer Y, Schnoor M, Schwartz M, et al. Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health, 2007, 121(10): 742-751.
35. Zimmerman RK, Santibanez TA, Janosky JE, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med, 2003, 114(1): 31-38.
36. Kwong EW, Lam IO, Chan TM. What factors affect influenza vaccine uptake among community-dwelling older Chinese people in Hong Kong general outpatient clinics? J Clin Nurs, 2009, 18(7): 960-971.
37. Avelino-Silva VI, Avelino-Silva TJ, Miraglia JL, et al. Campaign, counseling and compliance with influenza vaccine among older persons. Clinics (Sao Paulo), 2011, 66(12): 2031-2035.
38. Blank PR, Bonnelye G, Ducastel A, et al. Attitudes of the General Public and General Practitioners in Five Countries towards Pandemic and Seasonal Influenza Vaccines during Season 2009/2010. PLoS One, 2012, 7(10): e45450.

Chinese Journal of Evidence-Based Medicine

Impact of Community Healthcare Workers’ Knowledge, Attitude and Practice on the Influenza Vaccination among Elderly People

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