The Social Ecological Model as a Framework for Determinants of 2009 H1N1 Influenza Vaccine Uptake in the United States

Research on influenza vaccine uptake has focused largely on intrapersonal determinants (perceived risk, past vaccine acceptance, perceived vaccine safety) and on physician recommendation. The authors used a social ecological framework to examine influenza vaccine uptake during the 2009 H1N1 pandemic...

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Bibliographic Details
Published in:Health education & behavior 2012-04, Vol.39 (2), p.229-243
Main Authors: Kumar, Supriya, Quinn, Sandra Crouse, Kim, Kevin H., Musa, Donald, Hilyard, Karen M., Freimuth, Vicki S.
Format: Article
Language:English
Subjects:
African Americans
Age Factors
Confidence intervals
Continental Population Groups - statistics & numerical data
Diseases
Ecological models
Ecology
Female
Financial Support
Guidelines
Health Behavior
Health Knowledge, Attitudes, Practice
Health Services Accessibility - statistics & numerical data
Hispanic Americans
Humans
Immunization - psychology
Immunization - statistics & numerical data
Immunization Programs
Influenza
Influenza A Virus, H1N1 Subtype - immunology
Influenza Vaccines - administration & dosage
Influenza, Human - epidemiology
Influenza, Human - prevention & control
Intention
Intervention
Interventions
Male
Middle Aged
Pandemics
Patient Acceptance of Health Care
Perception
Physicians
Predictor Variables
Public Policy
Residence Characteristics - statistics & numerical data
Risk
Safety
Sex Factors
Social Environment
Surveys
Swine flu
United States - epidemiology
Uptake
Vaccines
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Summary:Research on influenza vaccine uptake has focused largely on intrapersonal determinants (perceived risk, past vaccine acceptance, perceived vaccine safety) and on physician recommendation. The authors used a social ecological framework to examine influenza vaccine uptake during the 2009 H1N1 pandemic. Surveying an adult population (n = 2,079) in January 2010 with significant oversamples of Blacks and Hispanics, this study found that 18.4% (95% confidence interval = 15.6-21.5) had gotten the 2009 H1N1 vaccine. Variables at each level of the social ecological model were significant predictors of uptake as well as of intent to get the vaccine. The intrapersonal level explained 53%, the interpersonal explained 47%, the institutional level explained 34%, and the policy and community levels each explained 8% of the variance associated with vaccine uptake. The levels together explained 65% of the variance, suggesting that interventions targeting multiple levels of the framework would be more effective than interventions aimed at a single level.
ISSN:1090-1981
1552-6127
DOI:10.1177/1090198111415105