Yale University

Multi-level intervention to prevent influenza infections in older low income and minority adults.

TitleMulti-level intervention to prevent influenza infections in older low income and minority adults.
Publication TypeJournal Article
Year of Publication2009
AuthorsSchensul, Jean J., Kim Radda, Emil Coman, and Elsie Vazquez
JournalAmerican journal of community psychology
Date Published2009 Jun
KeywordsAfrican Americans, Catchment Area (Health), Connecticut, Female, Health Promotion, Healthcare Disparities, Hispanic Americans, Humans, Influenza Vaccines, Influenza, Human, Intervention Studies, Male, Middle Aged, Minority Groups, Outcome and Process Assessment (Health Care), Preventive Health Services, Psychological Theory, Socioeconomic Factors, Vaccination
AbstractIn this paper we describe a successful multi-level participatory intervention grounded in principles of individual and group empowerment, and guided by social construction theory. The intervention addressed known and persistent inequities in influenza vaccination among African American and Latino older adults, and associated infections, hospitalizations and mortality. It was designed to increase resident ability to make informed decisions about vaccination, and to build internal and external infrastructure to support sustainability over time. The intervention brought a group of social scientists, vaccine researchers, geriatricians, public health nurses, elder services providers and advocates together with senior housing management and activist African American and Latino residents living in public senior housing in a small east coast city. Two buildings of equal size and similar ethnic composition were randomized as intervention and control buildings. Pre and post intervention surveys were conducted in both buildings, measuring knowledge, attitudes and peer norms. Processes and outcomes were documented at four levels: Influenza Strategic Alliance (macro and exo levels), building management (meso level), building resident committee (meso level) and individual residents. The Influenza Strategic Alliance (I.S.A.) provided ongoing resources, information and vaccine; the building management provided economic and other in-kind resources and supported residents to continue flu clinics in the building. The V.I.P. Resident Committee conducted flu campaigns with flu clinics in English and Spanish. The vaccination rate in the intervention building at post test exceeded the study goal of 70% and showed a significant improvement over the control building. The intervention achieved desired outcomes at all four levels and resulted in a significant increase in influenza vaccination, and improvements in pro-vaccination knowledge, beliefs, and understanding of health consequences.
Alternate JournalAm J Community Psychol

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