Article2011

Adolescent Attitudes Toward Influenza Vaccination and Vaccine Uptake in a School-Based Influenza Vaccination Intervention: A Mediation Analysis

Julia E. Painter · Jessica McDermott Sales · Karen Pazol · Gina M. Wingood · Michael T. Windle · Walter Albert Orenstein +1 more

28 citations0/0 files storedJournal of School Health

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Abstract

BACKGROUND: School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake. METHODS: Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention trial in rural Georgia (N = 337). Data were collected from surveys distributed to adolescents at pre- and post-intervention time points and from documents indicating vaccine uptake. Guided by the Health Belief Model and the Integrated Behavioral Model, surveys assessed demographic, behavioral, and psychosocial variables. A mediation analysis was used to test whether changes in psychosocial variables from baseline to follow-up mediated the relationship between study condition and influenza vaccine uptake. RESULTS: Controlling for background variables, step 1 of the mediation analysis revealed a significant relationship between study condition and vaccine uptake (odds ratio = 1.77, p = .038). Step 2 of the mediation analysis revealed a significant relationship between study condition and changes in psychosocial variables from baseline to follow-up. Steps 3 and 4 of the mediation analysis revealed that there was full mediation of the relationship between study condition and receipt of an influenza vaccination by intention to receive an influenza vaccination. CONCLUSION: Findings suggest that the success of our school-based influenza vaccination intervention in increasing vaccine uptake was mediated by adolescents' intention to receive an influenza vaccination. Future influenza vaccination efforts geared toward rural adolescents may benefit from addressing adolescent attitudes toward influenza vaccination, particularly increasing intention to receive a vaccine.

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1992Health Behavior and Health Education: Theory, Research, and Practice 1974The Health Belief Model and Sick Role Behavior 1999Strategies to Sustain Success in Childhood Immunizations 1986Predicting and Understanding Influenza Vaccination Behavior 2007Mass Distribution of Free, Intranasally Administered Influenza Vaccine in a Public School System 2001Predictors of Influenza Virus Vaccination Status in Hospitalized Children 2007Misperceptions About Influenza Vaccination Among Parents of Healthy Young Children 2006Influenza Vaccinations of Young Children Increased With Media Coverage in 2003

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