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Multi-Level Intervention to Prevent Influenza Infections in Older Low Income and Minority Adults

  • Original Paper
  • Published:
American Journal of Community Psychology

Abstract

In 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.

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Notes

  1. From its founding in 1987, the mission of the Institute for Community Research has been to develop partnerships and collaborations with communities and other concerned organizations to address long term or persistent community health, education and cultural development concerns, using the tools of social science research—theories, methods and results.

  2. There is indication that the scale may be operating differently by ethnicity, because the reliabilities by ethnicity were .72 for Blacks and .66 for Puerto Ricans for the first factor, and .78 for Blacks and .52 for Puerto Ricans for the second.

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Acknowledgments

Authors wish to express special appreciation to partners and collaborators in this intervention effort, including Debbye Rosen, B.S.N., M.S., State Department of Public Health; Janet McElhaney, M.D., University of British Columbia, B.C., Canada; George Kuchel, M.D., and Rita Jepsen, M.D., University of Connecticut Health Center, Center on Aging; Laurie Browne, B.A., & Carmen Y. Reyes, M.S.M., CT North Central Area Agency on Aging; William B. Disch, Ph.D., University of Connecticut; Ken Williamson, Ph.D., University of South Florida; Alessandro Rey Bermudez, & Michelle Garner, B.A., Institute for Community Research; Laurie St. John, R.N., M.S.N., VNA Health Care, Inc. and the VNA nurses who administered the flu clinics in treatment and control buildings; staff and residents of the Hartford Housing Authority buildings.

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  1. Institute for Community Research, 2 Hartford Square West, Ste. 100, Hartford, CT, 06106, USA

    Jean J. Schensul, Kim Radda, Emil Coman & Elsie Vazquez

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  1. Jean J. Schensul
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Schensul, J.J., Radda, K., Coman, E. et al. Multi-Level Intervention to Prevent Influenza Infections in Older Low Income and Minority Adults. Am J Community Psychol 43, 313–329 (2009). https://doi.org/10.1007/s10464-009-9235-y

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