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A comprehensive investigation of barriers to adult immunization: a methods paper.
- Source :
-
The Journal of family practice [J Fam Pract] 2001 Aug; Vol. 50 (8), pp. 703. - Publication Year :
- 2001
-
Abstract
- Objective: Immunization rates for influenza and pneumococcal vaccines among the elderly (especially minority elderly) are below desired levels. We sought to answer 4 questions: (1) What factors explain most missed immunizations? (2) How are patient beliefs and practices regarding adult immunization affected by racial or cultural factors? (3) How are immunizations and patient beliefs affected by physician, organizational, and operational factors? and (4) Based on the relationships identified, can typologies be created that foster the tailoring of interventions to improve immunization rates?<br />Study Design: A multidisciplinary team chose the PRECEDE-PROCEED framework, the Awareness-to-Adherence model of clinician response to guidelines, and the Triandis model of consumer decision making as the best models to assess barriers to and facilitators of immunization. Our data collection methods included focus groups, face-to-face and telephone interviews, self-administered surveys, site visits, participant observation, and medical record review.<br />Population: To encounter a broad spectrum of patients, facilities, systems, and interventions, we sampled from 4 strata: inner-city neighborhood health centers, clinics in Veterans Administration facilities, rural practices in a network, and urban/suburban practices in a network. In stage 1, a stratified random cluster sample of 60 primary care clinicians was selected, 15 in each of the strata. In stage 2, a random sample of 15 patients was selected from each clinician's list of patients, aiming for 900 total interviews.<br />Conclusions: This multicomponent approach is well suited to identifying barriers to and facilitators of adult immunizations among a variety of populations, including the disadvantaged.
- Subjects :
- Aged
Female
Focus Groups
Guideline Adherence standards
Guideline Adherence statistics & numerical data
Health Services Research
Humans
Male
Minority Groups education
Minority Groups psychology
Models, Psychological
Organizational Culture
Patient Acceptance of Health Care statistics & numerical data
Pennsylvania
Practice Guidelines as Topic
Regression Analysis
Surveys and Questionnaires
Family Practice organization & administration
Health Knowledge, Attitudes, Practice
Health Services Accessibility organization & administration
Immunization psychology
Immunization statistics & numerical data
Influenza Vaccines
Patient Acceptance of Health Care psychology
Pneumococcal Vaccines
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0094-3509
- Volume :
- 50
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The Journal of family practice
- Publication Type :
- Academic Journal
- Accession number :
- 11509165