Using the social ecologic framework to improve the influenza vaccination strategy among the Portuguese elderly

Machado, Ausenda; Santos, Ana João; Kislaya, Irina; Larrauri, Amparo; Nunes, Baltazar

Publication

Using the social ecologic framework to improve the influenza vaccination strategy among the Portuguese elderly

2019-09Conference object

dc.contributor.author	Machado, Ausenda
dc.contributor.author	Santos, Ana João
dc.contributor.author	Kislaya, Irina
dc.contributor.author	Larrauri, Amparo
dc.contributor.author	Nunes, Baltazar
dc.date.accessioned	2020-05-15T13:45:20Z
dc.date.available	2020-09-01T00:30:13Z
dc.date.issued	2019-09
dc.description.abstract	Background: In a context of lower than targeted influenza vaccination (IV) coverage, identifying factors associated IV uptake is essential to improve population coverage. Although extensive work has been done in this field, scarcer studies focused on framing these factors within a multifactorial model. Having the social ecological model (SEM) as framework, this study intended to identify and quantify the SEM levels associated to seasonal IV uptake in the Portuguese population aged 65 and more years. Methods: Data from the Portuguese 2014 National Health Survey was restricted to individuals aged 65 and more years (n=5669). The outcome of interest was self-reported IV uptake in the 2 years previous to the interview. Twenty three independent variables were selected from the survey and were allocated in one of the five SEM levels: individual, interpersonal, organizational, community and policy. Sex stratified and age adjusted analysis using Poisson regression were performed for each SEM level. To evaluate statistical significance and marginal contribution of each SEM level for explaining IV uptake, the full model was fitted (all variables from all 5 SEM levels). To determine joint statistical significance of variables of each SEM level, the model without respective SEM level was compared with the full model using likelihood ratio test. Additionally, marginal contribution of each SEM level was measured by relative reduction in magnitude of pseudo R square. Results: For both men and women, older age groups (85 or more vs 65-69 age group; PR=1.59 for men and PR=1.56 for women); having 3 or more chronic conditions (PR=1.39 for men and PR=1.35 for women); number of GP and outpatient visits in the previous 4 weeks were associated to higher IV uptake. For men, only 2 out of the 5 SEM levels were associated to IV uptake (individual and organizational). For women 3 levels were relevant for this preventive measure (individual, organizational and community). Main marginal contribution for explaining the IV uptake, came from individual (17.9% and 16.3%) and organizational (30.7% and 22.7%) levels for both men and women respectively. Conclusions: Besides individual characteristics, like age and health status - known determinants of IV uptake - this study highlights the importance of access and use of health care services for adoption of IV preventive measure. Moreover, it evidences a sex differential behaviour that should be accounted in the definition of the IV campaign strategy.	pt_PT
dc.description.version	N/A	pt_PT
dc.identifier.doi	10.1136/jech-2019-SSMabstracts.186	pt_PT
dc.identifier.uri	http://hdl.handle.net/10400.18/6674
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.relation.publisherversion	https://jech.bmj.com/content/73/Suppl_1/A87.2	pt_PT
dc.subject	Influenza Virus	pt_PT
dc.subject	Vaccination	pt_PT
dc.subject	População Idosa	pt_PT
dc.subject	Modelo Sócio Ecológico	pt_PT
dc.subject	Determinantes da Saúde e da Doença	pt_PT
dc.subject	Vacina Antigripal	pt_PT
dc.title	Using the social ecologic framework to improve the influenza vaccination strategy among the Portuguese elderly	pt_PT
dc.type	conference object
dspace.entity.type	Publication
oaire.citation.conferencePlace	Cork, Irlanda	pt_PT
oaire.citation.title	Society for Social Medicine & Population Health and International Epidemiology Association European Congress Joint Annual Scientific Meeting 2019, 4- 6 Sep 2019	pt_PT
rcaap.rights	openAccess	pt_PT
rcaap.type	conferenceObject	pt_PT