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- Title
Health education and factors influencing acceptance of and willingness to pay for influenza vaccination among older adults.
- Authors
Worasathit, Rawipun; Wattana, Wantanee; Okanurak, Kamolnetr; Songthap, Archin; Dhitavat, Jittima; Pitisuttithum, Punnee
- Abstract
<bold>Background: </bold>The influenza vaccine is recommended in older population. However the immunization coverage varies globally. It has been reported as low as 10-20 % in some countries. This study explored the acceptance of and willingness to pay for influenza vaccination, comparing acceptance and willingness to pay before and after health education.<bold>Methods: </bold>The study was conducted with 2693 older people in Bangkok, Thailand. Participants were divided into an education group (n = 1402) and a control group (n = 1291). A validated questionnaire measuring acceptance of and willingness to pay for vaccination was administered during semi-structured interviews before and after education. Data on factors influencing acceptance were analyzed.<bold>Results: </bold>Participants' mean age was 69.5 years, 80 % were women and 82.1 % had at least one co-morbidity. Of the participants, 43.5 % had previously received vaccination more than once, although 92.8 % expressed acceptance of vaccination. Acceptance was associated with a positive attitude toward vaccination (OR 2.1, 95 % CI 1.5-2.9) and a history of receiving vaccination (OR 4.1, 95 % CI 2.8-6.1). At baseline, there were no differences between the education and control groups in terms of work status (p = 0.457), co-morbidities (p = 0.07), medical status (p = 0.243), and previous vaccination (p = 0.62), except for educational background (p = 0.004). Acceptance of vaccination increased to 95.8 % (p < 0.001) after education and willingness to pay increased to 82.1 % (p < 0.001). Education significantly affected those with primary school-level education and no previous vaccination history, with acceptance increasing from 83.3 to 92.6 % (p < 0.001); more than twice as high as the control group (OR 2.4, 95 % CI 1.2-4.7). Viewing an educational video increased the proportion of participants with a high level of knowledge from 29.2 to 49.2 % (p < 0.001), and increased the proportion of participants with a positive attitude from 52.4 to 70.7 % (p <0.001). No significant difference was found in any parameter between the first and second assessment in the control group.<bold>Conclusions: </bold>The strategies to increase positive attitudes may enhance the acceptance of vaccination. Health education using an educational video demonstrated a significant impact on acceptance, willingness to pay, knowledge and attitude in older people. This may lead to increased sustainability of the immunization program in older people.
- Subjects
BANGKOK (Thailand); THAILAND; INFLUENZA vaccines; MEDICAL care for older people; WILLINGNESS to pay; HEALTH education; ACCEPTANCE (Psychology); OLDER people; ECONOMICS; INFLUENZA prevention; HEALTH outcome assessment; IMMUNIZATION; PATIENT compliance; PATIENT education; USER charges; PSYCHOLOGY; VACCINATION; THERAPEUTICS
- Publication
BMC Geriatrics, 2015, Vol 15, p1
- ISSN
1471-2318
- Publication type
journal article
- DOI
10.1186/s12877-015-0137-6