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Project V.I.P.: Vaccinate for Influenza Prevention – a Pilot Study of Influenza Vaccine Acceptability Among Residents of Senior Housing
Research Method: Intervention Research
Principal Investigator: Jean J. Schensul, Ph.D. (PI), Janet McElhaney, M.D. (Co-PI)
Grant: Core-funding, ICR
Partners: University of Connecticut Health Center’s Center for Immunotherapy of Cancer and Infectious Diseases (UCHC-CICID), Hartford Housing Authority (HHA), VNA Health Care Inc. of Greater Hartford (VNA), North Central Area Agency on Aging (NCAAA)
Dates of Study: December 2004 – February 2005

Background

Influenza disproportionately affects African-American, Latino and other minority and low-income older adults.  Complications related to influenza may cause older adults’ health to deteriorate significantly.  In densely populated residential communities, an increase in flu vaccination rates can greatly improve both individual and community health.  To raise the rates, it is first necessary to correct misconceptions about the vaccine, and to identify reasons the older adults are averse to it.  A peer-led intervention can offer education, health promotion, community advocacy, and direct access to care.   V.I.P.: Vaccinate for Influenza Prevention was designed to increase influenza vaccination rates and promote a proactive and sustainable approach to health maintenance among low-income, primarily minority older adults living independently in a senior housing building in Hartford, CT. 

This pilot study was based on six years of community-based collaborative research with older adults.  A study of HIV exposure in Hartford and Chicago, AIDS Risk in Older Urban Adult Senior Housing Residents, showed that older adults living in senior housing are concerned for their health. A study of depression, Improving Access to Mental Health Services for Older Hartford Residents, showed what barriers keep senior housing residents from accessing healthcare. These projects helped forge ICR’s relationship with building staff and residents. The VIP pilot provided formative research for an expanded one-year study, VIP II, funded by the Centers for Disease Control.
Project Goals and Objectives
  • Pilot test a survey about flu vaccine acceptability and behavior with approximately 60 building residents.
  • Pilot test and critique an empowerment-based peer educator curriculum to address residents’ concerns about influenza and promote pro-vaccine norms. 
  • Pilot test a peer-led motivational interviewing strategy with a follow-up group discussion to critique the process.
  • Pilot test the development and implementation of a peer-led flu education event, facilitated and documented by project staff.
  • Provide opportunities for convenient influenza vaccination for building residents and staff through scheduled on-site flu vaccine clinics in collaboration with the VNA and NCAAA.    
  • Analyze pilot survey and ethnographic data for feasibility, acceptability and sustainability, to inform revisions to the study materials, and to establish a foundation for further studies.

Project Details
In one senior housing facility, this study pilot-tested a survey instrument in English and Spanish with 54 residents. The respondents, as closely as possible, reflected the age, ethnic, gender and ability composition of the building. Project staff also recruited residents to participate in the peer education trainings and Motivational Interviewing components of the study. Four residents completed the flu education training to become peer health educators, forming the V.I.P. Committee that advocated vaccination and health maintenance to other residents. The VNA, in collaboration with the NCAAA, conducted 3 influenza vaccine clinics in the building, which served approximately 25% of the building community bringing vaccination levels in the building up to approximately 50%. With the assistance of project staff, the V.I.P. Committee organized a “flu fair,” which more than 50 residents and staff attended. This event included a flu vaccine clinic, theme-related games, an information table, and a luncheon. At a study debriefing immediately following the fair, V.I.P. Committee members and other residents expressed their enthusiasm to discuss further plans and opportunities for health education and advocacy. The project resulted in a curriculum that was tested in a CDC funded efficacy study.

Project Results

Residents on the V.I.P. Committee and project staff worked together to coordinate a flu vaccine promotion campaign. ICR interviewers completed surveys with 54 residents on their knowledge, attitudes and beliefs about influenza and influenza vaccination, and their previous vaccination practices. The committee also worked with staff to organize three flu clinics. Conducted by the VNA, the clinics vaccinated 39 residents (approx. 25% of the total building population). This brought the estimated total of vaccinated residents to approximately 50%. Even with these clinics, residents were under-vaccinated but survey results showed resident interest in vaccination in the future.

Project Contact:
Jean J. Schensul, Ph.D.
Principal Investigator

Kim E. Radda, R.N., ABD

Project Director


Project Staff:
ICR

Jean J. Schensul, Ph.D.

Principal Investigator

Founder and Senior Scientist

Kim Radda, R.N., ABD

Project Director

Ken Williamson, Ph.D.

Intervention Facilitator

William B. Disch, Ph.D.

Senior Research Analyst

Michelle Garner, B.A.

Data Manager

Evelyn Baez, B.A.

Community Researcher

Helena de Moura-Castro, B.A.

Community Researcher

Julianne Gonzalez

Community Researcher

University of Connecticut Health Center, Center for Immunotherapy of Cancer and Infectious Diseases

Janet McElhaney, M.D.

Co-Principal Investigator

Daniel Chaput, M.M.

Community Researcher

Hartford Housing Authority

Elizabeth Rodriguez

Wanda Moore

VNA Health Care Inc. of Greater Hartford

Laurie St. John, R.N., M.S.N.

North Central Area Agency on Aging (NCAAA)

Carmen Y. Reyes, M.S.M.

Laurie Brooks

Links to Other Projects:

VIP: Vaccinate for Influenza Prevention

Improving Access to Mental Health Services for Older Hartford Residents

AIDS Risk in Older Urban Adult Senior Housing Residents

Recipes for Life