This work was supported by the Centers for Disease Control and Prevention (Award Numbers R36 IP000289-01 and R18IP000166) and the National Institute of Allergy and Infectious Diseases (Award Number T32AI074492). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control and Prevention, the National Institute of Allergy and Infectious Diseases, or the National Institutes of Health. This study was made possible by the cooperation and assistance of many people: Ja’net Bishop, Truett Abbott, Bill Pendrey, and Steve Echols, who were very supportive principals of participating schools; Angela Engram and Michelle Fanning, our key school staff contacts; Chris Morfaw, RN, for assistance with data acquisition; the Emory doctoral students and friends who assisted with survey preparation; all of the students who participated in the study, and their parents for allowing them to participate.
Adolescent Attitudes Toward Influenza Vaccination and Vaccine Uptake in a School-Based Influenza Vaccination Intervention: A Mediation Analysis
Article first published online: 18 MAY 2011
© 2011, American School Health Association
Journal of School Health
Volume 81, Issue 6, pages 304–312, June 2011
How to Cite
Painter, J. E., Sales, J. M., Pazol, K., Wingood, G. M., Windle, M., Orenstein, W. A. and DiClemente, R. J. (2011), Adolescent Attitudes Toward Influenza Vaccination and Vaccine Uptake in a School-Based Influenza Vaccination Intervention: A Mediation Analysis. Journal of School Health, 81: 304–312. doi: 10.1111/j.1746-1561.2011.00595.x
- Issue published online: 18 MAY 2011
- Article first published online: 18 MAY 2011
- Received on February 8, 2010, Accepted on July 1, 2010
- influenza vaccine;
- psychological theories;
- rural population
BACKGROUND: School-based vaccination programs may provide an effective strategy to immunize adolescents against influenza. This study examined whether adolescent attitudes toward influenza vaccination mediated the relationship between receipt of a school-based influenza vaccination intervention and vaccine uptake.
METHODS: Participants were recruited from 2 counties participating in a school-based influenza vaccination intervention trial in rural Georgia (N = 337). Data were collected from surveys distributed to adolescents at pre- and post-intervention time points and from documents indicating vaccine uptake. Guided by the Health Belief Model and the Integrated Behavioral Model, surveys assessed demographic, behavioral, and psychosocial variables. A mediation analysis was used to test whether changes in psychosocial variables from baseline to follow-up mediated the relationship between study condition and influenza vaccine uptake.
RESULTS: Controlling for background variables, step 1 of the mediation analysis revealed a significant relationship between study condition and vaccine uptake (odds ratio = 1.77, p = .038). Step 2 of the mediation analysis revealed a significant relationship between study condition and changes in psychosocial variables from baseline to follow-up. Steps 3 and 4 of the mediation analysis revealed that there was full mediation of the relationship between study condition and receipt of an influenza vaccination by intention to receive an influenza vaccination.
CONCLUSION: Findings suggest that the success of our school-based influenza vaccination intervention in increasing vaccine uptake was mediated by adolescents' intention to receive an influenza vaccination. Future influenza vaccination efforts geared toward rural adolescents may benefit from addressing adolescent attitudes toward influenza vaccination, particularly increasing intention to receive a vaccine.