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APHA Scientific Session and Event Listing

Recorded presentation

Philip Noyes, MPH, MA¹, Edward Wake², Moses Mansu, MPA³, Regina Graham, MPH¹, Yoreel Fraser, DMin, MDiv, MA⁴, Kesha Crichlow, MD⁵, Jane Zucker, MD², Victor Hunter³, and Adam Karpati, MD, MPH¹. (1) Brooklyn District Public Health Office, NYC Department of Health and Mental Hygiene, 485 Throop Ave., Brooklyn, NY 11221, 646-253-5715, pnoyes@health.nyc.gov, (2) Bureau of Immunization, NYC Department of Health and Mental Hygiene, 2 Lafayette St, New York, NY 10007, (3) Office of Minority Health, NYC Department of Health and Mental Hygiene, 485 Throop Ave., Brooklyn, NY 11221, (4) Bureau of Chronic Disease Prevention and Control - Asthma Initiative, NYC Department of Health and Mental Hygiene, 2 Lafayette Street, New York, NY 10007, (5) Public Health Detailing Program, NYC Department of Health and Mental Hygiene, 485 Throop Ave., Brooklyn, NY 11221

The NYC Department of Health and Mental Hygiene recently established a “District Public Health Office” in Central Brooklyn to address neighborhood health disparities. Responding to historically low vaccination rates and low demand during the 2004-2005 vaccine shortage in this predominantly Caribbean and African American community, the Office initiated a participatory study. The study, guided by a steering committee of faith leaders, examined the determinants of influenza vaccine for residents over age 50. The multifaceted study included brief interviews with health providers, and self-administered surveys and focus groups with community residents. Community participants, recruited through faith institutions, were asked about their attitudes and experiences with the vaccine, and trust in the medical profession. Results from the provider interviews (n=11) indicated that few providers had systematic methods to ensure patients receive influenza vaccination. Community survey participants (n=337) were mainly women (81%); 43% were over 65 and 38% were foreign born (primarily Caribbean). There were strong associations between receiving the vaccine and favorable beliefs about vaccine efficacy (OR=2.9, p<.01), doctor recommendation (OR=3.4, p<.001) and mistrust in the medical profession (OR=0.3, p<.001). Focus group findings further delineated issues of need and trust in flu vaccine decision making. The perceived need for vaccination must be strong enough to overcome convention and contrary advice of friends. The decision is also influenced by layers of trust: in the vaccine, in home-remedies and in the medical profession and government. These results, and guidance from the steering committee, will shape future neighborhood and citywide strategies to promote adult immunization.

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