Increased interest in vaccination following a community-based intervention in New York City

Despite the proven benefits of influenza vaccination, vaccination rates among adults in the U.S. remain lower than the recommended levels. This problem is particularly acute among racial/ethnic minorities in disadvantaged areas and “hard-to-reach” populations (e.g., homebound elderly, substance users, undocumented immigrants, homeless and sex workers). A community and academic partnership designed, conducted and evaluated a community-based multilevel intervention targeting East Harlem and the South Bronx neighborhoods of New York City to determine whether the intervention increased interest in receiving influenza vaccination in non-traditional settings, such as door-to-door in apartment buildings or on street corners. Intervention activities were carried out at the individual, community organization and neighborhood-level and included disseminating project information, attending community meetings and conducting street-based and door-to-door surveys coupled with vaccination in two successive years. Among the 6,826 participants, 72% were Hispanic/Latino, 60% were female, and mean age was 41 years. 68% reported income of $9,600/yr or less and 37% were members of a hard-to-reach population. In multivariate analyses, variables significantly associated with an increased likelihood of being interested in receiving influenza vaccine at the time of survey were: being surveyed post-intervention (p<0.0001), being a member of a hard-to-reach population (p=0.03), having ever received an influenza vaccine (p<0.0001), and being medically-indicated to receive vaccine (p=0.0019). Targeting underserved neighborhoods through a multilevel community-based intervention increased interest in influenza vaccination, particularly among hard-to-reach populations. This approach has the potential to be implemented in other areas or used to address other health disparities.