Publication: Health education and factors influencing acceptance of and willingness to pay for influenza vaccination among older adults
Issued Date
2015
Valid Date
2017-11-08
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eng
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Mahidol University
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BioMed Central
Bibliographic Citation
BMC Geriatrics. Vol.15, (2015), 136
Suggested Citation
Rawipun Worasathit, Wantanee Wattana, Kamolnetr Okanurak, Archin Songthap, Jittima Dhitavat, Punnee Pitisuttithum Health education and factors influencing acceptance of and willingness to pay for influenza vaccination among older adults. BMC Geriatrics. Vol.15, (2015), 136. doi:10.1186/s12877-015-0137-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3083
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Title
Health education and factors influencing acceptance of and willingness to pay for influenza vaccination among older adults
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Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.