November 5, 2013

Social and Behavioral Determinants of
Adult Vaccination: Literature Review
Prepared by: Stephanie Gati
Goal for Literature Search
• Determine the research that has been done thus
far
• Learn from prior vaccination campaigns
•...
Literature Search for Social and Behavioral Determinants of Adult
Vaccination
Initial Search and High-Level Screening Sour...
Social Determinants
• Few articles addressed social determinants of
vaccination, but many addressed social
determinants of...
Models of Social Determinants of Health
• Diderichsen Model: Social stratification and status
correspond to differential e...
Social Determinant Conceptual Framework

World Health Organization (2010) A Conceptual Framework for Action on the Social ...
Social Determinants
• Findings from HPV, Influenza, HepB Vaccination
– HPV: School-based programs achieved high coverage f...
Behavioral Determinants
• Theory of Planned Behavior (6 Papers): intention to
engage in a health behavior is based on:
– S...
Behavioral Determinants
• Liao, et al. (2011) Factors Affecting Intention to
Receive and Self Report 2009 Pandemic (H1N1)
...
Summary
• Social determinants:
– Barriers to access for adult vaccinations include: a lack
of funded and targeted programs...
Gaps in Research
• Social determinants of adult vaccination
– Frequently do not consider social determinants of
vaccinatio...
Thank You.
References: Relevant Social Determinant
Articles
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References: Relevant Behavioral
Determinant Articles
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Baars J, et al. (2008...
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Social and behavioral determinants lit review

  1. 1. November 5, 2013 Social and Behavioral Determinants of Adult Vaccination: Literature Review Prepared by: Stephanie Gati
  2. 2. Goal for Literature Search • Determine the research that has been done thus far • Learn from prior vaccination campaigns • Identify gaps in current research 2
  3. 3. Literature Search for Social and Behavioral Determinants of Adult Vaccination Initial Search and High-Level Screening Sources     MeSH/PubMed Keyword searches Free-text Google search Publications  Key organization Web sites (e.g. WHO, GAVI, PATH, etc.)  GAVI Investment Cases  Unpublished papers 32 Less Relevant Publications 71 Publications Reviewed in Detail 39 Relevant Publications 25 Social Determinants Publications 9 High-Income Countries 3 Low/Middle Income Countries  WHO Bulletins  Grey papers (unpublished)  Abstracts 13 General 14 Behavioral Determinants Publications 13 High-Income Countries 1 Low/Middle Income Countries 3
  4. 4. Social Determinants • Few articles addressed social determinants of vaccination, but many addressed social determinants of health • Plans of action to address social determinants of health are applicable to increasing adult vaccination • Access to vaccination may be an important component of social determinants of health 4
  5. 5. Models of Social Determinants of Health • Diderichsen Model: Social stratification and status correspond to differential exposure and vulnerability to disease (3 papers) • Intermediary Determinants of Health (2 papers) – – – – Materialist/Structuralist Theory Psychosocial Theory Social Production Theory Eco-Social Theory 5
  6. 6. Social Determinant Conceptual Framework World Health Organization (2010) A Conceptual Framework for Action on the Social Determinants of Health. 6
  7. 7. Social Determinants • Findings from HPV, Influenza, HepB Vaccination – HPV: School-based programs achieved high coverage for adolescent girls, but missed those who don’t attend school. Major cost and price barriers (3 papers) – Influenza: Vaccination associated with education, accessibility of care, and social support. Racial/ethnic divides in vaccination rates (4 Papers) – HepB: Minimal vaccination programs are in place; trying to target the high-risk groups, because they tend to have little access to health care (1 Paper) • Lack of fully-funded programs for adult vaccinations 7
  8. 8. Behavioral Determinants • Theory of Planned Behavior (6 Papers): intention to engage in a health behavior is based on: – Subjective Norms (3) – Attitude (2) – Perceived Behavioral Control (3) • Health Belief Model (5 papers): engagement in a health behavior depends on – – – – Perceived Susceptibility (2) Perceived Severity (1) Perceived Effectiveness/Benefits (3) Perceived Barriers (3) • Overlap with Social Determinants 8
  9. 9. Behavioral Determinants • Liao, et al. (2011) Factors Affecting Intention to Receive and Self Report 2009 Pandemic (H1N1) Vaccine in Hong Kong: A Longitudinal Study. PLoS One 9
  10. 10. Summary • Social determinants: – Barriers to access for adult vaccinations include: a lack of funded and targeted programs for vaccination; minimal access to health care; lack of education – In high income countries, certain racial/ethnic groups have lower vaccination rates (Black & Hispanic vs. White populations) • Behavioral determinants: – Theory of Planned Behavior and Health Belief Models are strong predictors of vaccination behavior – Most significant factors: Perceived behavioral control, social norms, perceived barriers, perceived benefits 10
  11. 11. Gaps in Research • Social determinants of adult vaccination – Frequently do not consider social determinants of vaccination – WHO states that the causal mechanisms of the Social Determinants of Health are mostly unknown • Behavioral determinants of adult vaccination – Very few articles focus on low and middle income countries  Are findings from high income countries applicable to low- and middle-income countries, or is more research necessary? 11
  12. 12. Thank You.
  13. 13. References: Relevant Social Determinant Articles 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Bonnefoy J, et al. (2007) Constructing the evidence base on social determinants of health: A guide. World Health Organization. Chiatti C, et al. (2011) Influenza vaccine uptake among community-dwelling Italian elderly: results from a large cross-sectional study. BMC Public Health 11:207 Fernandez ME, et al. (2010) Integrating Clinical, Community, and Policy Perspectives on HPV Vaccination. Annu Rev Public Health. 31: 235-252. Fiscella K, et al. (2002) Disparities in Health Care by Race, Ethnicity, and Language Among the Insured. Medical Care. 40(1) 52-59. Harris KM, et al. (2012) A Blueprint for Improving the Promotion and Delivery of Adult Vaccination in the United States. RAND Corporation. High KP, et al. (2010) Workshop on Immunizations in Older Adults: Identifying Future Research Agendas. J Am Geriatri Soc. 58: 765-776 Kelly MP, et al. (2007) The social determinants of health: Developing an evidence base for political action. Measurement and Evidence Knowledge Network. LaMontagne DS, et al. (2011). Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries. Bull World Health Organ. 89: 821-830. Lee JH & Sadana R. (eds.) (2011) Improving Equity in Health by Addressing Social Determinants. World Health Organization Mouy B & Barr E. (2006) The social determinants of health: is there a role for health promotion foundations? Health Promotion Journal of Australia, 17(3); 189-196 Nagata JM, et al. (2013) Social determinants of health and seasonal influenza vaccination in adults over 65 years: a systematic review of qualitative and quantitative data. BMC Public Health 13: 388. National Foundation for Infectious Disease. (2002) A Report on Reaching Underserved Ethnic and Minority Populations to Improve Adolescent and Adult Immunization Rates. Nowalk MP, et al. (2006) Determinants of adult vaccination at inner-city health centers: A descriptive study. BMC Family Practice 7(2). Rangel MC, et al. (2005) Racial and ethnic disparities in influenza vaccination among elderly. J Gen Intern Med. 20: 426-431. Shepard CW, et al. (2006) Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiol Rev 28: 112-125. Soeung SC, et al. (2012) The social determinants of health and health service access: an in depth study in four poor communities in Phnom Penh Cambodia. International Journal for Equity in Health. 11(46) Uddin M, et al. (2010) Demographic and socioeconomic determinants of influenza vaccination disparities among university students. J Epidemiol Community Health 64: 808-813. World Health Organization (2001) Universities and the health of the disadvantaged. World Health Organization (2007) Addressing sex and gender in epidemic-prone infectious diseases World Health Organization (2008) Challenges to Implementing the Social Determinants for Health Equity Agenda in Countries. World Health Organization (2008) Human Papillomavirus Vaccine Background Paper. September 2008. World Health Organization (2010) A Conceptual Framework for Action on the Social Determinants of Health. World Health Organization (2011) Report of the ad-hoc Consultation on Ageing and Immunization. World Health Organization (2013) Global Vaccine Action Plan, 2011-2020 Zimmerman RK, et al. (2005) Predictors of pneumococcal polysaccharide vaccination among patients at three inner-city neighborhood health centers. American Journal of Geriatric Pharmacotherapy. 3(3); 149-159 13
  14. 14. References: Relevant Behavioral Determinant Articles 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Baars J, et al. (2008) Drug Users' Participation in a Free Hepatitis B Vaccination Program: Demographic, Behavioral, and SocialCognitive Determinants. Substance Use and Misuse. 43(14); 2145-2162 Chapman GB & Coups EJ. (1999) Predictors of Influenza Vaccine Acceptance among Health Adults. Preventive Medicine 29L 249-262. Chi R-C & Neuzil KM. (2004). The Association of Sociodemographic Factors and Patient Attitudes on Influenza Vaccination Rates in Older Persons. Am J Med Soc. 327(3): 113-117 de Wit JBF, et al. (2005) Social-cognitive determinants of vaccination behavior against hepatitis B: An assessment among men who have sex with men. Preventive Medicine 40: 795-802 Gagnon MP & Godin G. (2000) Young Adults and HIV vaccine: Determinants of intention of getting immunized. Canadian Journal of Public Health. 91(6); 432-434 Gallagher S & Povey R. (2006) Determinants of older adults’ intention to vaccinate against influenza: a theoretical approach. Journal of Public Health 28(2); 139-144. Gerend MA, Shepherd MA, & Shepherd JE. (2013) The Multidimensional Nature of Perceived Barriers: Global Versus Practical Barriers to HPV Vaccination. Health Psychology 32(4); 361-369. Liao Q, et al. (2011) Factors Affecting Intention to Receive and Self-Reported Receipt of 2009 Pandemic (H1N1) Vaccine in Hong Kong: A Longitudinal Study. PLoS ONE 6(3): e17713 Looijmans-van den Akker I, et al. (2007) No intention to comply with influenza and pneumococcal vaccination: Behavioral determinants of smokers and non-smokers. Preventive Medicine. 45; 380-385 Myers LB & Goodwin R. (2011) Determinants of adult’s intention to vaccinate against pandemic swine flu. BMC Public Health 11:15 Reiter PL, et al. (2009) Parents’ health beliefs and HPV vaccination of their adolescent daughters. Social Science & Medicine. doi:10.1016/j.socscimed.2009.05.024. Schutten M, de Wit JBF, van Steenbergen JE. (2002) Why do gay men want to be vaccinated against Hepatitis B? An assessment of psychosocial determinants of vaccination intention. International Journal of STD & AIDS. 13(2) 86-90 Van Keulen HM, et al (2013) Determinants of HPV vaccination intentions among Dutch girls and their mothers: a crosssectional study. BMC Public Health 13:111 Zijtregtop EAM, et al. (2010) Which factors are important in adult uptake of a (pre)pandemic influenza vaccine? Vaccine 28; 207-227. 14

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