This document summarizes a capstone presentation on a research project assessing adult perceptions of flu illness and vaccine knowledge. The following key points were made: - A survey of 30 working adults found that while most felt flu was dangerous, many also believed common misconceptions about the flu vaccine (e.g. that it causes flu, is ineffective, or inconvenient to access). - Younger adults and non-parents showed the least intent to get vaccinated compared to other groups. Perceptions of risk increased with age while views on flu severity decreased. - The research had limitations like a small sample size but identified opportunities to increase vaccine rates by addressing common misperceptions tailored to different age and parental status groups

1. An Assessment of Adult Perceptions
of Flu Illness and Vaccine
Knowledge
Jonna S. Lloyd
Oral Capstone Defense Multimedia Presentation
Western Governors University

2. Personal Introduction
• Diploma in nursing, Graduated 1993
• 8 years in public health, 5 years as a PHN, 3 years as a
WHNP (1 year certificate program via Emory University,
1997-1998)
• 13 years in secondary Health Science Education
▫ A&P, Intro to Health Sciences, Rehab Therapies, Diagnostic
Medicine, EMS
• Nursing experience: maternal/child health, family
planning, low risk obstetric care, communicable disease
treatment and tracking
• Teaching experience: curriculum development, test item
development, classroom management, differentiated
learning
2

3. Influencing Factors in Topic Choice
• Interest in communicable disease tracking from
previous work as a PHN
• Use of flu trends and other public health data
from CDC website as a teaching tool for my
current students
• Hospitalization of my 25 yr. old daughter for flu
related Acute Respiratory Distress Syndrome
(ARDS), December 2013
▫ Flu vaccine would likely have prevented her illness
▫ Began to wonder how many others in her situation
3

4. Topic’s Relevance to Nursing
• Nurses are trusted healthcare
professionals in both
professional and community
settings
• Specifically poised to correct
misinformation re: flu illness
and vaccine and encourage
vaccination
• Can be accomplished via
formal and informal
encounters
4
Ask me
about flu
shots!

5. Overview of Project
• Up to 95% of vaccine preventable deaths every year are
adults with flu complications
• $10.4 billion direct medical costs, $87 billion overall,
and yearly average of > 23,000 deaths
• U.S. has low adult vaccine rates yearly when many have
resources to obtain vaccine
• H1N1 virulence led to Advisory Committee On
Immunization Practices (ACIP) recommending all
persons >6 mo. old receive flu vaccine in 2010-2011
• Need to determine and remove barriers to vaccination to
decrease burden of flu
• 30 working adults surveyed re: risk perception for flu
and knowledge of flu vaccine
5

6. Project Development
• Multiple informal questioning encounters with
coworkers to determine need for research (early
January 2014)
• Literature review revealed barriers to vaccination
and gaps in research
• RQ: What are the perceptions of working age adults
in a secondary school system on flu illness and
vaccine knowledge?
6

7. Barriers to Vaccination and Gaps in Research
Barriers Research Gaps
• Belief that vaccine will
cause flu illness
• Vaccine is ineffective
• Inconvenience
• Cost
• Fear of injection
• Unaware of need for
vaccination
• Need localized
estimates of:
▫ Flu vaccination coverage
▫ Direct costs: provider
visits, prescriptions,
inpatient care
▫ Indirect costs: lost wages
for employees, lost
productivity for
employers
7

8. Methodology
• Quantitative descriptive design chosen to
determine impact of perceptions on intent to
receive flu vaccine
• Survey items developed from most common
misconceptions related to flu vaccine
• Answers to research question sought via survey
instrument:
▫ Did they know they were at risk?
▫ What did they believe re: flu illness and vaccine?
▫ Did these beliefs impact intent to receive vaccine?
8

9. Notable Results for the Group Overall
• 97% felt flu is dangerous for
adults
9
• 70% of the group
overall felt they were
at risk for flu
infection

10. Notable Results for the Group Overall
10
57% felt vaccine
can cause illness
63% felt access is
inconvenient
87% felt vaccine
might not work
67% intend to get
vaccine for 2014-
2015 flu season

11. Notable Statistics by Age Division
11
87.5
87.5
75
0
37.5
25
50
75
69.2
76.8
69.2
7.8
30.8
54
92.2
69.2
100
100
40
20
40
80
100
80
50
100
50
0
50
100
80
50
0 50 100 150
10. Intent to get vaccine
9. Vaccine might not work
8. Vacc access is inconvenient
7. Vaccine is painful
6. Vaccine has side effects
5. Vaccine may cause flu
4. Flu is dangerous for adults
3. Feel I am at risk
21-30 yr. old
31-40 yr. old
41-50 yr. old
51-64 yr. old

12. Notable Statistics by Parental Status
12
79.2
83.3
66.7
4.2
37.5
50
95.8
83.3
16.7
100
50
16.7
16.7
83.3
100
16.7
0 20 40 60 80 100 120
10. Intent to get vaccine
9. Vaccine might not work
8. Vacc access is inconvenient
7. Vaccine is painful
6. Vaccine has side effects
5. Vaccine may cause flu
4. Flu is dangerous for adults
3. Feel I am at risk
Non-parent
Parent,
dependent or independent
children

13. Conclusions
• Higher percentage than expected for the group
overall of those who intend to be vaccinated
• Younger participants and non-parents have the
least intent to be vaccinated
• Concept of infection risk increases with age
while concept of flu severity decreases with age
• Higher numbers than expected for belief that
vaccine can cause actual flu infection
13

14. Challenges Encountered
• Literature review:
finding current
literature/statistics,
synthesizing resources,
staying organized
• Primary challenge was in
creating a concise survey
instrument that would
collect data that
answered research
question
14

15. Strategies to Overcome
Challenges
Application to Future
Research
• Reviewed multiple previous
studies for most common
barriers and beliefs about flu
illness and vaccine
• Combined with information
gained from informal
encounters with population of
interest to develop most
pertinent constructs for survey
▫ Demo data
▫ Risk perception and susceptibility
▫ Flu vaccine knowledge
• Organization and
categorization of sources by
these three constructs
• Thorough literature reviews
vital before beginning research
• Develop organizational system
for sources
• Check for gaps in literature
and previous research during
preliminary idea development;
don’t chase “red herrings”
• Design research to eliminate
gaps; ensure work is
meaningful
15

16. Limitations of Research
• Small sample size
• Numbers of respondents
per age division
disproportionate
• Limited number of
variables assessed
• Homogenous group;
results cannot be applied
to all adults
16

17. Strategies to Strengthen Research
• Increase sample size and diversify to include
adults with varying socioeconomic statuses
• Include the following variables
▫ Previous vaccine receipt
▫ Previous clinician recommendation
▫ Gender
▫ Race
17

18. Strengths of Research
Application to Future
Research
• Thorough literature review
revealed clear direction for
research design/implementation
• Statistical differences noted that
could help tailor vaccine
campaign to increase vaccine
acceptance in this population
• Enthusiastic participation from
population of interest
• Most pertinent variables
assessed in relation to intent to
receive vaccine; brief survey
increased participation
• Literature reviews for clear
direction in research
• Concise design of survey
instrument to answer research
question
• Brief time needed for
participation on behalf of
respondents
18

19. Future Research on This Topic
• Impact of severity of 2013-2014 flu season on
intent to receive vaccine
• Impact of timing of survey; research
implemented in October 2014, height of flu
vaccine campaigns in the community
• 2014-2015 statistics on vaccine receipt and
actual infection rate
• Impact of participation in survey on actual
vaccine receipt
19

20. Application of Capstone Concepts to
Current Work Environment
• Increased ability to utilize assessment data to impact
future teaching and determine areas for review
• Assessments contain more higher order thinking
questions that determine students’ abilities to apply,
analyze, and synthesize information
• Current high school students to complete research
using CDC weekly surveillance data
▫ Will compare and contrast morbidity and mortality
from past flu seasons with vaccine receipt data
▫ Increase knowledge base and ability to synthesize
statistical data
20