Project VIVA: A Multilevel Community-Based Intervention to Increase Influenza Vaccination Rates Among Hard-to-Reach Populations in New York City

Coady, Micaela H.; Galea, Sandro; Blaney, Shannon; Ompad, Danielle C.; Sisco, Sarah; Vlahov, David

doi:10.2105/ajph.2007.119586

Cited by 54 publications

(63 citation statements)

References 44 publications

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“…Interventions within underserved populations can generate vaccine interest, particularly if they involve community-based participatory research. 23 25 . One multilevel intervention in East Harlem and the Bronx entitled Project VIVA employed door-to-door and street-based inoculation to create a local environment amenable to the vaccine while developing a generalizable method of rapid urban vaccine dissemination.…”

Section: Discussionmentioning

confidence: 99%

Disparities in Influenza Vaccine Coverage in the United States, 2008

Linn

Guralnik

Patel

2010

J American Geriatrics Society

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Objective To determine the distribution of influenza vaccine coverage in the U.S. in 2008. Design, Setting, and Participants Cross-sectional analysis of the 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). The BRFSS employs random-digit dialing to interview non-institutionalized adults in the U.S. and the territories. The sample was restricted to persons ≥50 years (N=249,723). Measurements Participants were asked if they had a flu shot during the past 12 months. Results In 2008, 42.0% of adults age 50–64 years and 69.5% of adults ≥65 years reported receiving a flu shot in the past 12 months. Vaccine coverage generally increased with advancing age (p<0.001), higher levels of education (p<0.001) and total household income (p<0.001), and greater morbidity (p<0.001). In 50–64 year olds, vaccine prevalence was lower in men than in women (39.9% vs 44.1%; p<0.001), although no significant differences were observed in older adults. Within each 5-year interval of age, non-Hispanic blacks and Hispanics had significantly lower vaccine prevalence than non-Hispanic whites (p<0.001 for all comparisons). Among participants ≥65 years, non-Hispanic blacks and Hispanics were 56% [adjusted prevalence ratio (PR): 1.56 (95% CI: 1.48, 1.64)] and 44% [adjusted PR: 1.44 (95% CI: 1.35, 1.54)], respectively, more likely to be unvaccinated compared with non-Hispanic whites, adjusting for age and sex. Racial/ethnic disparities in vaccine coverage narrowed with increasing number of diseases; however, these disparities remained significant in older adults with ≥2 diseases (p<0.05). Conclusions There were large disparities in influenza vaccine coverage in 2008, particularly across race/ethnicity and socioeconomic position. Accordingly, more targeted interventions are needed to improve vaccine delivery to disadvantaged segments of the U.S. population.

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Section: Discussionmentioning

confidence: 99%

Disparities in Influenza Vaccine Coverage in the United States, 2008

Linn

Guralnik

Patel

2010

J American Geriatrics Society

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“…Coady et al 86 describes increased interest in receiving influenza vaccine among hard-to-reach populations as a result of an integrated communication and social mobilization program through which both researchers and community members provided information and counseling via multiple channels. Conversely, Facanha et al 87 examined the impact of health team training and active community surveillance by area residents on TB detection, with significant increases in the number of detected cases.…”

Section: Multi-sectoral Settingmentioning

confidence: 99%

Communicating risk and promoting disease mitigation measures in epidemics and emerging disease settings

Schiavo

Leung

Brown

2014

Pathogens and Global Health

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Objective: This review aims to identify and assess evidence on interventions to communicate risk and promote disease mitigation measures in epidemics and emerging disease outbreak settings. The study focuses on data that are relevant to low and middle-income country (LMIC) settings. Methods: We conducted a comprehensive literature search using five major electronic databases (Pubmed Medline, Biomed Central, EMBASE, Science of Citation Index, and Cochrane Library) and other sources to identify relevant studies published from January 2002 to July 2013. The review was guided by the socioecological model/perspective of public health and the ideation theory and focused on interventions at the community, healthcare, and multi-sectoral settings, which also reflect key intervention levels of the Ottawa Charter for Health Promotion. Eligible quantitative studies were selected according to specific study criteria and assessed using the Critical Appraisal Skills Program (CASP) framework. Conversely, qualitative studies, reviews, case studies, and editorials were not included. Studies were selected by two independent reviewers. Results: Twenty-nine relevant studies from 16 countries were included. Most studies focused on a single intervention or intervention level, rather than multi-sectoral interventions. The majority of the evidence relates to programs aimed at behavioral and social results (or relevant intermediate steps) within a specific population group. Two studies included implications for improvements in health service delivery, two studies examined the intervention's impact on health systems-related outcomes, and three had also implications for environmental health outcomes. Cost-and health equity-related implications for select evidence were also discussed. Conclusions: The paucity of well-designed quantitative evaluations of interventions to communicate health risk and promote disease control measures in LMICs does not allow for any definitive conclusions. Yet, the review identified several promising interventions and areas for future investigation. Among them, community-based and participatory interventions seemed to be central within epidemic and emerging disease settings, particularly in low-resource settings. Yet, evidence on their effectiveness is not conclusive and needs to be explored by future studies. Other promising areas for future investigation include multicomponent and multi-sectoral approaches to intervention design. Major research gaps referred to any evaluation of the impact of these kinds of interventions on health policy adoption and/or implementation, and social determinants of health. Research on cost-effectiveness also needs to be strengthened. This review identified several research gaps and questions, and discusses potential future directions for increasing capacity for future and more rigorous assessments.

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“…Many health researchers are interested in developing, implementing, and evaluating multilevel interventions (1,3,5,(18)(19)(20) because they believe that we are most likely to achieve substantial and sustained change with interventions based on ecological theory that target multiple levels, or sources of influence (6,18,(21)(22)(23)(24). The expectation for a multilevel intervention usually is that that the combined effect of the interventions used will at least be additive, which is the sum of the effects of what the interventions would have achieved separately.…”

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confidence: 99%