title: Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults.
abstract: OBJECTIVE
  This cross-sectional survey assessed factors associated with influenza and pneumococcal vaccination behaviors among high-risk patients exposed to highly organized vaccination programs.
  
  
  METHODS
  Self-administered questionnaires were mailed to 700 patients randomly selected from the outpatient roster of the medical center. Questions were asked about patient demographic and health characteristics in addition to their knowledge and attitudes regarding influenza and pneumococcal diseases and vaccines.
  
  
  RESULTS
  After three mailings, the response rate was 68%, and 80% of these respondents were in a high-risk ++group. Influenza and pneumococcal vaccination rates for high-risk respondents were 74.4% and 62.5%, respectively. Factors independently associated with both influenza and pneumococcal vaccination behaviors included health care providers' recommendations and having positive attitudes toward immunization. In addition, for influenza vaccination, willingness to comply with the provider's recommendation was also associated with receipt of the vaccine while cigarette smoking was associated with failure to receive the vaccine.
  
  
  CONCLUSIONS
  Emphasis on provider recommendations and the knowledge and attitudes of patients may enhance influenza and pneumococcal vaccination rates, even in the context of organized vaccination programs.
authors.affiliation: Medical Service, Minneapolis Veterans Affairs Medical Center, MN 55417, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Nichol
authors.forename: R
authors.initials: R
authors.lastname: Mac Donald
authors.forename: M
authors.initials: M
authors.lastname: Hauge
mesh_terms: D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D001428:Bacterial Vaccines; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D010045:Outpatients; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D011023:Pneumonia, Staphylococcal / Q000517:prevention & control; D011897:Random Allocation; D012306:Risk; D013296:Streptococcus pneumoniae / Q000276:immunology*; D011795:Surveys and Questionnaires
chemical_list: D001428:Bacterial Vaccines; D007252:Influenza Vaccines