title: Predictors of influenza immunization among home care clients in Ontario.
abstract: BACKGROUND
  This study examined factors associated with the receipt of influenza vaccination among Ontario home care clients.
  
  
  METHODS
  Home care clients were assessed, as part of a routine home visit, during a pilot study of the Resident Assessment Instrument - Home Care (RAI-HC) in 12 Ontario Community Care Access Centres (CCACs). The RAI-HC is a multidimensional assessment that identifies clients' needs and level of functional ability. Multiple logistic regression was used to identify factors associated with influenza immunization in the two years prior to assessment.
  
  
  RESULTS
  The overall rate of immunization reached about 80% by 2002. Factors such as age, respiratory problems, diabetes and congestive heart failure were associated with greater uptake, but overall rates of influenza immunization were lower than expected. Low education, smoking and poor medication adherence were negatively associated with influenza immunization. In addition, there was considerable variation in uptake among CCACs after adjusting for other significant individual-level independent variables.
  
  
  CONCLUSIONS
  Comprehensive assessments like the RAI-HC can be used to help identify and respond to health promotion and disease prevention issues in this population, and to compare rates across Canada.
authors.affiliation: Department of Health Studies and Gerontology, University of Waterloo, Waterloo, ON N2L 3G1. hirdes@healthy.uwaterloo.ca
authors.forename: John P
authors.initials: JP
authors.lastname: Hirdes
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Dalby
authors.forename: R Knight
authors.initials: RK
authors.lastname: Steel
authors.forename: G Iain
authors.initials: GI
authors.lastname: Carpenter
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.forename: John N
authors.initials: JN
authors.lastname: Morris
authors.forename: Brant E
authors.initials: BE
authors.lastname: Fries
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018574:Home Care Agencies; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007251:Influenza, Human / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009864:Ontario