title: Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAP-registered pharmacies: pharmacists' role in reducing racial/ethnic disparities in influenza vaccinations in New York City.
abstract: New York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39-2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. ndc2102@columbia.edu
authors.forename: Natalie D
authors.initials: ND
authors.lastname: Crawford
authors.forename: Shannon
authors.initials: S
authors.lastname: Blaney
authors.forename: Silvia
authors.initials: S
authors.lastname: Amesty
authors.forename: Alexis V
authors.initials: AV
authors.lastname: Rivera
authors.forename: Alezandria K
authors.initials: AK
authors.lastname: Turner
authors.forename: Danielle C
authors.initials: DC
authors.lastname: Ompad
authors.forename: Crystal M
authors.initials: CM
authors.lastname: Fuller
mesh_terms: D003153:Community Health Services; D005006:Ethnicity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010594:Pharmacies; D010595:Pharmacists; D024382:Professional Role; D044469:Racial Groups; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*