title: Do vaccination strategies implemented by nursing homes narrow the racial gap in receipt of influenza vaccination in the United States?
abstract: OBJECTIVE
  To determine whether the racial inequity between African Americans and Caucasians in receipt of influenza vaccine is narrower in residents of nursing homes with facility-wide vaccination strategies than in residents of facilities without vaccination strategies.
  
  
  METHODS
  Secondary data analysis using the National Nursing Home Survey 2004, a nationally representative survey.
  
  
  METHODS
  One thousand one hundred seventy-four participating nursing homes sampled systematically with probability proportional to bed size.
  
  
  METHODS
  Thirteen thousand five hundred seven randomly sampled residents of nursing homes between August and December 2004.
  
  
  METHODS
  Receipt of influenza vaccine within the last year. Logistic regression was used to examine the relationship between facility-level influenza immunization strategy and racial inequity in receipt of vaccination, adjusted for characteristics at the resident, facility, state, and regional levels.
  
  
  RESULTS
  Overall in the United States, vaccination coverage was higher for Caucasian and African-American residents; the racial vaccination gaps were smaller (<6 percentage points) and nonsignificant in residents of homes with standing orders for influenza vaccinations (P=.14), verbal consent allowed for vaccinations(P=.39), and routine review of facility-wide vaccination rates (P=.61) than for residents of homes without these strategies. The racial vaccination gap in residents of homes without these strategies were two to three times as high (P=.009, P=.002, and P=.002, respectively).
  
  
  CONCLUSIONS
  The presence of several immunization strategies in nursing homes is associated with higher vaccination coverage for Caucasian and African-American residents, narrowing the national vaccination racial gap.
authors: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. bfb7@cdc.gov
authors: Barbara
authors: B
authors: Bardenheier
authors: Abigail
authors: A
authors: Shefer
authors: Faruque
authors: F
authors: Ahmed
authors: Robin
authors: R
authors: Remsburg
authors: Carol J
authors: CJ
authors: Rowland Hogue
authors: Stefan
authors: S
authors: Gravenstein
mesh_terms: D001741:Black or African American; D000368:Aged; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000208:ethnology / Q000517:prevention & control*; D009735:Nursing Homes; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D007252:Influenza Vaccines