title: Factors associated with seasonal influenza immunization among church-going older African Americans.
abstract: OBJECTIVE
  Churches and faith institutions can frequently influence health behaviors among older African Americans. The church is a centerpiece of spiritual and social life among African American congregants. We explored its influence on influenza immunization coverage during the 2012-2013 influenza season.
  
  
  METHODS
  A cross-sectional study was conducted among congregation members ages 50-89 years from six churches in the Atlanta region in 2013-2014. We computed descriptive statistics, bivariate associations, and multivariable models to examine factors associated with immunization uptake among this population.
  
  
  RESULTS
  Of 208 study participants, 95 (45.7%) reported receiving the influenza vaccine. Logistic regression showed that increased trust in their healthcare providers' vaccine recommendations was a positive predictor of vaccination among participants who had not experienced discrimination in a faith-based setting (OR: 14.8 [3.7, 59.8]), but was not associated with vaccination for participants who had experienced such discrimination (OR: 1.5 [0.2, 7.0]). Belief in vaccine-induced influenza illness (OR: 0.1 [0.05, 0.23]) was a negative predictor of influenza vaccination.
  
  
  CONCLUSIONS
  Members of this older cohort of African Americans who expressed trust in their healthcare providers' vaccine recommendations and disbelief in vaccine-induced influenza were more likely to obtain seasonal influenza immunization. They were also more likely to act on their trust of healthcare provider's vaccine recommendations if they did not encounter negative influenza immunization attitudes within the church. Having healthcare providers address negative influenza immunization attitudes and disseminate vaccine information in a culturally appropriate manner within the church has the potential to enhance future uptake of influenza vaccination.
authors.affiliation: Emory University, Rollins School of Public Health, Department of Epidemiology, United States.
authors.forename: Sahithi
authors.initials: S
authors.lastname: Boggavarapu
authors.affiliation: Emory University, Rollins School of Public Health, Department of Epidemiology, United States.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Sullivan
authors.affiliation: Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, United States.
authors.forename: Jay T
authors.initials: JT
authors.lastname: Schamel
authors.affiliation: Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, United States; Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, United States. Electronic address: pfrew@emory.edu.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012067:Religion
chemical_list: D007252:Influenza Vaccines
keywords: African Americans; Churches; Disparities; Influenza; Vaccination