title: Factors associated with maternal influenza immunization decision-making. Evidence of immunization history and message framing effects.
abstract: OBJECTIVE
  We examined pregnant women's intention to obtain the seasonal influenza vaccine via a randomized controlled study examining the effects of immunization history, message exposure, and sociodemographic correlates.
  
  
  METHODS
  Pregnant women ages 18-50 participated in a randomized message framing study from September 2011 through May 2012. Venue-based sampling was used to recruit racial and ethnic minority women throughout Atlanta, Georgia. Key outcomes were evaluated using bivariate and multivariate analyses.
  
  
  RESULTS
  History of influenza immunization was positively associated with intent to immunize during pregnancy [OR=2.31, 90%CI: (1.06, 5.00)]. Significant correlates of intention to immunize included perceived susceptibility to influenza during pregnancy [OR=3.8, 90% CI: (1.75, 8.36)] and vaccine efficacy [OR=10.53, 90% CI: (4.34, 25.50)]. Single message exposure did not influence a woman's intent to vaccinate.
  
  
  CONCLUSIONS
  Prior immunization, perceived flu susceptibility and perceived vaccine effectiveness promoted immunization intent among this population of pregnant minority women. Vaccine efficacy and disease susceptibility are critical to promoting immunization among women with no history of seasonal influenza immunization, while those who received the vaccine are likely to do so again. These findings provide evidence for the promotion of repeated exposure to vaccine messages emphasizing vaccine efficacy, normative support, and susceptibility to influenza.
authors.affiliation: a Emory University School of Medicine ; Department of Medicine; Division of Infectious Diseases ; Atlanta , GA USA.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Owens
authors.forename: Diane S
authors.initials: DS
authors.lastname: Saint-Victor
authors.forename: Samantha
authors.initials: S
authors.lastname: Benedict
authors.forename: Siyu
authors.initials: S
authors.lastname: Zhang
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy; D015331:Cohort Studies; D003657:Decision Making; D005260:Female; D005845:Georgia; D006801:Humans; D007114:Immunization; D007251:Influenza, Human / Q000517:prevention & control*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D055815:Young Adult
keywords: immunization coverage; influenza vaccination; message framing; pregnant women; racial/ethnic minorities