title: Factors Influencing Seasonal Influenza Vaccination Uptake in Emergency Medical Services Workers: A Concept Mapping Approach.
abstract: Seasonal influenza has serious impacts on morbidity and mortality and has a significant economic toll through lost workforce time and strains on the health system. Health workers, particularly emergency medical services (EMS) workers have the potential to transmit influenza to those in their care, yet little is known of the factors that influence EMS workers' decisions regarding seasonal influenza vaccination (SIV) uptake, a key factor in reducing potential for transmitting disease. This study utilizes a modified Theory of Planned Behavior (TPB) model as a guiding framework to explore the factors that influence SIV uptake in EMS workers. Concept mapping, which consists of six-stages (preparation, generation, structuring, representation, interpretation, and utilization) that use quantitative and qualitative approaches, was used to identify participants' perspectives towards SIV. This study identified nine EMS-conceptualized factors that influence EMS workers' vaccination intent and behavior. The EMS-conceptualized factors align with the modified TPB model and suggest the need to consider community-wide approaches that were not initially conceptualized in the model. Additionally, the expansion of non-pharmaceutical measures went above and beyond original conceptualization. Overall, this study demonstrates the need to develop customized interventions such as messages highlighting the importance of EMS workers receiving SIV as the optimum solution. EMS workers who do not intend to receive the SIV should be provided with accurate information on the SIV to dispel misconceptions. Finally, EMS workers should also receive interventions which promote voluntary vaccination, encouraging them to be proactive in the health decisions they make for themselves.
authors.affiliation: Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA. dsubramaniam2@kumc.edu.
authors.forename: Dipti P
authors.initials: DP
authors.lastname: Subramaniam
authors.affiliation: Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Baker
authors.affiliation: Department of Environmental and Occupational Health, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Zelicoff
authors.affiliation: Department of Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Elliott
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D004632:Emergency Medical Services; D005260:Female; D015438:Health Behavior; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control / Q000523:psychology; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D008960:Models, Psychological; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Concept mapping; Emergency medical services; Health behavior; Health promotion; Health services; Immunization; Occupational health; Seasonal influenza vaccination