title: Factors affecting uptake of influenza vaccination among family physicians.
abstract: OBJECTIVE
  The aim of this study was to determine the factors that influenced the decisions of family physicians working in primary care health services to receive influenza vaccines.
  
  
  METHODS
  This cross-sectional study was performed between June 2014 and September 2014. Physicians were reached electronically via e-mail. A self-reported questionnaire consisting of 50 items covering potential factors that may have influenced their decision to receive vaccination, including perceived risk, severity of the perceived risk, perceived benefit, perceived barriers, cues to action, attitudes, social influences and personal efficacy, was administered to the study participants. Cronbach's alpha for the questionnaire was determined to be 0.92 in the pilot study.
  
  
  RESULTS
  The response rate was 27.5% (n=596). Regularly vaccinated physicians accounted for 27.3% of the responses. The median age was 41.84±7.80, and the median working duration of the group was 17.0±7.8years. The factors that led to increased vaccination compliance (p<0.05) included working duration, age, chronic disease history and living with a person over 65years. Nearly all major domains, i.e., perceived risk, severity of the perceived risk, perceived benefit, perceived barriers, attitudes, social influences and personal efficacy, there were differences between the compliant and noncompliant groups. Multi-regression analyses revealed that risk perception, organizational factors such as time and convenient vaccination increased vaccine compliance. However, the perceived necessity to be vaccinated annually had a negative effect on vaccination behaviour (p<0.05).
  
  
  CONCLUSIONS
  Strategies aimed to increase the flu vaccination ratio among physicians that do not take different factors into account are more likely to be unsuccessful. In the planning and implementation of strategies aiming to increase the vaccination ratio among physicians, it is both necessary and important to take into account behavioural and organizational factors.
authors.affiliation: Department of Family Medicine, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad., 26 Ağustos Yerleşimi, 34755 Kadıköy, İstanbul, Turkey. Electronic address: hakan@yeditepe.edu.tr.
authors.forename: H
authors.initials: H
authors.lastname: Akan
authors.affiliation: Public Health Institution of Turkey, 1st Family Health Center, Family Medicine Clinic Samsun Training and Research Hospital Kadıköy Samsun, Rize, Turkey. Electronic address: erdincyavuz@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Yavuz
authors.affiliation: Turkey Public Health Office, Saricam Mehmet Akif Ersoy Family Medicine Center, Ministery of Health, Adana, Turkey. Electronic address: meyayla76@yahoo.com.
authors.forename: M E
authors.initials: ME
authors.lastname: Yayla
authors.affiliation: Turkey Public Health Office, Zumrutevler Number 1 Family Medicine Clinic, Istanbul, Turkey. Electronic address: medicine80@hotmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Külbay
authors.affiliation: Department of Biostatistics and Medical Informatics, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad., 26 Ağustos Yerleşimi, 34755 Kadıköy, İstanbul, Turkey. Electronic address: ecaltunok@yeditepe.edu.tr.
authors.forename: E Ç
authors.initials: EÇ
authors.lastname: Kaspar
authors.affiliation: Department of Psychiatry, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad., 26 Ağustos Yerleşimi, 34755 Kadıköy, İstanbul, Turkey. Electronic address: ozahmacioglu@yeditepe.edu.tr.
authors.forename: O
authors.initials: O
authors.lastname: Zahmacıoğlu
authors.affiliation: Department of Virology, Istabul University Faculty of Medicine 34093Fatih/Çapa, İstanbul, Turkey. Electronic address: sbadur@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Badur
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000627:therapeutic use; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014421:Turkey; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Family physicians; Health care workers; Influenza vaccination