1. Community Change By: Emily Alpers, Shirley Iler, Barbara Lentz, & Sharon Lumbert

2. Review of Findings Problem statement: Adults aged 65 and older in Kent County Michigan are at risk of hospitalization and death related to failure to obtain yearly influenza (flu) shot as evidence by data showing that 32.9% of the elderly in Kent County have not received the flu shot (AccessKent). (How are the populations/factors the same and/or differ ent?) ␣ What local factors are relevant to the success of the Our goal is to see 90% of seniors in Kent County receiving the flu vaccine. Our proposed intervention is focused on education and the specifics will be discussed fully throughout this power point.

3. Interventions

4. The who, what, when, where, why and how? This flu season, we will be targeting those in the Kent County area who are 65-years-old and older. These individuals show a higher percentage of not receiving the flu vaccine when compared to the rest of counties in MI. Our primary goal and intervention will focus on education. We will focus on educating those individuals ages 65 and older on the importance of the flu vaccine, where to get the flu vaccine, how much the vaccine costs, and education on available transportation to sites where the vaccine can be received.

5. What will we do specifically? Create an educational flier. Contact local TV and radio stations for free air time and local newspapers for free adds. Find Volunteers to post bulletins at buildings and businesses frequented by seniors. Send educational fliers by mail to homes of seniors. Contact local home health care agencies to have their nurses provide shots to clients and have volunteer nurses go to homes to provide shots. Enlist public transportation in Kent County to offer free rides to seniors on certain days to the locations available for flu vaccines.

6. Best Practices The nature of vaccinations makes this a primary prevention as the intervention is taking place before illness.

7. Has this intervention been done before? Educational information has been given out before and the Vaccine Information Sheet provides a lot of educational material. Local television advertisements have also been aired before for multiple things, including breast cancer awareness and drug abuse. These ads are often part of local TV networks. For those who do not own a television, ads can be posted in free newspapers. As a result of these interventions having been done before, it should be easier to carry out this type of intervention again.

8. Evidence-Based Practice The evidence-based practice that best fits this intervention is the decreased rate of vaccinated people over the age of 65 coupled with the hospitalization rate for the flu of those over the age of 65. This evidence makes the importance of education on the flu vaccine and availability highly important.

9. Adequate Local Resources Kent County has 6 available places through the health department where individuals can receive the flu vaccine. The flu vaccine can also be received through many pharmacies, including Rite Aide and Walgreens. There are also urgent cares and doctor’s offices that provide vaccines as well. Local transportation provides access to receiving the vaccine and local newspapers and television stations can help provide adequate advertising.

10. What else might be needed? Education is our primary focus. Providing education on the importance of the vaccine, where to receive the vaccine, and how to get to a place where one can receive the vaccine is part of our educational plan. We have also examined what insurances will cover the vaccine as many people over the age of 65 will likely have medicare. According to the medicare website, those with Part B coverage will have the flu vaccine covered 100% (Medicare Part B).

11. Community Interests The statistics regarding the flu vaccination and hospital admissions for the flu for those over the age of 65 makes it clear that this would fit well with community interests. It is estimated that 90% of seasonal flu related deaths and more than 60% of seasonal flu related hospitalizations in the United States each year are people 65 and over (CDC, 2010). If the flu vaccine can be better prevented in this age group, then all age groups are less likely to be exposed to the flu and less deaths from complications for the flu will be seen.

12. Permission Local television networks would need to be contacted to see if they would be willing to run advertisements for free regarding this education. Local free newspapers and coupon fliers would need to be contacted as well. Local transportation services would need to be contacted to determine if they are willing to provide free transportation to the elderly. Permission would need to be granted from these agencies.

13. Evaluation

14. Desired Outcome The desired outcome would be to increase the percentage of people in Kent county, 65 years of age and older, who receive the influenza (flu) vaccine. This in turn would decrease the amount of hospitalizations and death due to contracting influenza. It would also decrease the risk of pneumonia and other complications that can be exacerbated by the flu, especially if an existing medical condition exists.

15. Anticipated Time Frame According to the government website for Michigan, MIShots 2012 will evaluate the progress annually for vaccine coverage; therefore, a change should be noted within a year. Review of influenza and pneumococcal vaccination will occur at least annually at long-term care facilities using results from other data sources (michigan.gov, 2011). In order to see any real progress in the change we anticipate the evaluation in 2020 would give us a more accurate percentage.

16. Outcomes to be Tracked The short-term outcomes that we will track are reported cases of influenza among people >65 years of age, hospitalization due to complications from influenza, and follow up on the benefits of the educational materials that we instituted. At each of the immunization site’s a flyer/questionnaire will be handed out with the immunization information which would include: How did you hear about this site? What public information did you find beneficial and educational? Were you assisted to your site by public transportation at low or no cost? Were you reached via telephone by the “phone a friend for prevention program”? Do you feel more educated regarding the importance and benefits of the influenza vaccine this year than you were last year? If so, how?

17. Tracking Changes There are available measures in place that would help track any changes in the elderly population >65 who have adopted or avoided the belief of receiving the flu shot. The annual surveillance that the local health department observes provides us with previous years immunization records. The website for this information can be obtained at http://www.accesskent.com/Health/HealthDepartment/F lu/. http://www.accesskent.com/Health/HealthDepartment/F lu/

18. References Access Kent (n.d.) Flu Vaccine Information. Retrieved on November 6, 2011 from: http:/ / www.accesskent.com/ Health/HealthDepartment/Flu/. Center for Disease Control and Prevention, (2010). What You Should Know and Do this Flu Season If You Are 65 Years and Older: Retrieved from http://www.cdc.gov/flu/about/disease/65over.htm Harkness, G. A., DeMarco, R. F., (2012). Community and Public Health Nursing: Evidence for Practice. Philadephia: Wolters Kluwer/Lippincott Williams & Wilkins. Medicare.gov (n.d.) Medicare Part B: Medical Insurance. Retrieved on November 15, 2011 from: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-b.aspx. State of Michigan (2011). Population Vaccination Assessment. Retreived on November 4, 2011 from: http://michigan.gov/mdch/0,4612,7-132-2940_2955_22779_ 40563_48357- 202902,00.html.http://michigan.gov/mdch/0,4612,7-132-2940_2955_22779_ 40563_48357- 202902,00.html