National Immunization Conference March 7, 2006 A Qualitative Study of the Efficacy of Messages and Materials Designed to Promote Influenza Vaccine to Nurses National Immunization Conference March 7, 2006

Karena Sapsis, MPH Centers for Disease Control and Prevention National Immunization Program Charlene Melcher, PhD Rosanne Hoffman, MPH Academy for Educational Development

Background All health care providers are recommended to receive influenza vaccinations, yet only about 38 percent do so. Influenza vaccination is primarily recommended for health care workers to reduce transmission to patients. CDC developed outreach materials based on research indicating that nurses want more information about influenza and influenza vaccination, and materials should focus on the nurse as a consumer, not just a professional.

Objectives To assess the effectiveness of CDC’s outreach materials before revising existing or launching new public education materials for nurses.

Methods 45 30-minute in-depth interviews were conducted with African American and Caucasian RNs. Onsite interviews were held with 32 nurses and telephone interviews with 13 nurse supervisors. Conducted in Birmingham and Detroit. Generally excluded those very likely or very unlikely to be vaccinated in upcoming season and those allergic to the vaccine.

Materials Tested Posters Articles for nursing magazines or hospital newsletters Announcement for in-service training or workshop (two versions) Flyer about nasal spray vaccine

Results Nurses use the terms “influenza” and “flu” interchangeably when discussing influenza. Many nurses said they were not vaccinated against influenza in the 2004-2005 influenza season; some were advised to step aside. Nurses expressed many of the same concerns about being vaccinated as members of the general public have.

Results Many nurses think they are not at risk for influenza because as nurses they have developed better than average immune systems. Many nurses had not considered that being vaccinated was a way to prevent transmitting influenza to patients. Materials with detailed information that answered their questions tended to motivate respondents to consider getting an influenza vaccine. Nurses want to learn more about influenza and want more CEU opportunities.

Conclusions Nurses prefer written materials to be presented in a clear, straightforward manner, that is not too technical, and often respond well to language that is similar to that which has tested well with the public Some nurses, just like members of the public, have concerns regarding the efficacy and safety of influenza vaccine. Written materials and in-services must address these concerns and misinformation.

Conclusions For those who are reluctant to being vaccinated Outreach items which are detailed should be developed and widely distributed. For those who are amenable to being vaccinated less detailed items, such as posters are effective behavioral triggers.

Conclusions Reminding nurses that being vaccinated can help them stop the spread of flu to others, including family members, can be an effective strategy. Hospitals and other worksites can increase vaccination rates by offering free, convenient vaccination. Educational in-services about influenza and influenza vaccination need to be offered in the workplace. CEUs should be included at these in-services.

Final Posters Promoting Flu Vaccination to Nurses