Field Placement: California Department of Health Services -- Southern California Regional Epidemiologic Support Team
Location: Gardena, California
Preceptor: Dr. Akiko Kimura
Student Name: Christine Nguyen
Year: 2002

Nursing Home Health Care Worker Influenza Vaccination Intervention Study

Throughout the summer 2002 and the 2002-2003 school year, I have been working on an intervention study with the California Department of Health Services, Southern California Regional Epidemiologic Support Team, located in Gardena, California. I worked closely with Dr. Akiko Kimura, my preceptor, to develop effective interventions to encourage nursing home employees to get vaccinated against the flu. The rationale for conducting this particular study was that studies have found that only 23% of nursing home employees were vaccinated against the flu, despite clear recommendations from the Advisory Committee on Immunization Practices. Influenza is a very serious disease, especially for elderly individuals and those with chronic medical conditions. Accordingly, nursing home residents are at particularly high risk of influenza-related complications and death. Targeting vaccination efforts toward nursing home employees is essential in decreasing influenza morbidity and mortality among nursing home residents. The low vaccination rates seen among nursing home employees was cause for concern and resulted in questions of why this particular group were not being vaccinated. One of the duties from my fieldwork experience was to analyze data from a knowledge, attitudes, and behavior study of nursing home employees in the acceptability of the influenza vaccine in order to understand the reasons that employees were not getting vaccinated. I was taught some SAS to analyze the data.

Interventions were developed by conducting extensive literature reviews on previous interventions for increasing vaccination rates, using the results from the knowledge, attitudes, and behavior study, and by talking with key informants from nursing homes. The study consisted of four groups- 1) control group 2) education-only group 3) vaccine-only 4) education and vaccine. A total of 70 nursing homes participated in the study. Educational materials were developed using strategies from the literature and from other organizations. The educational materials consisted of posters, handouts, brochures, and a video. I made all of the posters, handouts, and brochures, and edited the video and the script. The posters were design on Adobe Photoshop. I conducted focus groups to help with the development of the various educational materials. I interfaced with the LA County Immunization Program, sharing with them through a Powerpoint Presentation the results of the knowledge, attitudes, and behavior study and the design of the intervention study, as well as updating them through various meetings the progress of the intervention study. They also guided me in conducting focus groups as well as giving me input on the educational materials.

Another integral task of mine was to recruit 70 nursing homes into the study. I was able to meet with many of the facilitators from the nursing homes through the delivery of the study materials. In order to evaluate the effectiveness of the interventions, I also helped to design various questionnaires to measure outcomes. I was also responsible for creating a database for the study and analyzing the data for the intervention study. My final task is to write a report of the findings and to offer recommendations.

Back to CHS Field Studies Placement Index | Back to CHS Field Studies | Back to Field Studies Home