Abstract:
OBJECTIVES:To understand the potential roles of various patient and provider factors in the underuse of pneumococcal vaccination in Medicare-eligible older African Americans. DESIGN:The Cardiovascular Health Study. SETTING:Four U.S. states. PARTICIPANTS:Seven hundred ninety-five pairs of community-dwelling Medicare-eligible African-American and white adults aged 65 and older, balanced according to age and sex. MEASUREMENTS:Data on self-reported race, receipt of pneumococcal vaccination, and other important sociodemographic and clinical variables were collected at baseline. RESULTS:Participants had a mean age ± standard deviation of 73 ± 6; 63% were female. Pneumococcal vaccination rates were 22% for African Americans and 28% for whites (unadjusted odds ratios (OR) for African Americans=0.75; 95% confidence interval (CI)=0.60-0.94; P=.01). This association remained significant despite adjustment for sociodemographic and clinical confounders, including education, income, chronic obstructive pulmonary disease, and prior pneumonia (OR=0.74, 95% CI=0.56-0.97; P=.03), but the association was no longer significant after additional adjustment for the receipt of influenza vaccination (OR=0.79, 95% CI=0.59-1.06; P=.12). Receipt of influenza vaccination was associated with higher odds of receiving pneumococcal vaccination (unadjusted OR=6.43, 95% CI=5.00-8.28; P<.001), and the association between race and pneumococcal vaccination lost significance when adjusted for influenza vaccination alone (OR=0.81, 95% CI=0.63-1.03; P=.09). CONCLUSION:The strong association between receipt of influenza and pneumococcal vaccinations suggests that patient and provider attitudes toward vaccination, rather than traditional confounders such as education and income, may help explain the underuse of pneumococcal vaccination in older African Americans.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Jones LG,Zhang Y,Ahmed MI,Ekundayo OJ,Akhter S,Sawyer P,Aban I,Sims RV,Ahmed Adoi
10.1111/j.1532-5415.2010.03181.xsubject
Has Abstractpub_date
2010-12-01 00:00:00pages
2323-8issue
12eissn
0002-8614issn
1532-5415journal_volume
58pub_type
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1996.tb02427.x
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1985.tb04890.x
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journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1986.tb04222.x
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abstract:OBJECTIVES:To evaluate the effectiveness of pelvic floor muscle (PFM) and fitness exercises in reducing urine leakage in elderly women with stress urinary incontinence (UI). DESIGN:Randomized, crossover, follow-up trial. SETTING:Urban community in Japan. PARTICIPANTS:Seventy women aged 70 and older who reported urin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
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更新日期:2007-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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更新日期:1998-11-01 00:00:00
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doi:10.1111/j.1532-5415.1997.tb04498.x
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journal_title:Journal of the American Geriatrics Society
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更新日期:2019-03-01 00:00:00
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更新日期:2015-12-01 00:00:00
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更新日期:2000-02-01 00:00:00
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doi:10.1111/j.1532-5415.1993.tb01883.x
更新日期:1993-05-01 00:00:00