Attitudes, perceived norms, and intentions: A needs assessment study of the influenza immunization intentions of elderly citizens in Vermont

Context: Influenza and pneumonia rank among the 5 leading causes of death among persons aged 65 and over. Although immunization has been demonstrated to prevent influenza or reduce its incidence and associated complications among the elderly, it has been largely underutilized. Purpose: This study examined the association of attitudes, perceived norms, and intention to obtain influenza immunization among community-dwelling rural elderly. The goal was to design an effective intervention program to increase the rate of flu immunization among the rural elderly. Methods: In spring 2000 random-digit dialing selected 1,239 households in 2 rural; Vermont counties. Telephone interviews were conducted with 799 persons aged 60 or older, resulting in a response rate of 65%. Findings: Factor analyses revealed 2 dimensions underlying attitudes and perceived norms. Subsequent regression analyses confirmed that 1 attitude construct-perceived benefits-and both normative indices were significant predictors of immunization intention, explaining 45% of its variation. Conclusions: An intervention program targeting rural elderly should emphasize the benefits and perceived side effects of immunization. The program should publicize that most elderly believe that the advantages of influenza immunization outweigh the disadvantages. These findings will inform an intervention program designed to increase immunization coverage among rural seniors in Vermont.