Understanding influenza vaccination attitudes and behaviors: An assessment of health decision-making preferences

Less than half of American adults comply with annual influenza vaccination recommendations. Stagnating flu vaccination rates suggest new approaches, particularly ones using theory-based approaches, are needed to better understand influenza vaccination beliefs, behaviors, and intentions. Health decision-making preferences are an important consideration rarely accounted for in understanding vaccination behavior and thus may provide further insight into stagnating vaccination rates. Building on the work of Groopman and Hartzband (2012), this study considers health decision-making preferences as a determinant of vaccination attitudes and behavior and introduces an instrument for measuring them. We constructed a measure of health decision-making preferences using population representative surveys of U.S. adults 18 years old and older, drawn from the National Opinion Research Center's (NORC) AmeriSpeak® Panel. We used ordinary least squares (OLS) regression to determine the relative explanatory power of health decision-making preferences in predicting vaccine confidence, vaccine hesitancy, recent vaccination behavior and future vaccination intention. In an initial assessment, our health decision-making preferences measure was significantly correlated with measures of vaccine confidence and vaccine hesitancy, prior flu vaccination and flu vaccination intentions.