Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

June D. Gorski

Committee Members

Barbara Thayer-Bacon, Gregory Petty, Steven Waller


A disproportionate number of African American adults are susceptible to influenza- related morbidity due to chronic health conditions. The purpose of this study was to examine factors influencing influenza vaccination decisions among African American adults ages 18 and older in Blount County, Tennessee. Factors included constructs of social influence, access, vaccine safety, doctor recommendations, and sources of knowledge regarding the flu vaccine. Research questions were formulated to specifically address factors influencing one’s decision to be immunized for influenza. The theory of planned behavior served as the framework for developing the study.

A survey based on national phone surveys was modified and used with permission. The survey was revised and modified based on results from the nominal group technique and pilot testing. The convenience sample for the study was drawn from local Black Churches, a barber/beauty shop, and community center events. A total of 230 completed surveys were used for the study, with 18 surveys omitted due to missing data. Statistical analysis was conducted with SPSS 18.0. Descriptive statistics, content analysis, logistical regression modeling, and chi-square testing were used to analyze the data and address the research questions.

According to this study, 53% of the participants received the flu vaccine during the 2009-2010 flu season, while 47% did not. Results indicated that there were no significant differences in demographic factors between vaccinated and non-vaccinated study participants. However, three specific factors were predictors of influenza immunization status between vaccinated and non-vaccinated study participants. Statistically significant predictors were social influence, vaccine safety, and sources of knowledge. For the predictor, social influence, study participants were twice as likely to receive the vaccine if family and close friends recommended immunization. Influenza immunization practices differed significantly according to positive perceptions of vaccine safety. Lastly, influenza immunization status differed significantly according to sources of knowledge about the vaccine. Family/friends, news/media, employer/work, community center, and school were significant sources of knowledge. The level of statistical significance was set at 0.05 for this study.

Further research and health education efforts on influenza immunizations need to focus on vaccine safety, social influence, and culturally appropriate sources of knowledge. The three areas impact influenza immunization status among African Americans.

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