Article Figures & Data
Figures
- Figure 1.
Factors included in the PRECEDE-PROCEED framework.
Tables
Characteristic Response No. (%) * Analysis included 60 physicians with both interview and self-administered questionnaire data. Stratum* Inner-city 15 (25) Rural 14 (23) Suburban 19 (32) Veterans Affairs 12 (20) Race (white) 49 (83) Sex (female) 20 (33) Medical school graduation year (median, range) 1984 (1954–1997) Age, years (median, range) 42 (26–72) Distance to primary admitting hospital <1 mile 22 (37) 1–10 miles 31 (53) >10 miles 6 (10) Usual number of patient office hours per week (median, range) 30 (8–50) Practice employs registered nurses 42 (71) Nursing assistance Share designated nurse 12 (22) Do not share designated nurse 17 (31) Nurses not designated 26 (47) Evening office hours offered 37 (63) Weekend office hours offered 26 (44) Practice educates medical or other students, residents or fellows 44 (75) - Table 2.
Enabling and Environmental Factors Related to Patient Pneumococcal Vaccination (PPV) Status
Patient PPV Status PRECEDE-PROCEED Factor Physician Responses No. (%) No. Vaccinated (%) Unvaccinated* (%) PValue * Includes those who did not know their PPV status. † Ratings were made on an 11-point Likert scale from 0 = very unlikely to 10 = very likely and collapsed into the groups: very unlikely = 0; somewhat unlikely to very likely = 1–10. Enabling factor Office promotes influenza vaccination through patient education efforts Yes 27 (45) 419 62 38 .035 No 33 (55) 506 Office promotes influenza vaccination through flu shot clinics Yes 23 (38) 369 77 23 .011 No 37 (62) 556 Office promotes influenza vaccination through patient reminders Yes 9 (16) 145 86 14 .030 No 49 (84) 747 66 34 Office promotes pneumococcal vaccination through provider reminders Yes 20 (33) 311 77 23 .031 No 40 (67) 614 63 37 Office promotes immunization through immunization clinics or other specific program Yes 27 (45) 411 76 24 .037 No 33 (55) 514 63 37 Environmental factor - economic † Refer adult without any insurance who is unable to pay to health department Very unlikely 14 (24) 220 82 18 .050 Somewhat unlikely to very likely 4 (76) 690 64 36 Refer adult with Medicaid coverage to health department Very unlikely 27 (46) 416 76 24 .019 Somewhat unlikely to very likely 32 (54) 494 62 38 Refer adult >65 years with Medicare to health department Very unlikely 32 (54) 499 73 27 .072 Somewhat unlikely to very likely 27 (46) 411 62 38 Refer adult with commercial insurance that pays for immunization to health department Very unlikely 33 (56) 494 76 24 .012 Somewhat unlikely to very likely 26 (44) 416 60 40 Refer adult with commercial insurance that does not pay for immunization to health department Very unlikely 17 (29) 268 78 22 .029 Somewhat unlikely to very likely 42 (71) 642 63 37 Environmental factor -competing demands Satisfaction with managing practice Dissatisfied 9 (16) 142 74 26 .033 Intermediate 28 (48) 423 60 40 Satisfied 21 (36) 328 73 27 Bothered by stress at work Never 14 (24) 207 54 46 .030 Intermediate 23 (40) 363 74 26 Always 21 (36) 324 67 33 - Table 3.
Physician Questionnaire Responses Significantly Associated with Patient Self-Reported Receipt of Pneumococcal Vaccination in Regression Analyses
Physician Factors Adjusted Odds Ratio (95% CI) PValue Note: All variables that had P <.10 in bivariate analyses with the dependent variable were entered into the forward selection logistic regression. Likelihood to refer an adult with commercial insurance that pays for immunization to the health department for immunizations Very unlikely 1.78 (1.49, 2.14) <.001 Unlikely to very likely referent Has received complaints from patients following influenza vaccination Yes 0.57 (0.45, 0.73) <.001 No referent Estimated percentage of patients >65 years that receive pneumococcal vaccine in your practice 0% – 70% 0.53 (0.42, 0.67) <.001 >70% referent I am bothered by stress and hassles at work Never 0.35 (0.23, 0.54) <.001 Intermediate 0.93 (0.74, 1.16) Always referent For the patient, convenience of referral to the health department for vaccination No inconvenience 0.69 (0.55, 0.87) .003 Major inconvenience referent Office has very effective mechanisms to ensure continuity of care Strongly disagree 1.05 (0.63, 1.74) .004 Neutral 0.64 (0.47, 0.89) Strongly agree referent Physician satisfaction with inpatient care aspect of practice Very dissatisfied 1.33 (0.96, 1.83) .03 Intermediate 1.37 (1.07, 1.75) Very satisfied referent
