Improving Influenza Immunization Rates Using Pender’s Health Promotion Model

Vaccination against influenza is an important preventive measure for health workers. Elaine Chang, a nurse working in infection prevention, noted the drop in her hospital staff members’ vaccination rates from 78% in 2009 to below 55% for the 2016–2017 period. This decline resulted in a huge outbreak among patients and healthcare workers. To address the situation, she used Pender’s Health Promotion Model (HPM), in which the focus is on the individual perception, barriers, and social supports that regulate behaviors toward health: Improving Influenza Immunization Rates Using Pender’s Health Promotion Model.

Assessment of Declining Immunization Rates

Ms. Chang additionally interviewed staff to determine why they would not get vaccinated. Findings indicated that 40% of staff members feared vaccination would lead to them contracting the flu, possibly a coincidental illness after previous vaccinations. Another 25% thought the vaccination schedule was inconvenient since it was only accessible during a short weekday schedule.

Another 10% did not believe in vaccines at all and considered them unnatural or dangerous. The remaining workers provided religious beliefs and inconvenience as refusal reasons. Such findings necessitate targeted interventions on misinformation, access, and trust.

To assess the decline in immunization rates, Ms. Chang should ask employees about their beliefs regarding the flu vaccine’s effectiveness, concerns about side effects, and whether they have experienced any illness post-vaccination. Additionally, she should inquire about barriers such as inconvenient scheduling, vaccine accessibility, and social or cultural influences.

Motivational Factors in Pender’s Model

HPM defines key influences on health behaviors, including perceived barriers, benefits, self-efficacy, and social influences (Rabiei et al., 2020). Fear of becoming ill is a perceived barrier, while lack of availability refers to situational influences. Vaccine doubt is symptomatic of low perceived benefits, and employee attitudes are shaped by social influences, such as colleagues and hospital policy.

We must determine the nature of these influences to guide effective interventions. Employees with lower self-efficacy in informed health decision-making are at greater risk of misinformation (Chen & Hsieh, 2021). It is possible to make a significant impact on vaccine take-up by changing these situational and psychological influences.

Intervention Strategies

To increase levels of vaccination, Ms. Chang will need to implement focused interventions. Education campaigns can remove misconceptions by providing scientific evidence and testimony of vaccinated staff. Increasing access by providing extended hours, mobile sites, and on-site services can remove logistical barriers.

Building trust by providing one-on-one counseling and culturally specific conversations can help apprehensive staff (Malik et al., 2023). Leveraging social influence by recruiting peer advocates and hospital leaders as champions can encourage staff to participate. Also, providing incentives, such as reward programs or token rewards, can also prompt employees to be vaccinated.

Conclusion

With Pender’s HPM, Ms. Chang can address vaccine hesitancy systematically, increase accessibility, and facilitate social influence. All these will lead to higher immunization rates, averting future outbreaks and a healthier work environment. With a combination of education, improved accessibility, and positive reinforcement, a culture of sustainable vaccination compliance can be fostered among hospital staff.

References

Chen, H.-H., & Hsieh, P.-L. (2021). Applying the pender’s health promotion model to identify the factors related to older adults’ participation in community-based health promotion activities. International Journal of Environmental Research and Public Health, 18(19). https://doi.org/10.3390/ijerph18199985

Malik, A. A., Ahmed, N., Shafiq, M., Elharake, J. A., James, E., Nyhan, K., Paintsil, E., Melchinger, H., Yale, Malik, F., & Omer, S. B. (2023). Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health Policy, 137(98), 104894. https://doi.org/10.1016/j.healthpol.2023.104894

Rabiei, L., Masoudi, R., Lotfizade, M., & Gheysarieha, M. (2020). Evaluating the effect of Pender’s health promotion model on self-efficacy and treatment adherence behaviors among patients undergoing hemodialysis. Journal of Education and Health Promotion, 9(1), 197. https://doi.org/10.4103/jehp.jehp_747_19

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Purpose:
The purpose of this assignment is intended to allow the student to show evidence of the following course objectives:

• Apply research outcomes within the practice setting, resolve practice problems, work as a change agent, and disseminate results.
• Explain how the advanced practice nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregated/identified populations.

Description:
Review the attached case study, Overview of Selected Middle Range Theories.

Case Study, Chapter 11, Overview of Selected Middle-Range Nursing Theories
Elaine Chang is an infection control nurse at a community hospital. She has been in her position for over 6 years, since finishing her master’s degree in community health nursing.

She has noted that the annual influenza immunization rate for employees has been decreasing each year after reaching a high in 2009 of 78%. The rate in 2016 to 2017 dipped under 55% for all employees. In addition, this past year, there was a large outbreak of influenza with multiple staff and patients affected.

Ms. Chang has decided she needs to review the situation using Pender’s Health Promotion Model and develop a plan to educate staff and increase immunization rates.

Improving Influenza Immunization Rates Using Pender’s Health Promotion Model

1. If Ms. Chang wanted to assess the reasons for the decline in immunization rates, what types of things should she ask about?
2. Ms. Chang developed a survey that was distributed by each unit manager. After analyzing her results, she identified three major reasons that many of the staff declined the flu vaccine:
   • • A large number (over 40%) believed that the vaccine might give them the flu. They believed this because either they or a family member had become sick with some sort of illness around the time they took a flu shot.
     • About 25% of those surveyed would have taken the flu vaccine, but it was only available at the hospital Monday to Friday between 10 AM and 2 PM.
     • About 10% of those surveyed believed that all vaccines are bad for one’s health because they introduce something unnatural into the body.
     • The remainder had a variety of reasons for declining the vaccine, from religious beliefs to inconvenience.
   • From Pender’s model, what motivational factors might each of these be?
3. Using Pender’s model, what actions might Ms. Chang take to improve the immunization rates?

Requirements:

• This assignment needs to be submitted following APA format (title page, headings, reference page, etc.). Citations from References that are synthesized from the assigned article, course text, evidence-based and peer-reviewed research articles, and other credible sources are required. A minimum of 3 resources are used. References must be current within 5 years.
• This assignment will be submitted below through Canvas and automatically run through TurnItIn. Course faculty monitor for the compliance of citations with Turnitin evaluation of the assignment during the course session.
• Please click here for more information on TurnItIn

NOTE: Evidence of plagiarism will result in a score of 0 for this assignment. Repeat offenses of plagiarism will result in more significant repercussions per the South College student handbook.
Evaluation: The following rubric will be used to score this assignment.

Textbook:

• McEwen, M., & Wills, W. (2018). Theoretical basis for nursing (5th edition). Wolters Kluwer Health(textbook)