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Message Framing Strategies to Increase Influenza Immunization Uptake Among Pregnant African American Women

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Abstract

We explored the attitudes, opinions, and concerns of African American women regarding influenza vaccination during pregnancy. As influenza immunization coverage rates remain suboptimal in the United States among this population, we elicited message framing strategies for multicomponent interventions aimed at decreasing future incident cases of maternal and neonatal influenza. Semi-structured in-depth interviews (N = 21) were conducted with pregnant African American women at urban OB/GYN clinics who had not received an influenza vaccine. Interviews were transcribed, subjected to intercoder reliability assessment, and content analyzed to identify common thematic factors related to acceptance of the influenza vaccine and health communication message preferences. Four major themes were identified. These were communication approaches, normal vaccine behavior, pregnancy vaccination, and positive versus negative framing. Two strong themes emerged: positively-framed messages were preferred over negatively-framed messages and those emphasizing the health of the infant. Additionally, previous immunization, message source, and vaccine misperceptions also played important roles in decision-making. The majority of women indicated that positively framed messages focusing on the infant’s health would encourage them to receive an influenza vaccine. Messages emphasizing immunization benefits such as protection against preterm birth and low birth weight outcomes have potential to overcome widespread negative community perceptions and cultural beliefs. Additionally, messages transmitted via interpersonal networks and social media strongly influence motivation to obtain vaccination during pregnancy. The findings of this study will assist in developing tailored messages that change pregnant African American women’s influenza vaccination decision-making to achieve improved coverage.

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Acknowledgments

This study was partially supported by a Kaiser Permanente Georgia community benefits grant and a grant from the Centers for Disease Control and Prevention (CDC), Grant 5P01TP000300 to the Emory Preparedness and Emergency Response Research Center, Emory University (Atlanta, Georgia). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. The authors would like to offer our gratitude to Drs. Robert Davis and Ruth Berkelman, and to Ms. Ellen Whitney, for their support and guidance throughout this study.

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No competing financial interests exist.

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Correspondence to Paula M. Frew.

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Marsh, H.A., Malik, F., Shapiro, E. et al. Message Framing Strategies to Increase Influenza Immunization Uptake Among Pregnant African American Women. Matern Child Health J 18, 1639–1647 (2014). https://doi.org/10.1007/s10995-013-1404-9

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  • DOI: https://doi.org/10.1007/s10995-013-1404-9

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