Student’s Name: BORE ANITAH JELAGAT

Institutional Affiliation: ACU

Unit: PUBH 102
Date: 03/11/2023

Topic: Health Promotion Programme

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Introduction
Influenza is one of the leading causes of death in the world. The disease primarily affects
older adult, children between six months to eight years and pregnant women. Influenza
vaccination has proven to be effective in averting influenza related problems. However,
vaccinations rates are low across the globe thus the need to sensitize people on the importance of
taking vaccines. Therefore, the topic I have chosen is identifying the appropriate health
promotion program or intervention for increasing uptake of the influenza vaccine. The program I
have identified is educational intervention which entails disseminating information either oral or
written to enhance awareness and knowledge on the benefits of influenza vaccine. The
educational intervention program will involve distributing materials such as posters, fliers, and
newsletters. Additionally, it will involve training sessions such as meetings, presentations and
lectures. Thus, in this paper, I will cover the upstream and downstream determinants of uptake of
influenza vaccine, the goals of the program, and health equity considerations of the program and
how the program will evaluated.
Upstream and Downstream Determinants of Uptake of Influenza Vaccine
As mentioned earlier, the uptake of influenza vaccine is quite low as a result of various
factors. These factors can be described as upstream and downstream determinants. They include
lack of awareness, inaccessibility of the vaccine, confidence, complacency and convenience
barriers. These factors must be addressed in order to ensure that vaccine uptake increases. Thus,
the educational intervention intends to address these determinants as discussed below.
Lack of Awareness
People may be willing to take the vaccines but they are not aware of its importance.
When people do not know the importance of vaccines, they tend to be reluctant leading to low
rates of vaccine intake (Baum & Fisher, 2011). Populations must be made aware of the risks
associated with influenza. These risks include myocarditis, encephalitis and multi-organ failure
hence it is evident that the disease poses severe health risks that must be addressed before it is
too late. The only way to avoid these complications is to get vaccinated. Once people are aware
of this, they will not hesitate to take the vaccines and improve their health. Therefore, lack of
awareness is one of the leading factors that hinder individuals from taking vaccines. The
educational intervention is an ideal strategy of ensuring that people get the right information
regarding the importance of taking the vaccine.
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Inaccessibility of the Vaccine

Apart from lack of awareness, inaccessibility or unavailability of the vaccine can
discourage people from taking the vaccine. For instance, the local clinics may not be having the
vaccine or the location of the facility offering the vaccine can be far resulting in accessibility
issues. Therefore, people should be given alternatives of where they can find the vaccine or the
vaccination centers can be brought closer to the people to ease accessibility (Brillo et al., 2023).
The moment accessibility is made easier; many people are likely to get vaccinated since they will
not have any problem accessing the vaccine. In that case, the government and other responsible
stakeholders should take the initiative of introducing accessible centers and ensuring that the
vaccines are readily available for any individual seeking vaccination against influenza.
Confidence
People can be hesitant to take the vaccine especially when they do not believe that the
vaccine is safe and effective. Thus, populations must be convinced that the vaccine is effective
and safe for their wellbeing. Although some vaccines may have some side effects, these effects
do not last for long instead the benefits of the vaccine are long-lasting. Additionally, the people
may not be having confidence in the system and individuals delivering the vaccine. In that case,
individuals delivering the vaccines must be professionals and must address the issues presented
by the people before administering the vaccine. As a result, the community will have confidence
in the system and will show up in large numbers take the vaccine.
Complacency
If people do not believe that the risks of contracting influenza are highly, they are less
likely to get vaccinated. On the other hand, if they believe that the risks of getting influenza are
high, they would go for the vaccination. Additionally, if they believe that contracting influenza
will impact their lives and those of their loved ones negatively, they are likely to get vaccinated.
Thus, people’s knowledge on the negative impacts of influenza plays an essential role in pushing
individuals to be vaccinated. These impacts should be made known to the people to encourage
them to go for vaccinations.

Convenience
If people are able to comprehend the purpose of vaccination in terms of health and
language literacy, then they are likely to be vaccinated. Additionally, if they believe in the
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quality of vaccination service, they would show up in large numbers to get the vaccination.
Nevertheless, if the time and location for getting the vaccination is appropriate, they would
definitely go for the vaccination (Malekafzali et al., 2021). Therefore, the intervention program
will aim at educating people on how they can interact with service providers to enhance the
quality of vaccination service and how they can easily access the services without interrupting
their daily routines.
Goals for the Educational Program/ Intervention
The overall goal of the program is to create awareness on the importance of taking
influenza vaccine and increase the number of individuals getting vaccinated. The target group
will be older adults, children and pregnant women. The program’s aim is to make these people
aware of the benefits that come with being vaccinated. Once they know the importance, they will
not resist or hesitate being vaccinated. Other goals include enhancing behavioral and social
drivers hence pushing people to go for vaccinations (Xiaoju et al., 2020). For instance, the
intervention will aim at improving people’s confidence on the vaccine in terms of its benefits,
safety and trust. The benefits and safety of the vaccine should be clearly highlighted to enhance
confidence and encourage more people to go for the vaccine.
The other goal is to promote social processes whereby family members, religious leaders,
and health workers will be motivated to encourage people to go for vaccinations. These people
have the power to influence people to make certain decisions. Therefore, the program aims at
reaching to these people and encouraging them to support community members and persuade
them to be vaccinated. Nevertheless, the program aims at addressing practical issues such as the
availability, affordability, ease of access and service quality (Ellingson et al., 2019). Individuals
may have problems with the availability of the vaccine or ease of access hence, the program will
address these issues and help the community understand how the vaccine can be accessed easily
without straining or spending more resources.
The diagram below represents the program’s desired goals.
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Health Equity Considerations

The program is intended to benefit all the targeted populations regardless of their gender,
age, race, education and abilities. Thus, the educational program will utilize various methods to
ensure that every targeted individual will be reached. The methods to be utilized are discussed
below.
Use of Presentations and Videos
Presentations and videos tend to enhance understanding since people can see what is
being taught. The presentations and videos will entail various aspects such as the importance of
getting influenza vaccine, the safety and benefits of the vaccine and health risks of not getting
the vaccine. Through presentation, little explanation is required since the people can see the
content and even interpret for themselves (Wong et al., 2016). This method is ideal for everyone
because people have different understanding abilities and they may require videos to enhance
understanding.
Home Visits
This method is ideal because elderly individuals or those with physical challenges will be
reached. These people find it challenging to move from one place to another thus, home visits
will play an essential role in ensuring that everybody regardless of their physical capabilities is
reached. The program will ensure that experts are distributed in different parts of the community
so that the elderly and physically challenged persons can be reached.
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Use of Common Language and Interpreters

In order to enhance understanding, the common language of a particular community will
be utilized to educated people. The language used should be common to the people and if there
are individuals who do not understand the language, interpreters will be available to interpret and
promote understanding (Wong et al., 2016). By doing so, information-delivery process will be
easier and everybody will have equal chance of comprehending what is being talked about.
Use of Fliers and Posters
In case all areas of the community will not be visited by the experts, fliers and posters
will be distributed. These materials will contain simplified information and images to enhance
understanding (Wong et al., 2016). The materials will also be straight to the point to quickly
catch the attention of the readers. Apart from posting in public places, the posters will be
available for individuals to take home and read at their convenient time.
Programme Evaluation
I will evaluate the programme’s goals by gauging whether they were achieved. If one or
more were not achieved, I will make adjustments to the programme to ensure that the intended
goals are made. For instance, I will involve various stakeholders to evaluate the goals by
gathering credible evidence. The conclusions made from the evidence obtained will be shared to
ensure the goals are met. The programme’s evaluation process will also involve process, impact
and outcome evaluation. Process evaluation entails assessing how the educational processes take
place. This evaluation can be undertaken throughout the programme’s activities and can act as a
guide to implement changes to enhance efficiency and effectiveness (McKenzie et al., 2022).
Process evaluation also evaluates whether the planned activities were undertaken as expected.
For instance, it evaluates whether the materials were effective and whether the appropriate topics
were taught.
On the other hand, impact evaluation is used to assess the immediate effect of the
intervention. It evaluates changes in attitudes, knowledge and awareness among other factors.
This type of evaluation is usually undertaken at the end of the programme. Interviews can be
used to check whether behavior change has been achieved, knowledge level has been improved
and whether a desired attitude has been attained (McKenzie et al., 2022). The final evaluation is
the outcome evaluation which involves assessing the long-term changes brought about by the
programme. The long-term changes can include decreases in mortality and morbidity rates and
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disease prevalence. Detailed research methods are usually used to assess long-term effects of the
program. Therefore, the evaluation process plays an essential role in ensuring that the
programme meets its objectives. If the objectives are not met, adjustments can be made to make
the programme appropriate and attain the desired results.
Type of Evaluation What needs to be measured How it will be measured
Process The effectiveness of the Observation and interviews
educational materials and are appropriate for measuring
content. In that case, the type, the effectiveness of the
quantity and quality of the educational process
educational materials and
activities will be evaluated.
Impact Thinking and feeling Interviews, observations and
(attitudes, knowledge, focus group discussions can be
awareness), social processes used to measure the impact of
(support from family members the educational materials and
and religious leaders, gender activities.
equity)
Outcome Motivation, practical issues Surveys are used to measure
(availability, ease of access, to determine the short-term
service quality, respect from and long-term impacts of the
health workers) programme.
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References
Baum, F., & Fisher, M. (2011). Are the national preventive health initiatives likely to reduce
health inequities?. Australian Journal of Primary Health, 17(4), 320-326.
Brillo, E., Tosto, V., & Buonomo, E. (2023). Interventions to increase uptake of influenza
vaccination in pregnancy: A systematic review and meta ‐analysis. International Journal
of Gynecology & Obstetrics.
Ellingson, M. K., Dudley, M. Z., Limaye, R. J., Salmon, D. A., O’Leary, S. T., & Omer, S. B.
(2019). Enhancing uptake of influenza maternal vaccine. Expert review of
vaccines, 18(2), 191-204.
Malekafzali, H., Eftekhari, M. B., Hejazi, F., Khojasteh, T., Noot, R. H., Falahat, K., & Faridi, T.
(2021). The effectiveness of educational intervention in the health promotion in elderly
people. Iranian journal of public health, 39(2), 18.
McKenzie, J. F., Neiger, B. L., & Thackeray, R. (2022). Planning, implementing and evaluating
health promotion programs. Jones & Bartlett Learning.
Wong, V. W. Y., Fong, D. Y. T., Lok, K. Y. W., Wong, J. Y. H., Sing, C., Choi, A. Y. Y., ... &
Tarrant, M. (2016). Brief education to promote maternal influenza vaccine uptake: A
randomized controlled trial. Vaccine, 34(44), 5243-5250.
Xiaoju, Z. H. O. U., Xuequn, Z. H. A. O., Jun, L. I. U., & Wenjie, Y. A. N. G. (2020).
Effectiveness of educational intervention on influenza vaccine uptake: a meta-analysis of
randomized controlled trials. Iranian Journal of Public Health, 49(12), 2256.