Influenza and influenza vaccine literacy among nursing home caregivers in plateau regions of China: a cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background To assess influenza and its vaccine literacy among nursing home caregivers in Qinghai province, a plateau region of China, by evaluating status and identifying gaps in knowledge, attitudes, and practices, and to explore individual and institutional determinants to inform targeted interventions. Methods A cross-sectional survey was conducted among 350 caregivers from 40 nursing homes across five prefectures in Qinghai Province, facility-level data were collected from administrators. Influenza and vaccine literacy were assessed across knowledge, attitudes, and practices domains, with literacy defined as a score ≥ 80%. Univariate and multivariate binary logistic regression analyses were performed using SPSS v26.0 to identify factors associated with literacy. Results A total of 40 nursing homes participated, with 350 online questionnaires distributed, and 343 (98.0%) valid questionnaires were recovered. Most caregivers were female (79.3%), aged ≤ 30 years (37.3%), and had high school or vocational education (37.3%). The literacy rate was 47.8% for influenza and 42.0% for the vaccine, with the lowest levels observed in Huangnan Prefecture. Knowledge awareness rates were 48.7% for influenza and 28.6% for the vaccine. Positive attitude rates were 57.1% for influenza and 46.4% for the vaccine. Practice rates were 46.4% for influenza prevention and 28.9% for vaccine-related behaviors, with influenza vaccination coverage at 24.2%. Multivariate analysis showed that lower vaccine literacy was associated with age 31–40 years (OR = 0.24) and ≥ 51 years (OR = 0.40), and location in Haibei, Yushu, or Huangnan (OR = 0.23–0.36); higher vaccine literacy with daily Internet use (>3 h: OR = 3.83; 2–3 h: OR = 2.57), a professional certificate (OR = 3.22), prior training (OR = 2.15), and facility-organized vaccination (OR = 1.86). Similar associations were observed for influenza literacy: age 31–40 years (OR = 0.35) for lower levels; daily Internet use (>3 h: OR = 3.60; 2–3 h: OR = 2.24) and a professional certificate (OR = 2.02) for higher levels. Conclusion Influenza and vaccine literacy among nursing home caregivers in Qinghai were moderate to low, with the lowest levels in Huangnan and suboptimal vaccination coverage. Given weaknesses in vaccine-related knowledge and practices, interventions should target older caregivers, those without formal qualifications, and facility-based strategies such as organized vaccination and tailored training. Trial registration Not applicable. This study did not involve any health care intervention on human participants.
Source: BMC Nursing
Authors: Xiaojuan Ma, Yingxin Pei, Xiaoming Ma, Binzhong Ma, Guangchao Zhang, Shoujiang Li, Ao Rong, Haijun Ma, Haixiao Jin, Fangming Guo, Lili Xu, Huihui Liu
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7164756277
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