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LaVela SL, Smith BM, Weaver FM. Perceived Risk for Influenza in Veterans with Spinal Cord Injuries and Disorders. Rehabilitation Psychology. 2007 Nov 1; 52(4):458-462.
Objective: Guided by the Extended Parallel Process Model, the objective was to assess the type of control processes that were dominant in influenza behavior decisions, and to compare characteristics and behaviors by dominating control type. Design: Cross-sectional survey of persons with spinal cord injuries and disorders (SCIandD). Results: Response rate was 31% (n = 968). Respondents on average were 60 years old, 98%men, 79% white, and 61% paraplegic. Most (~60%) were in danger control in regard to influenza risk. Persons in fear control were more likely to report having had an influenza infection in the prior year (p = 0.000). Among the non-vaccinated, those in fear control were more likely to indicate not knowing where to get the vaccine (p = 0.016) and that it was not available (p = 0.027). Alternatively, the non-vaccinated who were in danger control believed they did not need it (p = 0.023). Respondents with critical values of zero were more likely to indicate that a health care professional did not recommend the shot to them (p = 0.002). Conclusions: Most persons with SCIandD perceived efficacy to be stronger than threat related to influenza; the EPPM suggests that they are aware of their risk, but recognize their ability to do something to effectively avert it. For the majority in danger control, theory suggests that messages about influenza should focus on increasing perceptions of severity and susceptibility to positively affect behavior change. Unexpected findings indicated no significant differences in vaccine receipt by control category which may be due to high overall vaccination rates. However, individuals in fear control were more likely to have had influenza in the prior year suggesting that they may have controlled the fear by ignoring the message and not getting vaccinated. For those in fear control, messages should focus on efficacy only. Among individuals with a critical value of zero, theory suggests that no threat was induced and/or there was no motivation and therefore a high threat/high efficacy approach should be taken.