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Chiatti C.,Marche Polytechnic University | Chiatti C.,Italian National Research Center On Ageing Inrca | Barbadoro P.,Marche Polytechnic University | Lamura G.,Italian National Research Center On Ageing Inrca | And 4 more authors.
BMC Public Health | Year: 2011

Background: Flu vaccination significantly reduces the risk of serious complications like hospitalization and death among community-dwelling older people, therefore vaccination programmes targeting this population group represent a common policy in developed Countries. Among the determinants of vaccine uptake in older age, a growing literature suggests that social relations can play a major role. Methods. Drawing on the socio-behavioral model of Andersen-Newman - which distinguishes predictors of health care use in predisposing characteristics, enabling resources and need factors - we analyzed through multilevel regressions the determinants of influenza immunization in a sample of 25,183 elderly reached by a nationally representative Italian survey. Results: Being over 85-year old (OR = 1.99; 95% CI 1.77 - 2.21) and suffering from a severe chronic disease (OR = 2.06; 95% CI 1.90 - 2.24) are the strongest determinants of vaccine uptake. Being unmarried (OR = 0.81; 95% CI 0.74 - 0.87) and living in larger households (OR = 0.83; 95% CI 0.74 - 0.87) are risk factors for lower immunization rates. Conversely, relying on neighbors' support (OR = 1.09; 95% CI 1.02 - 1.16) or on privately paid home help (OR = 1.19; 95% CI 1.08 - 1.30) is associated with a higher likelihood of vaccine uptake. Conclusions: Even after adjusting for socio-demographic characteristics and need factors, social support, measured as the availability of assistance from partners, neighbors and home helpers, significantly increases the odds of influenza vaccine use among older Italians. © 2011 Chiatti et al; licensee BioMed Central Ltd.

Barbadoro P.,Marche Polytechnic University | Chiatti C.,Marche Polytechnic University | Chiatti C.,Italian National Research Center On Ageing Inrca | D'Errico M.M.,Marche Polytechnic University | And 4 more authors.
European Journal of Integrative Medicine | Year: 2011

Introduction: Complementary and Alternative Medicine (CAM) is attracting attention within the context of health care provision in western countries. Patterns of CAM use and related satisfaction were analysed in Italy according to socio-demographic and health variables. Materials and methods: 104,544 individuals (aged. >18) were interviewed by the cross-sectional ISTAT survey on " Health status of the population and use of health services" (2004-2005). CAM use and related satisfaction were evaluated by bivariate analysis and logistic regression models. Results: 14.4% (n=14,963) of sample used at least one CAM typology in the three years before the interview; manual treatments were the most widespread (7.6%), followed by homeopathy (7.0%), herbal medicine (4.1%), and acupuncture (2.1%). Factors associated with CAM use included gender, age, educational level, social class and area of residence: use was more frequent among women, middle-aged, highly educated and upper-middle class persons, living in Northern Italy. People with chronic diseases used CAM more frequently. Most CAM users reported complete satisfaction (60.6% acupuncture; 69.2% herbal medicine; 70.8% homeopathy; 77.8% manual treatments), with high satisfaction also among subjects with chronic conditions. A higher education level predicted satisfaction more than social class while refusing to combine conventional medicine and CAM was the strongest determinants of complete satisfaction. Conclusion: One out of seven adult Italians had used CAM the last three years. Users are mainly highly educated persons, belonging to the upper social class, and people affected by chronic conditions. Levels of self-rated satisfaction are generally high, both in the absence and in the presence of chronic diseases. © 2011 Elsevier GmbH.

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