Tuesday, September 28, 2010

Importance of leadership in the public health response

The Republic of Turkey
We are all influenced by those around us.  On an individual level, this is particularly true if the person nearby is senior or has an elevated rank in comparison to those being influenced. For example, Mary Lankford and others from Chicago published in EID (Feb 2003) a study which aimed to determine if a new hospital design would improve hand hygiene compliance.  What they ultimately found was that health-care workers in a room with a senior (e.g., higher ranking) medical staff person who did not wash hands were much less likely to wash their own hands (OR = 0.2). Of course seniority in another more direct way, say a CEO who supports HAI prevention initiatives, can also influence a hospital's HAI response. Could others, such as political leaders,  also influence our HAI prevention behavior?

An interesting new study out of Turkey in BMC ID reports what factors most influenced HCW uptake of 2009 H1N1 influenza vaccine. In a two hospital survey of HCW, where the vaccination rate was only 12.7%, the factors that were associated with poor influenza vaccine uptake included the vaccine's perceived side effects, disbelief in the vaccine's protectiveness, negative news about the vaccine and the perceived negative attitude of the Prime Minister to the vaccine. Thus, our leaders can have a big impact on our public health response.  Perhaps this is something we should take into account when we vote this fall.

Lankford et al, EID, February 2003
Savas et al BMC ID, Sept 2010

2 comments:

  1. I'm not so sure about this. I remember when George Bush got the smallpox vaccine in December 2002 as a gesture to convince others they should be vaccinated. It didn't work--only 10% of the targeted population received the vaccine.

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  2. Mike, your GWB example may even prove the point. If it is merely seen as a gesture and not an actual belief, the public may see through the act.

    However, it's also possible that a political leader's impact could be limited to one direction. For example, their negative responses could drive down compliance while their active or positive responses might have little impact. Thus the GWB and the Turkish PM examples could both work.

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