Please cite this article in press as: Antón A, et al. Visualizing knowledge and attitude factors related to influenza vaccination of physicians. Vaccine (2014), http://dx.doi.org/10.1016/j.vaccine.2014.12.012 ARTICLE IN PRESS G Model JVAC 15987 1–7 Vaccine xxx (2014) xxx–xxx Contents lists available at ScienceDirect Vaccine j our na l ho me page: www.elsevier.com/locate/vaccine Visualizing knowledge and attitude factors related to influenza vaccination of physicians Ane Antón a , Susana García a,b , Núria Soldevila c,∗ , Fernando González-Candelas c,d , Q1 Pere Godoy c,e , Jesús Castilla c,f , José María Mayoral g , Jenaro Astray h , Vicente Martín i , Sonia Tamames j , Diana Toledo c,k , Urko Aguirre a,b , Angela Domínguez c,k , the CIBERESP Working Group for the Survey on Influenza Vaccination in Primary Health Care Workers 1 a Unidad de Investigación, Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain b Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain c CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain d Unidad Mixta Genómica y Salud FISABIO-Salud Pública, Universidad de Valencia, Valencia, Spain e Agència de Salut Pública de Catalunya, Barcelona, Spain f Instituto de Salud Pública de Navarra, Pamplona, Spain g Servicio de Vigilancia de Andalucía, Sevilla, Spain h Área de Epidemiología, Comunidad de Madrid, Madrid, Spain i Instituto de Biomedicina, Universidad de León, León, Spain j Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain k Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain a r t i c l e i n f o Article history: Received 8 July 2014 Received in revised form 24 October 2014 Accepted 8 December 2014 Available online xxx Keywords: Influenza vaccination Physicians Knowledge Attitudes a b s t r a c t Purpose: To characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011–2012 season. Methods: We carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple corre- spondence analysis and cluster analysis were used to define groups of physicians. Results: We included 835 physicians and identified three types. Type B were physicians with low pro- fessional experience of influenza. Types A and C were physicians with high professional experience with influenza, type A also had a high awareness of influenza and seasonal vaccination. Types A and C were older and more often male than type B (p < 0.0001). Knowledge of influenza was greatest in type A and lowest in type B. Awareness of influenza was greatest in type A and lowest in type C. In type A, 71.0% of physicians were vaccinated in the 2011–2012 season, compared with 48.1% and 33.6% from types B and C, respectively (p < 0.001). Conclusions: Additional efforts should be made to increase interest and concerns about preventing the transmission of influenza in physicians who do not believe influenza is a severe disease and are not concerned about its transmission. © 2014 Published by Elsevier Ltd. 1. Introduction Influenza is a highly-contagious disease that causes signifi- Q3 cant morbidity and mortality in the community [1]. Healthcare Abbreviations: CA, cluster analysis; FA, factor analysis; HCW, healthcare work- ers; MCA, multiple correspondence analysis. ∗ Corresponding author. Tel.: +34 93 402 45 66; fax: +34 93 402 90 84. E-mail address: nuriasolde@gmail.com (N. Soldevila). workers (HCW) are exposed to patients with influenza in the work- place and, consequently, are at risk of acquiring the disease and may act as vectors for nosocomial transmission. Because up to 25% of unimmunized HCW may develop influenza during the winter months, infected HCW may introduce infection into a healthcare facility [2,3]. HCW infected by patients are a frequent source of secondary transmission of influenza to patients and other HCW [4–6]. In addi- tion, acquisition of influenza by HCW may cause absenteeism and disruption of health care [5,7]. Studies have shown that influenza http://dx.doi.org/10.1016/j.vaccine.2014.12.012 0264-410X/© 2014 Published by Elsevier Ltd. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45