Harris, Jeffrey R.Cook, Meredith Anne2013-07-252015-12-142013-07-252013Cook_washington_0250E_11791.pdfhttp://hdl.handle.net/1773/23779Thesis (Ph.D.)--University of Washington, 2013Influenza is common among adults and has consequences for productivity and healthcare costs. Pertussis rates in adults are on the rise and adults with pertussis can miss work and may expose high-risk populations to infection. Influenza and Tdap (tetanus-diphtheria-pertussis) vaccination rates are low among working-age adults, but workplace-based vaccination programs can help to address this problem. Specifically, employers can use evidence-based practices to increase vaccination rates among their employees. In Chapter 2, I describe a qualitative analysis of large employers' views on workplace-based vaccination programs. Large employers offered influenza vaccinations as a benefit to employees and to keep them healthy, but were not aware of the potential benefits of promoting Tdap vaccination to their workers. Overall, they had not considered how to maximize vaccination rates among their employee population. In Chapter 3, I describe a quantitative analysis of large employers' practices related to workplace vaccination programs. I estimate the prevalence of employers' use of evidence-based practices to increase vaccination rates among their employees. I show that while some promotion practices are well-used by employers, there is room for improvement in others. Employers could maximize the impact of their vaccination programs by increasing the use of some practices, particularly those related to increasing physical access to vaccination. In Chapter 4, I shift the focus to the use of evidence-based practices in a particular small to mid-sized workplace setting, restaurants. I describe a pilot study to evaluate a workplace-based intervention to increase vaccination rates among restaurant employees. The intervention increased influenza vaccination rates among restaurant employees, although the size of the increase differed among restaurants. Restaurants can successfully implement workplace-based influenza vaccination programs, although increasing physical and financial access does not guarantee an improvement in vaccination rates. I conclude that while employers are generally open to offering vaccinations at the worksite, they could do more to increase the impact of their vaccination programs. The full potential benefits of vaccination, both for their businesses and for the population, will only be realized if they commit to maximizing physical and financial access for employees. The investment required is modest and higher employee influenza vaccination rates are within reach for employers.application/pdfen-USCopyright is held by the individual authors.employer; influenza; vaccination; workplacePublic healthhealth servicesThesis