{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:34:36Z","timestamp":1777376076142,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess whether caregiving status influenced influenza vaccination uptake during the COVID-19 pandemic and identify key sociodemographic, behavioral, and health-related determinants of vaccine receipt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional analysis using multivariable logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Twenty-six U.S. states that administered caregiver and marijuana modules in the Behavioral Risk Factor Surveillance System (BRFSS), 2021 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>105\u2009384 adult BRFSS respondents; 21\u2009965 identified as caregivers for individuals with health conditions or limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Primary outcome was self-reported influenza vaccination in the past 12\u00a0months. Primary exposure was caregiver status. Covariates included age, sex, race\/ethnicity, income, education, healthcare access, and health-related risk behaviors (eg, smoking, binge drinking).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>Weighted multivariable logistic regression assessed associations between caregiver status and vaccination. Interaction terms and caregiver-only models evaluated differential effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Caregiver status was not significantly associated with influenza vaccination (AOR \u2248 1.0). Healthcare access (eg, recent check-up) strongly predicted vaccination (AOR \u2248 2.7), while risk behaviors reduced likelihood (AOR \u2248 0.7). Findings were consistent in analyses restricted to caregivers. Disparities were observed by race and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Caregiver status alone did not predict influenza vaccination. Sociodemographic and behavioral factors, particularly healthcare access and risk behaviors were stronger influences. Interventions addressing structural barriers and behavioral risks may improve caregiver vaccination rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171251383862","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T06:21:15Z","timestamp":1759558875000},"page":"449-458","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral and Sociodemographic Determinants of Influenza Vaccination Among Caregivers During the COVID-19 Pandemic"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9408-1424","authenticated-orcid":false,"given":"Danika M.","family":"Williams","sequence":"first","affiliation":[{"name":"University of Nevada Reno"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann M.","family":"Weber","sequence":"additional","affiliation":[{"name":"University of Nevada Reno"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Cook","sequence":"additional","affiliation":[{"name":"University of Nevada Reno"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minggen","family":"Lu","sequence":"additional","affiliation":[{"name":"University of Nevada Reno"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"University of Nevada Reno"},{"name":"University of Nevada Reno"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"CDC. People with certain medical conditions and COVID-19 risk factors. COVID-19. 2022. https:\/\/www.cdc.gov\/covid\/risk-factors\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra-precautions\/people-with-medical-conditions.html. Accessed 4 May 2022."},{"key":"e_1_3_6_3_2","unstructured":"CDC. Flu Symptoms & Complications. Centers for Disease Control and Prevention; 2022. https:\/\/www.cdc.gov\/flu\/signs-symptoms\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/flu\/symptoms\/symptoms.htm. Accessed 4 September 2024."},{"key":"e_1_3_6_4_2","volume-title":"People at High Risk of Flu","author":"CDC","year":"2023","unstructured":"CDC. People at High Risk of Flu. Centers for Disease Control and Prevention; 2023. https:\/\/www.cdc.gov\/flu\/highrisk\/index.htm. Accessed 9 May 2023."},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7305a1"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2019.1593726"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7334a2"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/00099228211036273"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd20.220125"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2017.1348442"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2022.28.2.196"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06902-6"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.07.004"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-021-00556-z"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2019.1588470"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.08.130"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2023.2246502"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10091539"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18105349"},{"key":"e_1_3_6_20_2","first-page":"162","volume-title":"Big Data for Epidemiology: Applied Data Analysis Using National Health Surveys","author":"Kindratt TB","year":"2022","unstructured":"Kindratt TB. Behavioral risk factor surveillance System. In: Big Data for Epidemiology: Applied Data Analysis Using National Health Surveys. Peace Ossom-Williamson Mavs Open Press; 2022:162-187. https:\/\/uta.pressbooks.pub\/bigdataforepidemiology\/chapter\/chapter9-brfss\/. Accessed 7 July 2025."},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1515\/em-2013-0005"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt158"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2017.07.001"},{"key":"e_1_3_6_24_2","volume-title":"Health Effects of Cigarette Smoking","author":"CDC","year":"2024","unstructured":"CDC. Health Effects of Cigarette Smoking. Centers for Disease Control and Prevention; 2024. https:\/\/www.cdc.gov\/tobacco\/about\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/health_effects\/effects_cig_smoking\/index.htm. Accessed 18 July 2023."},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.3928\/24748307-20210712-01"}],"container-title":["American Journal of Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171251383862","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08901171251383862","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171251383862","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:03:55Z","timestamp":1777367035000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08901171251383862"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/08901171251383862"],"URL":"https:\/\/doi.org\/10.1177\/08901171251383862","relation":{},"ISSN":["0890-1171","2168-6602"],"issn-type":[{"value":"0890-1171","type":"print"},{"value":"2168-6602","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]}}}