Abstract

Background:
Health care workers may protect residents from the (sometimes severe) consequences of influenza infection by taking oseltamivir as Post Exposure Prophylaxis (PEP) during a nursing home influenza outbreak. The main aim of this study was to explore demographic, social, and organizational factors associated with willingness to take PEP among health care workers.
Methods:
We distributed to 652 health care workers an anonymous, self-administered questionnaire with 46 questions in three parts: 11 demographic questions, 31 social questions and four organization questions. All statistically significant factors identified in the Univariate analysis were tested in the multivariate analysis using backward selection logistic regression. Area under the Curve (AUC) was calculated to estimate the contribution of significant variables to overall willingness.
Results:
In total, 524 of 652 (80%) distributed questionnaires were returned. Of these respondents, 61% declared they were willing to take PEP during an influenza outbreak. The multivariate analysis resulted in a seven-item logistic regression model with three demographic (under 42 years of age, no children living at home, and reporting ‘physician’ as profession), and four social factors (perceived benefits, agreeing with the Dutch guideline for prevention and control of nursing home influenza outbreaks, and the social influences ‘people close to me think it’s important to get PEP with oseltamivir during an influenza outbreak’ and ‘finding it important to do what people close to me think is important’) independently associated with willingness to take PEP. The AUC was found to be 0.85 (95% CI 0.81- 0.89).
Conclusion:
We identified seven factors, which contribute to a willingness to take oseltamivir as PEP among health care workers in nursing homes. By providing social support and enhanced formal education about perceived benefits, acceptance and adherence of health care workers may be improved.

Keywords: Influenza; Prevention; Post exposure prophylaxis; Oseltamivir; Nursing homes; Health care workers; Willingness