Date of Conferral





Public Health


David Segal


To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination perception predicted vaccination behaviors among union and nonunion health care workers. A secondary analysis was performed on the 2013-2014 Influenza Vaccination Survey, which was completed by 2,480 health care workers. While a chi-square analysis showed that vaccination compliance was not statistically different between facilities, a binary logistic regression revealed a significant difference in predicted vaccination behaviors for each domain of influenza vaccination perceptions. Among union health care workers, perceived barriers yielded the highest positive predictability of vaccination compliance, whereas perceived benefits were positively associated with vaccination compliance among nonunion workers. These study findings affect social change by identifying vaccine compliance predictors among union and nonunion health care workers. By focusing on these predictors, health care facilities may be able to improve levels of vaccination compliance and achieve the Joint Commissions' vaccination goal of 90% compliance amongst all healthcare workers.