Vaccination Education Through Pharmacists and Senior Centers (VEPSC)

In the pharmacist-led ("PHARM") intervention group, participants will be given a 60-minute
formal didactic presentation on vaccine-preventable diseases and vaccination. This
presentation will be designed to address knowledge and beliefs related to zoster, pneumonia,
and influenza, as well as barriers to receiving vaccination. It will be delivered by a
pharmacist, will be appropriate for the participants' educational level, and will aim to
establish an understanding of vaccine-preventable illnesses. The presentation will
specifically discuss the following: causes, symptoms and potential complications of
infections in the three diseases of interest (pneumococcal disease, zoster, and influenza);
risk factors for developing the infections; incidence and prevalence of each disease of
interest; modes of transmission; and disease prevention through vaccination. To improve the
interactivity of the presentation, brief 30-60 second video clips excerpted from interviews
with community members and physicians will be shown. Community member clips will consist of
older adults from the African-American (AA) population who have experienced
vaccine-preventable infections. These clips will provide culturally relevant testimony to the
program audience and reinforce participant understanding of concepts introduced during
didactic teaching.

In the peer-led ("PEER") intervention, peer educators will be recruited from an experienced
cohort of peer educators at our senior center partner site. A pharmacist will train the peer
educators about vaccine-preventable diseases over the course of two didactic sessions.
Following this training, a third session will be held to train the peer educators on the
script that they will deliver to participants. The script will include the key learning
points to be taught by the peer educators to participants about vaccine preventable diseases
and vaccination. The script will also include roleplay exercises. In the roleplay exercises,
3 scripted vaccination-related scenarios (one for each disease of interest) will be acted out
by participants to illustrate scenarios participants might encounter when interacting with
healthcare providers or friends/family. The skit and roleplay exercises will be practiced as
needed, under the leadership of the senior center's project manager, to ensure that the peer
educators are confident and consistent when delivering PEER. After completing the training,
peer educators' competency on PEER program content will be assessed through a formal
multiple-choice knowledge test. Each peer educator must achieve a minimum score of 80%
correct over all items assessed, and 100% correct for all items deemed "core" knowledge. Once
peer educator competency has been established, each peer educator will deliver PEER through a
60-minute small group session. During this session, peer educators will deliver the
educational objectives through an informal discussion and will lead the group through the
roleplay exercises. Participants will then be asked what key points they learned about
vaccine-preventable diseases and vaccines. Finally, the peer educator will engage in a
dialogue to clarify and summarize these key points.

Objectives are:

1. Compare the efficacy of PHARM vs. PEER at improving participant's knowledge regarding
vaccine-preventable diseases

2. Compare the efficacy of PHARM vs. PEER at improving participants' beliefs about
vaccination

3. Measure the costs of PHARM and PEER from the senior center perspective

4. Compare the percent of participants taking activation step(s) to get vaccinated
following receipt of PHARM vs. PEER

5. Determine the extent to which participants are satisfied with and trust the PHARM vs.
PEER interventions

Hypotheses supporting these objective are:

1. PHARM and PEER will achieve similar improvements in older adults' knowledge of vaccine
preventable diseases (primary hypothesis)

2. PHARM and PEER will improved beliefs about vaccine-preventable disease

3. PEER will be a lower cost approach to educating participants in the senior center
compared to PHARM

4. PHARM and PEER will result in similar rates of participants taking one or more
activation step(s) to obtain vaccination

5. Participants will be highly satisfied with the PHARM and PEER interventions

Inclusion Criteria:

- Age ≥50;

- Can attend a 2-hour session (though both PHARM and PEER entail 60 minutes of
intervention, an additional hour is needed to allow for informed consent and data
collection);

- Speak and read English at ≥4th grade level as determined by a brief reading passage;

- Cognitively intact as evidenced by an Abbreviated Mental Status Test score ≥7.

Exclusion Criteria:

- Failure to meet inclusion criteria

- Failure to give informed consent to participate in the study