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Table 1 Components of a social-ecological model*

From: Factors influencing H1N1 vaccine behavior among Manitoba Metis in Canada: a qualitative study

Categories

Factors

Definitions

System and institutional level factors

Vaccine roll-out and availability

Vaccine services and availability of H1N1 vaccine (e.g. how vaccine was delivered)

Government communication

How and when H1N1 information from authorities was received and who delivered that information

Institutional prevention activities

H1N1 prevention programs (e.g. vaccine clinics), provision of prevention information (e.g. information materials) instituted by an organization (e.g. school, workplace, etc.)

Organization of the public into priority groups

Who was able to receive vaccinations and who was considered at-risk for contracting H1N1

Social context factors

Public discourse

How media covered H1N1, and how reliable or important media coverage was in relation to vaccination decisions

“Bandwagoning”

Deciding to be vaccinated or not to be vaccinated because “everyone is doing it”

Interpersonal level

Interpersonal influences

Broad social pressure about what is expected of individuals by their social environment. Interaction with friends, family, coworkers, and others more generally in relation to vaccination and/or H1N1

Interface with health professionals

Any mention of interaction and/or communication (or lack thereof) with a health professional

Intrapersonal factors

Habitual behavior

What individuals usually do or perceive in relation to the seasonal influenza or other vaccinations

Altruism

An individual’s decision to vaccinate or not to vaccinate is made in order to protect or benefit someone else or to forego vaccination when vaccine supply is low in order to allow those more at risk to vaccinate

“Free-loading”

Relying on herd immunity to protect against H1N1 and therefore deciding not to be vaccinated

Vaccine risk perception

How safe or unsafe individuals felt the H1N1 vaccine to be

Personal risk perception

How at-risk individuals perceived themselves to be in contracting and becoming seriously ill from H1N1

Knowledge state

Knowledge or lack of knowledge regarding H1N1, vaccination, vaccination roll-out process, priority groups

Trust

Who is trusted and not trusted has an influence on what information one accepts and subsequent actions

Protected values

Ideals held so strongly that individuals would be unwilling to act counter to these values no matter what the benefits might be

Past experiences

Past experience with vaccines and/or influenza

Perceived alternatives

Tendency to prefer natural products and substances or other non-medical alternatives to vaccination (such as eating properly and exercising)

  1. *As adapted by Boerner et al. [38].