Increasing vaccination rates among health care workers using unit "champions" as a motivator.


Key members (a.k.a. "champions") within specific work units were provided with a brief training session designed to increase awareness of the benefits associated with influenza vaccination. The champions were responsible for encouraging members of their work units to accept an influenza vaccination and in some cases had the requisite training to administer the vaccination on site. Work units were randomly assigned to either champion present or champion absent conditions. Results show increased vaccination compliance for groups where a champion was present (N = 23). An independent sample t-test revealed a significant difference between the two groups t = 2.30, p < .03 which resulted in a percentage change from 41% in the unchampioned group to 52% in the championed group. Analyses which included only those units that had a fully trained champion (N = 13) produced a similar percentage increase in vaccine uptake from 41% to 54% (although this did not reach statistical significance; p = .08). Overall, the presence of a unit champion did produce a clinically relevant increase in vaccination rates in championed work units. This result has implications for future vaccination campaigns in hospital settings. Future research targeting the barriers and drivers of influenza vaccination among HCWs is recommended.

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    ABSTRACT: Although vaccination of health care workers against influenza is widely recommended, vaccination uptake is low. Data on interventions to increase staff immunization in primary care are lacking. We examine the effect of a promotional and educational intervention program, not addressing vaccine availability, to raise the influenza vaccination rate among staff in primary care clinics. The study included all 344 staff members with direct patient contact (physicians, nurses, pharmacists, and administrative and ancillary staff) in 27 primary care community clinics in the Jerusalem area during the 2007-2008 influenza season. Thirteen clinics were randomly selected for an intervention that consisted of a lecture session given by a family physician, e-mail-distributed literature and reminders, and a key figure from the local staff who personally approached each staff member. Influenza immunization rate was 52.8% (86 of 163) in the intervention group compared with 26.5% (48 of 181) in the control group (P<.001). When compared with the rate of immunization for the previous season, the absolute increase in immunization rate was 25.8% in the intervention clinics and 6.6% in the control clinics. Multivariate analysis showed a highly significant (P<.001) independent association between intervention and immunization, with an odds ratio of 3.51 (95% confidence interval, 2.03-6.09). We have developed an effective intervention program to increase previously low vaccination rates among primary health care workers. This simple intervention could be reproduced easily in other clinics and organizations with an expected substantial increase in influenza immunization rates.
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