A novel approach to improve influenza vaccination rates among health care professionals: A prospective randomized controlled trial

Department of General Pediatrics, The Cleveland Clinic Foundation, Cleveland, OH, USA.
American journal of infection control (Impact Factor: 2.21). 06/2008; 36(4):301-3. DOI: 10.1016/j.ajic.2007.10.019
Source: PubMed


Although influenza is the leading infections cause of death in the United States, only 40% of health care workers (HCW) comply with Centers for Disease Control and Prevention recommendation for routine influenza vaccination.
This study investigated a novel approach for improving influenza vaccination rates among HCW. Eight hundred employees we selected, 200 each from the following 4 categories: professional staff, resident physicians, registered nurses, and licensed practical nurses. Subjects were randomly assigned to receive (1) no intervention, (2) a letter explaining the importance of influenza vaccine for HCW, (3) a ticket activated with influenza vaccine administration for a raffle of a free Caribbean vacation for 2, or (4) both the educational letter and the raffle ticket. We compared the proportion of employees receiving vaccination and participating in the raffle across groups.
The influenza vaccination rate for all study subjects was 41%. The number of subjects receiving vaccine did not differ by occupation (P = .87) or intervention group (P = .66).
This study provides no evidence to support the use of mailed educational letters or a single large raffle prize incentive as a means to boost hospital employee influenza vaccination rates.

6 Reads
  • Source
    • "Unfortunately, with vaccination coverage rates ranging from 6.4–26.3% among European HCP [7] [8], the recommendations have not had their intended impact, and recent intervention programs developed to increase vaccination rates show at most small effects [9] [10] [11] [12] [13]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Health Authorities recommend annual vaccination of healthcare personnel (HCP) against influenza to protect vulnerable patients. Nevertheless, vaccination rates have been low among European HCP. Here we report on a longitudinal survey study to identify social cognitive predictors of the motivation to obtain influenza vaccination, and to test whether intention is a good predictor of actual vaccination behaviour. Dutch HCP (N = 1370) were invited to participate in a survey (baseline). To link intention to behaviour, participants who completed the first survey (N = 556) were sent a second survey after vaccinations were offered (follow-up). Multinominal regression analysis showed that HCP with a positive attitude and a higher frequency of past vaccinations were more likely to have a high intention to get vaccinated. A negative attitude, high feelings of autonomy in the decision whether to get vaccinated, a preference of inaction over vaccination, a lesser sense of personal responsibility, and high self-protection motives increased the probability of no intention to get vaccinated. Social cognitive predictors were identified that explain the intention to get vaccinated against influenza of HCP, which in turn proved to be a good predictor of behaviour. Future interventions should focus on these variables to increase vaccination coverage rates.
    Full-text · Article · Oct 2014 · Vaccine
  • Source
    • "Influenza vaccination has been shown to be safe and effective [7,8] and can be given relatively effortless to a large group of people. Although benefits are clearly demonstrated [6,7] and hospitals simplified the process of HCP getting vaccinated by offering free vaccine on work-site and by giving necessary information [9-11], the actual vaccination numbers are generally low and stay far below Health Authority recommendations [2,12,13]. A study comparing 11 European countries found vaccination coverage rates of 6.4 to 26.3% among HCP [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Health Authorities recommend influenza vaccination of healthcare personnel (HCP) to decrease the transmission of influenza to vulnerable patients. Recent studies have almost exclusively used quantitative questionnaires in order to identify determinants of vaccination behaviour. Interviews enable HCP to express freely why they think they are (not) willing to get vaccinated against influenza. By means of semi-structured one-on-one interviews with 123 Belgian, Dutch and German HCP, reasons for and against vaccination, experiences with influenza vaccination, intention to get vaccinated and possible barriers, as well as willingness to advice influenza vaccination to patients were investigated. Data were processed with QSR NVivo 8.0 and analysed using a combination of a deductive and a general inductive approach. Across countries, self-protection, patient protection, and protection of family members were reported as most important reasons to get vaccinated against influenza. Reasons to not get vaccinated against influenza were fear of side effects caused by the vaccine, a low risk-perception, the disbelief in the effectiveness of influenza vaccination, organizational barriers, misconceptions, and undefined negative emotions. The social cognitive variables underlying the decision of HCP to get vaccinated against influenza (or not) seem to be similar in Belgium, Germany, and the Netherlands, even though some differences surfaced. A quantitative investigation of those social cognitive variables is needed in order to determine the importance of the social cognitive variables in explaining the intention to get vaccinated and the importance of the similarities and differences between countries that have been found in this study.
    Full-text · Article · Apr 2014 · BMC Public Health
  • Source
    • "Intrapersonal .53 Posters, videos, etc. for health education (Bourgeois et al., 2008;Coady et al., 2008;Kimura et al., 2007;Panda et al., 2011) Mailed education letters (Doratotaj et al., 2008) Advertizing vaccine clinics (Lin et al., 2010;Nowalk et al., 2010)Vlahov, Coady, Ompad, and Galea (2007) have suggested that interventions aimed at multiple levels are especially important when targeting hard-to-reach populations, including minorities.Coady et al. (2008)found that education materials such as posters, flyers, and so on, interpersonal dialog between implementers of the intervention and community members during community meetings, and the provision of vaccine in clinics and door-to-door campaigns resulted in an increase in interest in getting the influenza vaccine even among hard-toreach populations.Nowalk et al. (2008)found that they could increase influenza vaccine uptake in all race/ethnicities at an inner city clinic through interventions that included patient reminders, standing orders for vaccination, and increasing access to the vaccine through community-based clinics and free flu shots. Similarly, our results point out the importance of real and perceived access to vaccine as a determinant of uptake by minorities, especially Blacks. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research on influenza vaccine uptake has focused largely on intrapersonal determinants (perceived risk, past vaccine acceptance, perceived vaccine safety) and on physician recommendation. The authors used a social ecological framework to examine influenza vaccine uptake during the 2009 H1N1 pandemic. Surveying an adult population (n = 2,079) in January 2010 with significant oversamples of Blacks and Hispanics, this study found that 18.4% (95% confidence interval = 15.6-21.5) had gotten the 2009 H1N1 vaccine. Variables at each level of the social ecological model were significant predictors of uptake as well as of intent to get the vaccine. The intrapersonal level explained 53%, the interpersonal explained 47%, the institutional level explained 34%, and the policy and community levels each explained 8% of the variance associated with vaccine uptake. The levels together explained 65% of the variance, suggesting that interventions targeting multiple levels of the framework would be more effective than interventions aimed at a single level.
    Full-text · Article · Oct 2011 · Health Education & Behavior
Show more