How effective are digital interventions in increasing flu vaccination among pregnant women? A systematic review and meta-analysis

Abstract

Background Flu can have serious consequences for pregnant woman and unborn babies. Vaccination provides safe and effective protection, yet uptake among pregnant women is below national targets. Digital interventions are effective at increasing adherence to health interventions. Aims This review aimed to establish whether digital interventions are effective at increasing rates of flu vaccination among pregnant women, and to determine the overall effect size. Method Systematic searches identified digital intervention trials, aiming to increase rate of flu vaccination among pregnant women. Random-effects meta-analysis provided a combined effect size and examined which mode of digital interventions had the largest effects on flu vaccination. Results Ten studies were included in the review. The majority of digital interventions were more effective at increasing rates of flu vaccination (7–81.3% uptake) than usual care or non-digital interventions (7.3–47.1% uptake). When meta-analysed, digital interventions had a small, non-significant effect (odds ratio [OR] = 1.29, 95% confidence interval [CI]: 0.71, 2.31), P = 0.40. Text messages (OR = 1.25, 95% CI: 0.58, 2.67), P = 0.57 appeared less effective than other digital interventions (OR = 1.58, 95% CI: 1.02, 2.46), P = 0.04. Conclusions Overall, there is a lack of high-quality studies reporting the effectiveness of digital interventions at increasing flu vaccination during pregnancy. Future interventions may benefit from using video or social media to communicate messages for maximum success in targeting an increase in rates of flu vaccination in pregnancy.

Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review

“…The eight studies that assessed publication bias did so using funnel plots [ 40 , 65 , 67 , 70 , 72 , 74 ], Egger’s [ 65 , 67 , 70 , 73 , 80 ] or Begg’s tests [ 70 , 80 ]. Although several predictors did not acquire enough included studies to assess publication bias [ 40 , 65 , 74 ], reviews mostly concluded that there was no publication bias [ 65 , 70 , 73 , 80 ].…”

“…The 19 included reviews ( Table 2 ) can be divided into three main categories; nine assessed barriers and facilitators to COVID-19 [ 67 , 69 – 71 , 73 , 77 – 80 ], four assessed barriers and facilitators to one or both of Influenza and Pertussis [ 38 , 40 , 64 , 65 ], and six assessed the effectiveness of interventions to increase vaccination of one or both of Influenza and Pertussis [ 66 , 68 , 72 , 74 – 76 ]. Of those in the latter two categories, six studied Influenza alone [ 64 , 65 , 72 , 74 – 76 ], one studied Pertussis only [ 68 ], and three included both [ 38 , 40 , 66 ]. No reviews assessed the effects of interventions to increase COVID-19 vaccination, likely due to the short period from the start of the COVID-19 outbreak.…”

Health and socio-demographic characteristics associated with uptake of seasonal influenza vaccination amongst pregnant women: Retrospective cohort study

“…A more nuanced programme, seeking to build relationships between providers and communities over time, and targeted social media messaging is worth considering for younger and older women, and those of Black and Black British ethnicity. 47 – 49 …”

“…A more nuanced programme, seeking to build relationships between providers and communities over time, and targeted social media messaging is worth considering for younger and older women, and those of Black and Black-British ethnicity. [47][48][49] Women with pre-existing medical conditions are an important group to target because of the additional morbidity and mortality risks associated, and GP information systems are likely to capture this accurately as part of their disease registers, especially if financially incentivised. 50 There may well be questions to address on who is best placed for discussing immunisation with women, especially since they will often be seen by both primary care and antenatal care teams.…”

Effectiveness of Digital Interventions for Preventing Alcohol Consumption in Pregnancy: Systematic Review and Meta-analysis

“…Regarding text messaging platforms, there were too few studies in our review to draw a conclusion regarding their effectiveness as digital platforms for alcohol abstinence. Previous studies on the use of text messaging services to raise awareness about smoking cessation and flu vaccinations among pregnant women have shown mixed results, with some studies reporting promise compared to nontailored or internet platforms [ 35 , 36 ], and others claiming that they are less effective than visually engaging interventions like videos and iBooks [ 35 ]. It should be noted that in the 2 text messaging trials in our review, the entire evaluation period only lasted for 4 weeks, which was relatively shorter than the period of the other platforms [ 37 ].…”