Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review

Corace, Kimberly; Srigley, Jocelyn A.; Hargadon, Daniel P.; Yu, Dorothy; MacDonald, Tara K.; Fabrigar, Leandre R.; Garber, Gary

doi:10.1016/j.vaccine.2016.04.071

Cited by 151 publications

(142 citation statements)

References 30 publications

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“…The observation that compliant and positive change groups were more likely to believe that influenza vaccine was effective and safe is consistent with international and local studies which associated influenza vaccine uptake and adherence with constructs from the Health Belief Model and Theory of Planned Behavior, which include effectiveness and safety beliefs. 8,15,18,[32][33][34][35] HCWs' perception on vaccine effectiveness and safety are subjected to biases from past experiences or anecdotes. 7,34 HCWs, especially those in the resistant group, might attribute illnesses caused by other respiratory viruses and unpleasant symptoms to the influenza vaccine, even long after the vaccination date because the event was easy to recall.…”

Section: Discussionmentioning

confidence: 99%

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Lim

Lee

et al. 2019

Human Vaccines & Immunotherapeutics

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Understanding the change in intention for influenza vaccine among health-care workers (HCWs) is important to increase influenza vaccination uptake. We aimed to investigate the psychosocial beliefs associated with a change in the intention for influenza vaccine. An anonymous cross-sectional survey was distributed to tertiary hospital HCWs in 2016. Of 3007 HCWs, 70% were compliant (vaccinated, with an intention to revaccinate), 8% were resistant (unvaccinated, without intention to vaccinate), 10% had positive change (unvaccinated, but with intention) and 12% had negative change (vaccinated, but without intention). Across HCW groups, medical staff had both the highest proportion receiving all influenza vaccinations in the last 5 years (101, 28.4%), as well as the highest proportion who had never received vaccination (41, 11.5%). With increasing age, HCWs were less likely to have a negative (p = .02) or positive change (p = .06) in intention, compared to the vaccine-resistant group. HCWs were more likely to be compliant or have a positive change in intention to receive influenza vaccine, if they perceived the vaccine as effective, safe, or had a higher frequency of influenza vaccination in the last 5 years (all with p < .05). HCWs who were medical staff, who believed that side effects of the vaccine were common, or had worked for 6 to 10 years (vs 5 years or less) were less likely to be compliant (all with p < .05). In conclusion, older HCWs were more likely to maintain the status quo in their behavior toward influenza vaccination. Influenza vaccination strategies should place emphasis on vaccine effectiveness and safety.

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Section: Discussionmentioning

confidence: 99%

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Lim

Lee

et al. 2019

Human Vaccines & Immunotherapeutics

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“…Therefore, it is important to recognise that information or educational interventions can involve much more than information provision ‐ they can be interactive, tailored, and targeted. Increasingly, interventions are designed with a theoretical underpinning, and are supported by qualitative data (Corace 2016; Jones 2014; Leask 2012). An appropriately designed information or educational intervention can potentially influence not only parents' knowledge, but also their attitudes, perceptions about their peers, sense of self‐efficacy, intention to vaccinate, and ultimately, their vaccination behaviours.…”

Section: Introductionmentioning

confidence: 99%

Face-to-face interventions for informing or educating parents about early childhood vaccination

Kaufman

Ryan

Walsh

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundEarly childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and acceptance of vaccines.Face‐to‐face information or educational interventions are widely used to help parents understand why vaccines are important; explain where, how and when to access services; and address hesitancy and concerns about vaccine safety or efficacy. Such interventions are interactive, and can be adapted to target particular populations or identified barriers.This is an update of a review originally published in 2013.ObjectivesTo assess the effects of face‐to‐face interventions for informing or educating parents about early childhood vaccination on vaccination status and parental knowledge, attitudes and intention to vaccinate.Search methodsWe searched the CENTRAL, MEDLINE, Embase, five other databases, and two trial registries (July and August 2017). We screened reference lists of relevant articles, and contacted authors of included studies and experts in the field. We had no language or date restrictions.Selection criteriaWe included randomised controlled trials (RCTs) and cluster‐RCTs evaluating the effects of face‐to‐face interventions delivered to parents or expectant parents to inform or educate them about early childhood vaccination, compared with control or with another face‐to‐face intervention. The World Health Organization recommends that children receive all early childhood vaccines, with the exception of human papillomavirus vaccine (HPV), which is delivered to adolescents.Data collection and analysisWe used standard methodological procedures expected by Cochrane. Two authors independently reviewed all search results, extracted data and assessed the risk of bias of included studies.Main resultsIn this update, we found four new studies, for a total of ten studies. We included seven RCTs and three cluster‐RCTs involving a total of 4527 participants, although we were unable to pool the data from one cluster‐RCT. Three of the ten studies were conducted in low‐ or middle‐ income countries.All included studies compared face‐to‐face interventions with control. Most studies evaluated the effectiveness of a single intervention session delivered to individual parents. The interventions were an even mix of short (ten minutes or less) and longer sessions (15 minutes to several hours).Overall, elements of the study designs put them at moderate to high risk of bias. All studies but one were at low risk of bias for sequence generation (i.e. used a random number sequence). For allocation concealment (i.e. the person randomising participants was unaware of the study group to which participant would be allocated), three were at high risk and one was judged at unclear risk of bias. Due to the educational nature of the intervention, blinding of participants and personnel was not possible in any ...

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“…In coproducing the intervention, UHB stipulated that it needed to be suitable for scale and spread to other hospitals,3 not run counter to other measures within their planned vaccination campaign and be informed by behavioural science frameworks such as nudge theory 4. Based on these requirements, four letter-based interventions were developed.…”

Section: Introductionmentioning

confidence: 99%

Randomised controlled trial of a theory-based intervention to prompt front-line staff to take up the seasonal influenza vaccine

et al. 2019

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ObjectiveTo evaluate the effectiveness of reminder letters informed by social normative theory (a type of ‘nudge theory’) on uptake of seasonal influenza vaccination by front-line hospital staff.DesignIndividually randomised controlled trial.SettingA large acute care hospital in England.ParticipantsFront-line staff employed by the hospital (n=7540) were randomly allocated to one of four reminder types in a factorial design.InterventionsThe standard letter included only general information directing the staff to take up the vaccine. A second letter highlighted a type of social norm based on peer comparisons. A third letter highlighted a type of social norm based on an appeal to authority. A fourth letter included a combination of the social norms.Main outcome measureThe proportion of hospital staff vaccinated on-site.ResultsVaccine coverage was 43% (812/1885) in the standard letter group, 43% (818/1885) in the descriptive norms group, 43% (814/1885) in the injunctive norms group and 43% (812/1885) in the combination group. There were no statistically significant effects of either norm or the interaction. The OR for the descriptive norms factor is 1.01 (0.89–1.15) in the absence of the injunctive norms factor and 1.00 (0.88–1.13) in its presence. The OR for the injunctive norms factor is 1.00 (0.88–1.14) in the absence of the descriptive norms factor and 0.99 (0.87–1.12) in its presence.ConclusionsWe find no evidence that the uptake of the seasonal influenza vaccination is affected by reminders using social norms to motivate uptake.

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Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review

Cited by 151 publications

References 30 publications

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Determinants of change in intention to receive influenza vaccination among health-care workers in Singapore

Face-to-face interventions for informing or educating parents about early childhood vaccination

Randomised controlled trial of a theory-based intervention to prompt front-line staff to take up the seasonal influenza vaccine

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