Does enhanced educational intervention reduce breakthrough infection and mental health problems via improving acceptance of COVID-19 booster shots in Chinese non-healthcare workers: A randomized controlled trial?

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-02-21 DOI:10.1016/j.jiph.2025.102719

Lap Ah Tse , Feng Wang , Phoenix Kit Han Mo , Cherry Choi Miu Wan , Natalie Hiu Yu Tang , Shuyuan Yang , Dong Dong , Kin Fai Ho , Samuel Yang-shan Wong

{"title":"Does enhanced educational intervention reduce breakthrough infection and mental health problems via improving acceptance of COVID-19 booster shots in Chinese non-healthcare workers: A randomized controlled trial?","authors":"Lap Ah Tse , Feng Wang , Phoenix Kit Han Mo , Cherry Choi Miu Wan , Natalie Hiu Yu Tang , Shuyuan Yang , Dong Dong , Kin Fai Ho , Samuel Yang-shan Wong","doi":"10.1016/j.jiph.2025.102719","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the acceptance of COVID-19 booster shots and reducing breakthrough infections among non-healthcare workers in Hong Kong.</div></div><div><h3>Methods</h3><div>In this 9-month randomized controlled trial (RCT), workers were randomly allocated to either the intervention or control group. The intervention group received educational sessions at baseline and at 3-month, covering general health and evidence-based information on the efficacy and safety of COVID-19 vaccines and booster shots. The control group received only general health information. All participants were followed up for an additional 6 months. The primary outcomes were intention and acceptance of booster shots, as well as breakthrough infections. The DASS-21 scale was used to evaluate participants’ mental health status, and two-way mixed ANOVA to analyze the group effect. A difference of ≥ 5 % in booster uptake between the intervention and control group indicated a practical significance in infection control.</div></div><div><h3>Results</h3><div>Among 310 consenting workers, 282 (91.0 %) of them completed the trial. At recruitment, the booster uptake rate was similar between the intervention and control groups (62.0 % vs. 62.1 %). After the educational intervention sessions, the intervention group showed a higher booster uptake rate (76.1 % vs. 67.9 %). A lower rate of breakthrough infection was observed in the intervention group during the latest follow-up period (23.2 % vs. 29.5 %); however, no change in the intention to get booster shots were recorded for all subjects.</div></div><div><h3>Conclusion</h3><div>This enhanced educational intervention program significantly improves booster uptake rates and reduces COVID-19 breakthrough infection rates among non-healthcare workers. (Trial registration: ClinicalTrials.gov - NCT05197673)</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 5","pages":"Article 102719"},"PeriodicalIF":4.7000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876034125000681","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the acceptance of COVID-19 booster shots and reducing breakthrough infections among non-healthcare workers in Hong Kong.

Methods

In this 9-month randomized controlled trial (RCT), workers were randomly allocated to either the intervention or control group. The intervention group received educational sessions at baseline and at 3-month, covering general health and evidence-based information on the efficacy and safety of COVID-19 vaccines and booster shots. The control group received only general health information. All participants were followed up for an additional 6 months. The primary outcomes were intention and acceptance of booster shots, as well as breakthrough infections. The DASS-21 scale was used to evaluate participants’ mental health status, and two-way mixed ANOVA to analyze the group effect. A difference of ≥ 5 % in booster uptake between the intervention and control group indicated a practical significance in infection control.

Results

Among 310 consenting workers, 282 (91.0 %) of them completed the trial. At recruitment, the booster uptake rate was similar between the intervention and control groups (62.0 % vs. 62.1 %). After the educational intervention sessions, the intervention group showed a higher booster uptake rate (76.1 % vs. 67.9 %). A lower rate of breakthrough infection was observed in the intervention group during the latest follow-up period (23.2 % vs. 29.5 %); however, no change in the intention to get booster shots were recorded for all subjects.

Conclusion

This enhanced educational intervention program significantly improves booster uptake rates and reduces COVID-19 breakthrough infection rates among non-healthcare workers. (Trial registration: ClinicalTrials.gov - NCT05197673)

查看原文本刊更多论文

加强教育干预是否可以通过提高中国非卫生保健工作者对COVID-19加强疫苗的接受度来减少突破性感染和心理健康问题：一项随机对照试验？

尽管在控制COVID-19大流行方面，疫苗接种和加强注射证明比工作场所措施更有效，但对强制加强注射仍然犹豫不决。本研究旨在评估强化教育干预计划在提高香港非医护人员对COVID-19加强疫苗的接受度和减少突破性感染方面的有效性。方法在为期9个月的随机对照试验（RCT）中，将工人随机分为干预组和对照组。干预组在基线和3个月时接受了教育课程，内容包括关于COVID-19疫苗和加强针的有效性和安全性的一般健康和循证信息。对照组只收到一般的健康信息。所有参与者都被随访了6个月。主要结局是有意和接受加强注射，以及突破感染。采用DASS-21量表评估被试的心理健康状况，采用双向混合方差分析分析群体效应。干预组与对照组加强剂吸收量差异≥ 5 %，对感染控制具有实际意义。结果在310名员工中，有282人（91.0 %）完成了试验。在招募时，干预组和对照组之间的增强剂摄取率相似（62.0 %对62.1 %）。在教育干预课程后，干预组显示出更高的助推器吸收率（76.1 % vs. 67.9% %）。在最近的随访期间，干预组的突破感染率较低（23.2% %对29.5% %）；然而，对所有受试者进行加强注射的意向没有变化记录。结论该强化教育干预方案可显著提高非医护人员的强化疫苗接种率，降低COVID-19突破感染率。（试验注册：ClinicalTrials.gov - NCT05197673）

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.