Effectiveness of a theory-informed intervention to increase care home staff influenza vaccination rates: a cluster randomised controlled trial.

David Wright, Jeanette Blacklock, Veronica Bion, Linda Birt, Allan Clark, Alys Wyn Griffiths, Cecile Guillard, Susan Stirling, Andy Jones, Richard Holland, Liz Jones, Thando Katangwe-Chigamba, Carys Seeley, Jennifer Pitcher, Helen Risebro, Sion Scott, Adam Wagner, Erika Sims, Saiqa Ahmed, Luke Cook, Amrish Patel
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Abstract

Background: Care home staff's (CHS's) influenza vaccination rate in England is 30%-40%, below the 75% WHO recommendation. We describe the effectiveness of a theory-informed and feasibility-tested intervention (in-home clinics; posters/videos to address vaccination hesitancy and care home financial incentives for uptake) to improve CHS vaccination rates.

Method: Recruited care homes in England with CHS vaccination rates <40% were randomised at the home level for intervention or control. Assuming a change in CHS vaccinated from 55% to 75%, 20% attrition, and 90% power, we required 39 homes per arm. Monthly data were collected throughout flu season. The difference in vaccination rates between the arms was compared using the intention-to-treat principle and a random effect logistic regression model.

Findings: The mean % vaccination rate was 28.6% in control (n = 35) and 32.7% in intervention (n = 35) [odds ratio (OR) = 1.29, 95% confidence interval (CI): 0.68-0.4, P = .435]. In a sub-analysis, including only homes receiving at least one clinic, control was 28.6% (n = 35) and intervention was 41.7% (n = 23) (OR = 2.08, 95% CI: 0.67-2.70, P = .045).

Interpretation: No effect on vaccination status was demonstrated. Within homes receiving clinics, a significant increase was observed. Process evaluation evidence suggests that starting 3 months into the influenza season partially explains this. Further evaluation initiating FluCare earlier is warranted.

一项理论知情干预提高养老院工作人员流感疫苗接种率的有效性:一项聚类随机对照试验。
背景:英国护理院工作人员(CHS)的流感疫苗接种率为30%-40%,低于世卫组织建议的75%。我们描述了一种理论知情和可行性测试的干预措施的有效性(家庭诊所;海报/视频,以解决疫苗接种的犹豫和养老院的财政激励,以提高CHS疫苗接种率。结果:对照组平均接种率为28.6% (n = 35),干预组平均接种率为32.7% (n = 35)[优势比(OR) = 1.29, 95%可信区间(CI): 0.68-0.4, P = 0.435]。在一项亚分析中,仅包括至少接受一家诊所的家庭,对照组为28.6% (n = 35),干预为41.7% (n = 23) (OR = 2.08, 95% CI: 0.67-2.70, P = 0.045)。解释:未证明对疫苗接种状况有影响。在接受诊所的家庭中,观察到显著增加。过程评价证据表明,从流感季节开始3个月部分解释了这一点。进一步的评估需要更早地启动FluCare。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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