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
{"title":"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。","authors":"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","doi":"10.1093/pubmed/fdaf023","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Findings: </strong>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).</p><p><strong>Interpretation: </strong>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.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":"246-257"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123319/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of a theory-informed intervention to increase care home staff influenza vaccination rates: a cluster randomised controlled trial.\",\"authors\":\"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\",\"doi\":\"10.1093/pubmed/fdaf023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Findings: </strong>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).</p><p><strong>Interpretation: </strong>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.</p>\",\"PeriodicalId\":94107,\"journal\":{\"name\":\"Journal of public health (Oxford, England)\",\"volume\":\" \",\"pages\":\"246-257\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123319/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of public health (Oxford, England)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/pubmed/fdaf023\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of public health (Oxford, England)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/pubmed/fdaf023","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Effectiveness of a theory-informed intervention to increase care home staff influenza vaccination rates: a cluster randomised controlled trial.
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.