Promotion of Influenza Vaccination in the Emergency Department.
Background: Influenza vaccine uptake is low among underserved populations whose primary health care access occurs in emergency departments. We sought to determine whether implementation of two interventions would increase 30-day influenza vaccine uptake in unvaccinated patients in the emergency depa...
| Publicado en: | NEJM Evidence Vol. 3; no. 4; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
MMS Publications
Apr2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176375651&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176375651 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27665526 MY6I jtl: NEJM Evidence issn: 27665526 maglogo: N pubinfo: dt: Apr2024 vid: 3 iid: 4 pid: 1373 pub: MMS Publications place: Waltham, Massachusetts artinfo: ui: 176375651 176375651 176375651 10.1056/EVIDoa2300197 176375651 ppf: 1 ppct: 9 formats: tig: atl: Promotion of Influenza Vaccination in the Emergency Department. aug: au: Rodriguez, Robert M. Eucker, Stephanie A. Rafique, Zubaid Nichol, Graham Molina, Melanie F. Kean, Efrat O'Laughlin, Kelli N. Bezek, Sarah K. Goicochea, Karina Ford, James S. Morse, Dana White, Jaran Arreguin, Mireya I. Shughart, Lindsey Chavez, Cecilia Lara Glidden, Dave V. Rising, Kristin L. affil: Department of Emergency Medicine, University of California, San Francisco, San Francisco sug: subj: Implementation Science Vaccination Promotion Influenza Vaccine Immunization Unvaccinated Persons Medically Underserved Primary Health Care Health Services Accessibility Emergency Service United States Human Randomized Controlled Trials Random Assignment Prospective Studies Record Review Telephone After Care Comparative Studies United States Middle Age Descriptive Statistics Male Female Confidence Intervals Videorecording Print Materials Attitude to Vaccines Funding Source Middle Aged: 45-64 years Male Female ab: Background: Influenza vaccine uptake is low among underserved populations whose primary health care access occurs in emergency departments. We sought to determine whether implementation of two interventions would increase 30-day influenza vaccine uptake in unvaccinated patients in the emergency department. Methods: This three-group, prospective, cluster-randomized controlled trial compared two interventions with a control group in noncritically ill, adult patients in the emergency department who were not vaccinated for influenza in the current vaccine season. The unit of randomization was individual calendar days. Participants received either Intervention M (an influenza vaccine messaging platform consisting of a video, one-page flyer, and scripted message, followed by a vaccine acceptance question and provider notification if participants indicated vaccine acceptance), Intervention Q (no messaging but the vaccine acceptance question and provider notification), or control (usual care/no intervention). The primary outcome was receipt of an influenza vaccine at 30-days ascertained by electronic health record review and telephone follow-up, comparing the Intervention M group with the control group. Secondary outcomes included comparisons of 30-day vaccine uptake in Intervention Q versus control and Intervention M versus Intervention Q. Results: Between October 2022 and February 2023, a total of 767 trial participants were enrolled at six emergency departments in five U.S. cities. Median age was 46-years; 353 (46%) participants were female, 274 (36%) were African American, and 158 (21%) were Latinx; 126 (16%) lacked health insurance, and 244 (32%) lacked primary care. The Intervention M, Intervention Q, and control groups had 30-day vaccine uptakes of 41%, 32%, and 15%, respectively (P<0.0001 for Intervention M vs. control). Comparing Intervention M versus Intervention Q, the adjusted difference in 30-day vaccine uptake was 8.7 percentage points (95% confidence interval, -0.1 to 17.6 percentage points). Conclusions: Implementation of influenza vaccine messaging platforms (video clips, printed materials, and verbal scripts) improved 30-day vaccine uptake among unvaccinated patients in the emergency department. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT05836818.) pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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