Major article
Evaluating influenza vaccination campaigns beyond coverage: A before-after study among health care workers

https://doi.org/10.1016/j.ajic.2013.04.006Get rights and content

Background

Influenza vaccination campaigns based on educational interventions do not seem to increase coverage in the hospital setting, and their impact on educational goals is not usually evaluated. This study describes the campaign implemented in a university hospital and assesses the achievement of the strategic objectives, which were to increase health care workers (HCW) perceptions of the risk of influenza and of their role as promoters of influenza vaccination among their colleagues and to increase knowledge about influenza.

Methods

A before-after study was conducted using a self-administered survey in a randomized sample of HCW during the 2010-2011 influenza vaccination campaign. The Wilcoxon paired measures test was used to assess attainment of the strategic objectives.

Results

The campaign had a positive impact on the strategic objectives (Wilcoxon test, P value <.05 in all cases). The reach of the campaign was high (91.9%), and HCW rated it as positive (7.19 [standard deviation, 2.3] out of 10) but did not achieve increased coverage (34%; 95% confidence interval: 33.8-36.4).

Conclusion

Evaluation of the campaign shows that its effect responded to the strategic objectives. However, it seems that increasing the information provided to HCW and heightening their risk perception do not necessarily lead to greater acceptance of influenza vaccination.

Section snippets

Methods

The study was conducted among HCW of the Hospital Clínic of Barcelona (HCB), a public university hospital with 700 beds. Before the campaign, during the first 2 weeks of September 2010, HCW were recruited and surveyed. After the campaign, during the second half of November of the same year, the same HCW were surveyed again. HCW were recruited by sequentially searching a list of 480 HCW compiled by randomizing a list of all HCW. The aim was to recruit 420 subjects from a total of 5,258 HCW,

Development of the program

The materials used in the campaign were developed according to 2 main messages, which are summarized in Box 1, Box 2:

Four promotional videos were shot using HCB HCW as the main characters.14 The videos were shown on strategically placed screens and on the Internet. Two posters15 were designed sequentially and were placed in 2 steps in all wards and hospital entrances. We also designed brochures15 with information on the transmission of influenza, the vaccine, and the risk groups. An adapted

Discussion

This voluntary influenza promotion campaign among HCW stressed the importance of being vaccinated for oneself and for others and tried to involve HCW in promoting vaccination among their colleagues. The campaign achieved an impact on the strategic objectives but not an increase in coverage. Our objective was to capture, using what we called the strategic objectives of the campaign, the issues that shape the culture of vaccination promoted by the vaccination campaign. Campaigns in the HCB17 are

Acknowledgment

The authors thank all Hospital Clínic of Barcelona workers who participated in this study; the interviewers (Xavier L. Llauradó, Consol Llupià, Maya Ninova, and Elisa Salas); the project support staff (María Isabel Gómez); the vaccination team (Pablo Casado, Gemma Salmeron, Pilar Sanz) for their professionalism; and Blackmilk Design & Communication Studio, Antaviana, and David Buss and Joaquim Puig for technical support.

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A.L., G.M., A.T., and J.M.B. designed the campaign, conceived and designed the study. A.L., G.M., and A.T. enrolled participants and collected data. A.L. analyzed the data, and wrote the manuscript. G.M., A.T., and J.M.B. also reviewed the final version of the manuscript. J.R. helped in the analysis of the data and reviewed the final version of the manuscript. V.O., S.Q., P.V., M.A., V.G.S., and A.G-B. designed the campaign and reviewed the final version of the manuscript.

Supported by the Solvay-Abbott Influenza Research Grant 2010. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The investigators were under contract to their institutions.

Conflicts of interest: J. M. Bayas has received fees for lectures, advice, and participation in working groups funded by the pharmaceutical industry and has participated as principal investigator in clinical trials of vaccines (influenza vaccines and others) promoted by GlaxoSmithKline and Sanofi Pasteur MSD. All other authors report no conflicts.

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