Incentives and Motivators in School‐Based Hepatitis B Vaccination Programs

Abstract

During a school-based vaccination program, incentives and education were offered to help motivate students to participate. Each student at all schools in the program received scholastic credit for returning a signed form, material rewards for receiving each vaccine dose, and free attendance at a social event after completing the vaccine series. In two of four schools, classes received a reward if every student in the classroom returned a signed form within five days: in these schools, 91% and 98% of students returned signed forms within five days, compared to 82% and 85%, respectively, in the two schools without this peer incentive. Approximately half the students receiving the peer incentive reported that it played a motivating role, whereas 60% cited wanting to be protected. Few students named individual rewards as motivators. Although peer incentives appeared effective in encouraging some students to return parent consent or refusal forms, the desire to be protected may have been a stronger motivator.

Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.

“…Our search identified four studies regarding the effectiveness of schoolbased vaccination programs for improving coverage. 51,75,109,189 Of these, three had limited execution and were not included in the review. 51,75,109 Details of the single qualifying study are provided at the website: http://web.health.gov/communityguide.…”

“…51,75,109 Details of the single qualifying study are provided at the website: http://web.health.gov/communityguide. The qualifying study 189 evaluated a school-based program to increase delivery of hepatitis B vaccinations to adolescents; the study used multiple components including teacher education, classroom lessons, written client educational materials, and peer and individual incentives to encourage children to bring in their consent forms. Results demonstrated: (1) generally positive attitudes toward vaccinations among students and teachers; (2) significant improvements in client knowledge regarding hepatitis B; (3) faster return of consent forms among schools when incentives were used; and (4) vaccination coverage with three doses of hepatitis B vaccine after the intervention of 66% (comparative data not available).…”

Voluntary School-Based Human Papillomavirus Vaccination: An Efficient and Acceptable Model for Achieving High Vaccine Coverage in Adolescents

“…Other factors used in school-based vaccination programs, but less systematically studied, include incentives [23] and the effect on uptake of delivering more than one vaccination at a time [45].…”

An evaluation of school-level factors used in a successful school-based hepatitis B immunization initiative

“…Educational and motivational approaches, including lessons on hepatitis B, school assemblies, parent information packages containing educational materials available in 6 languages, and incentives to return signed forms within 1 week (individual extra credit points and a class party for students in classes in which 100% of the students returned signed forms by the deadline) were utilized to increase program compliance [14,21,27]. A survey analysis determined that the desire to be protected from HBV infection and the positive peer pressure induced by group incentives were the important motivating factors for adolescent vaccination completion [21,27]. Schools that offered peer incentives had higher return rates of signed consent/refusal forms than those without peer incentives; individual incentives were found to be unimportant to the students except for the incentive to receive extra credit points with the return of signed forms [21,27].…”

“…A survey analysis determined that the desire to be protected from HBV infection and the positive peer pressure induced by group incentives were the important motivating factors for adolescent vaccination completion [21,27]. Schools that offered peer incentives had higher return rates of signed consent/refusal forms than those without peer incentives; individual incentives were found to be unimportant to the students except for the incentive to receive extra credit points with the return of signed forms [21,27].…”