Promoting Influenza Vaccination among Staff of Nursing Homes According to Behavioral Insights: Analyzing the Choice Architecture during a Nudge-Based Intervention

Lorini, Chiara; Ierardi, Francesca; Gatteschi, Claudia; Galletti, Giacomo; Collini, Francesca; Peracca, Laura; Zanobini, Patrizio; Gemmi, Fabrizio; Bonaccorsi, Guglielmo

doi:10.3390/vaccines8040600

Cited by 19 publications

(48 citation statements)

References 35 publications

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“…The survey instrument used in this study consisted of 52 items related to vaccine confidence [ 23 ], vaccine literacy [ 24 ], multilevel-theory-model-based initiation of vaccination behavior [ 25 , 26 ], and demographic questions. Vaccine literacy instruments (14 items) include functional (5 items), iterative or communicative (5 items), and critical literacy (4 items).…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Booster Vaccination Hesitancy in the United States: A Multi-Theory-Model (MTM)-Based National Assessment

et al. 2022

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Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = 209, 41.7%), a significantly larger proportion of respondents were unvaccinated with the primary series (43.5% vs. 11%, p < 0.001), were among 18–44 years age group (51.2% vs. 31.8%, p < 0.001), single or never married (33.0% vs. 24.3%, p = 0.04), had lower education with some high school (6.2% vs. 2.4%, p = 0.03), and identified themselves as Republicans (31.6% vs. 20.5%, p = 0.01). The hesitant group had lower mean scores of vaccine literacy, and vaccine confidence, and had 19% lower odds of behavioral confidence than their non-hesitant counterparts (adjusted odds ratio = 0.81, 95% CI: 0.71–0.92). Conclusions: The findings of this study underscore the need of raising public awareness through effective multi-theory-model-based communication campaigns.

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Section: Methodsmentioning

confidence: 99%

COVID-19 Booster Vaccination Hesitancy in the United States: A Multi-Theory-Model (MTM)-Based National Assessment

et al. 2022

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“…49 A mixed-methods study in Italy demonstrated that a personalised individual letter significantly increases influenza vaccine intentions among healthcare workers (HCWs) who received the nudge intervention compared with the control group. 50 An RCT in the USA showed that sending reminder postcards to elderly adults who were late for at least one vaccine significantly increases vaccination rates. 51 On the other hand, using the same approach in terms of frequency and nature of reminders, an RCT in a large acute care hospital in the UK found no evidence that influenza vaccine uptake is affected by reminder letters.…”

Section: Make Available Information Salientmentioning

confidence: 99%

Nudging toward vaccination: a systematic review

et al. 2021

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BackgroundVaccine hesitancy (VH) and the global decline of vaccine coverage are a major global health threat, and novel approaches for increasing vaccine confidence and uptake are urgently needed. ‘Nudging’, defined as altering the environmental context in which a decision is made or a certain behaviour is enacted, has shown promising results in several health promotion strategies. We present a comprehensive synthesis of evidence regarding the value and impact of nudges to address VH.MethodsWe conducted a systematic review to determine if nudging can mitigate VH and improve vaccine uptake. Our search strategy used Medical Subject Headings (MeSH) and non-MeSH terms to identify articles related to nudging and vaccination in nine research databases. 15 177 titles were extracted and assessed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The final list of included articles was evaluated using the Mixed Methods Appraisal Tool and the Grading of Recommendations, Assessment, Development and Evaluations framework.FindingsIdentified interventions are presented according to a framework for behaviour change, MINDSPACE. Articles (n=48) from 10 primarily high-income countries were included in the review. Nudging-based interventions identified include using reminders and recall, changing the way information is framed and delivered to an intended audience, changing the messenger delivering information, invoking social norms and emotional affect (eg, through storytelling, dramatic narratives and graphical presentations), and offering incentives or changing defaults. The most promising evidence exists for nudges that offer incentives to parents and healthcare workers, that make information more salient or that use trusted messengers to deliver information. The effectiveness of nudging interventions and the direction of the effect varies substantially by context. Evidence for some approaches is mixed, highlighting a need for further research, including how successful interventions can be adapted across settings.ConclusionNudging-based interventions show potential to increase vaccine confidence and uptake, but further evidence is needed for the development of clear recommendations. The ongoing COVID-19 pandemic increases the urgency of undertaking nudging-focused research.PROSPERO registration numberCRD42020185817.

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“…Open only about their professional responsibility but also the personal working burden the staff would have to deal with in cases of colleagues getting sick. Unlike Schmidtke et al, 30 Lorini et al 31 found a significant effect in the intervention group regarding the intention to get the influenza vaccine, which increased from 2018 to 2019 and 2020.…”

Section: Dos Santos Et Al 37mentioning

confidence: 72%

“…That said, HCPs might now have a much different emotional and cognitive response to COVID-19 than influenza, and new intervention strategies should be investigated. The significant positive results found by Lorini et al 31 could for instance be due to the already large impact of COVID-19 affecting inclination towards vaccination among HCPs. Other studies have shown vaccine hesitancy among skilled nursing facility staff regarding the COVID-19 vaccine, either because of the development and testing or personal fears of getting sick.…”

Section: Nudging Vaccinationmentioning

confidence: 91%

“…5545926 for full view). Four studies related to ventilation of intubated patients, [18][19][20][21] five targeted hand hygiene measures, [22][23][24][25][26] six focused on increasing vaccination rates [27][28][29][30][31][32] and five focused on encouraging judicious antibiotic prescription. [33][34][35][36][37] Out of the 20 studies included for analysis, seven employed more than one medium of intervention, and 13 employed only one.…”

Section: Summary Of the Included Studiesmentioning

confidence: 99%

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Nudging healthcare professionals to improve treatment of COVID-19: a narrative review

Vilhelmsson

Sant'Anna²,

Wolf

2021

BMJ Open Qual

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Narrative review © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. METHODSWe conducted a narrative review to explore the role of nudging in supporting HCPs in the prevention and treatment of COVID-19.Studies eligible for inclusion were: (1) interventions conducted in a clinical setting targeting healthcare personnel, (2) behavioural interventions using the term nudging, (3) randomised controlled trials, quasi-experimental or longitudinal (beforeafter) studies, (4) original research articles published in English and in peer-reviewed journals between 2010 and 2020.Articles were searched by an information specialist at the university library on two electronic databases: PubMed and PsycINFO. We searched the term 'nudging', 'nudges', or 'nudge' in the titles or abstracts of articles published from January 2010 to December 2020. Two of the authors performed individual blinded screening of titles and abstracts from the search using the Rayyan QCRI systematic review tool. 16 Studies were selected in three phases: (a) removing duplicates, (b) screening titles and abstracts, and (c) screening full-text articles.Articles that described an intervention to change the behaviour of HCPs in a clinical setting and deemed relevant to COVID-19 were included. Reviews, opinion letters, editorials, and publications that were not published in English were excluded and nudging interventions not relevant to the treatment of COVID-19 (The table is in the repository Zenodo. https:// doi. org/ 10. 5281/ zenodo. 5545926).The blind was then lifted, and any disagreements between authors were discussed with a third author until a consensus was reached.The included articles were then reviewed to extract key information about each copyright.

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Promoting Influenza Vaccination among Staff of Nursing Homes According to Behavioral Insights: Analyzing the Choice Architecture during a Nudge-Based Intervention

Cited by 19 publications

References 35 publications

COVID-19 Booster Vaccination Hesitancy in the United States: A Multi-Theory-Model (MTM)-Based National Assessment

COVID-19 Booster Vaccination Hesitancy in the United States: A Multi-Theory-Model (MTM)-Based National Assessment

Nudging toward vaccination: a systematic review

Nudging healthcare professionals to improve treatment of COVID-19: a narrative review

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