The impact of a theory-driven flu vaccine compliance communications campaign: a multiyear evaluation

Achieving full participation in a flu vaccination program for health care workers remains a persistent challenge. While previous studies in the literature have looked at the theoretical background surrounding flu vaccination, few studies have looked at the efficacy and effectiveness of flu vaccination communications campaigns that have been used to encourage populations to become vaccinated. Over three years, a novel flu vaccine compliance communications campaign was developed and implemented at two pilot sites, Western Psychiatric Institute and Clinic of UPMC (WPIC), and Magee-Womens Hospital of UPMC (Magee). Pilot sites received the intervention as a rolled-out approach, with UPMC Presbyterian Shadyside serving as a control arm for all three years of the intervention. In the third year of the program, a policy mandate was introduced across UPMC. Moderate increases compared to the initial baseline data, and then year-to-year increases within the individual hospital campus, were seen when a risk-based communications campaign was introduced at Magee and WPIC, with no significant changes when a social-norms component was added. In this population, a social-norms-based approach is unlikely to deliver measurable results with employee vaccination. The largest increases came during the final year of the policy mandate, with no significant changes across the three populations. This indicates that policy is the strongest influencer in employee influenza vaccination, but moderate increases can be achieved with the adoption of a risk-based approach to vaccine communications if such a policy is not feasible. Additionally, employees demonstrated greater engagement with communications materials when theory-driven campaigns were introduced, compared to employee response to communications materials used in the control hospital. This communications approach and campaign carries public health significance by shaping future campaigns and programs, and delivering lessons learned regarding application of motivators, related to routine influenza vaccination, and the expansion of vaccination to other HCW and general adult populations. By developing a novel practice that can be applicable toward a range of vaccination practices, this project carries public health significance in filling a gap toward best practices for encouraging vaccination when organizational or other mandates are not available