FluCare: Results from a randomised feasibility study of a complex intervention to increase care home staff influenza vaccination rates

David Wright, Amrish Patel, Jeanette Blacklock, Veronica Bion, Linda Birt, Terry Bryant, Allan Clark, Luke Cook, Alys Griffiths, Cecile Guillard, Amber Hammond, Richard Holland, Andy Jones, Liz Jones, Thando Katangwe-Chigamba, Jennifer Pitcher, Po Ruby, Sion Scott, Erika Sims, Susan StirlingAdam P. Wagner

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Abstract

Background: To protect care home residents, annual staff influenza vaccination uptake is recommended to be greater than 75%. In the UK it is under 40%. With barriers and enablers to care home staff flu vaccine uptake identified, the purpose of this study was to feasibility test a theory informed intervention to improve vaccination rates.

Methods: This was a five-arm (one intervention, four different control) study designed to inform the development of a definitive trial protocol. The intervention comprised of videos/posters to change vaccination attitudes, on-site clinics to increase access, a financial incentive for homes to reach target, and monthly monitoring of vaccination uptake. Control arms consisted of a mix of monthly or end of the study monitoring and provision of informational materials to identify the most suitable control arm for a definitive trial.

Care homes were recruited via sector associations and purposively allocated. The feasibility outcomes were: ability to recruit enough homes; data quality (variables reported, variable completeness and consistency with a national reporting system); intervention implementation; control arm reactivity bias and signal of efficacy. Staff vaccination data was collated from homes and via a national healthcare tracking system. Process evaluation and economic data collation were undertaken to optimise intervention and research design.

Results: Ten homes were recruited as per target within 11 weeks. Recruitment delays meant intervention delivery began towards end of flu season. Only 2 clinics took place in each home. All homes in intervention and chosen control arm (monthly monitoring only) reported all variables with over 90% completeness. There was a 15% difference between control homes’ reported vaccination rates and that in the national healthcare tracker, home reported data was more reliable. Signal of efficacy: intervention arm had a vaccination rate 13.6% higher than control arm. Bias: control arm did not have a higher vaccination rate than usual care control.

Conclusions: Better recruitment processes, earlier start in flu season, and data collection direct from care homes are required for a definitive trial. A control arm of monthly monitoring only was identified as optimal for data collection purposes and minimising reactivity bias. The signal of efficacy was acceptable.
Original languageEnglish
Pages (from-to)273-290
Number of pages18
JournalArchives of Clinical and Biomedical Research
Volume8
DOIs
Publication statusPublished - 2 Jul 2024

Keywords

  • Residential homes; Nursing homes; Long-term care facilities; Staff; Employees; Influenza vaccination

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