NUR 504 - Summary of Research Article: Influenza Vaccination Rates

This document provides a summary of a research article investigating interventions to increase influenza vaccination rates in individuals aged 60 and older living in the community. The study, which includes an analysis of 44 randomized controlled trials (RCTs), examines the effectiveness of various interventions such as personalized postcards, home visits, and physician reminders. The research aims to address the gap in evidence supporting influenza vaccination despite its promotion by health authorities. Key findings highlight the heterogeneity of the studies and the limited number of RCTs with low risk of bias, making it difficult to draw definitive recommendations. The interventions were categorized into those increasing community demand, access (e.g., home visits, free vaccination), and system-based approaches. The summary references relevant citations to support its analysis of the research article.

Running head: SUMMARIZES RESEARCH ARTICLES
Summary of the Research Articles:
Article #2: Interventions to Increase Influenza Vaccination Rates of those 60 years and Older
Living in the Community
Jennifer Enriquez
Grand Canyon University: NUR 504
June 20, 2018
1

Article #2: INTERVENTIONS TO INCREASE INFLUENZA VACCINATION RATES OF
THEOSE 60 YEARS AND OLDER LIVING IN THE COMMUNITY
Problem Statement
Since the year 1964, the advisory committee on the Immunisation practices of the
United States Public Health Service has recommended influenza vaccination of the high risk
individuals, comprising of the older people. There are very poor evidences to support the
influenza vaccination and still it is promoted by most of the health authorities (Dixon et al.,
2017). The effectiveness of the interventions for increasing the rates of influenza vaccination in
60 years or older is still undetermined.
Statement of Purpose
Influenza vaccine is effective in decreasing the influenza-like illnesses, physician visits
and working days lost (Petrie et al., 2015). In many nations, only the high-risk groups are
subsidised a free vaccination service. The non-high-risk groups generally include the individuals
of below the age of 65 years without any chronic disease, and those who are not working in
healthcare sector. In countries like Europe and Australia, the influenza coverage rates for the
non-high-risk adults ranges from 5.8 to 45.1 percent.
Research Question(s)
What is the efforts of the interventions for increasing the rates of influenza vaccination
among the human beings aged 60 years or older than that?
Method
A total of 44 RCTs (Randomised controlled trials) were included in the study and all of
them studied the seniors in the community and within the high-income nations. There were no
RCTs belonging from the society-level interventions. With the same, the authors of this article
2

Article #2: INTERVENTIONS TO INCREASE INFLUENZA VACCINATION RATES OF
THEOSE 60 YEARS AND OLDER LIVING IN THE COMMUNITY
searched the CENTRAL (Cochrane Central Register of Controlled Trials), comprising the
Cochrane Acute Respiratory Infections Group's Specialized Register, MEDLINE, EMBASE,
AgeLine, ERIC and CINAHL.
Key Findings
The heterogeneity was marked up and meta-analysis was very limited. There were only
five RCTs who were graded low and six of them were at the risk of the bias. They comprised of
three of the thirteen personalised postcard interventions, and two among the four home visit
interventions, three of the four reminder to the physicians interventions as well as three of the
four facilitator interventions. However, it is also to mention that the other remaining 33 RCTs
were all at higher risks of the biases and there were no recommendations for the practice that
could be drawn. The interventions that were reviewed were categorised as those to increase the
demand of the community, increase the access such as home visits, group visits and the provision
of the free vaccination and the system or provide based interventions. The fourth category of the
interventions are at society level. However, there are no randomised controlled trials that were
found, this category would comprise of the mandated programs as well as government policies
like paying healthcare workers for achieving the specific vaccination targets. All the RCTs were
of the older people in the high income nations and other specific communities. The articles did
not find any includable RCTs of the interventions for increasing the rates in the institutions.
Elven out of forty four RCTs were at moderate or low risk of the biases. It is also to mention that
there is a summary of the effects of the interventions for increasing the rates of influenza
vaccinations in the article. They comprise of three of the thirteen personalised phone call or post
card interventions, two out of four home visit interventions, three out of four facilitator
interventions and three out of four reminders to the physicians interventions. The remaining
3

Article #2: INTERVENTIONS TO INCREASE INFLUENZA VACCINATION RATES OF
THEOSE 60 YEARS AND OLDER LIVING IN THE COMMUNITY
thirty three RCTs were at the high risk of the biases as well as the limited outcomes of the RCTS
at the moderate and the low risk of bias should also be viewed in this context.
Citation
Dixon, B. E., Kasting, M. L., Wilson, S., Kulkarni, A., Zimet, G. D., & Downs, S. M. (2017).
Health care providers’ perceptions of use and influence of clinical decision support
reminders: qualitative study following a randomized trial to improve HPV vaccination
rates. BMC medical informatics and decision making, 17(1), 119.
Petrie, J. G., Cheng, C., Malosh, R. E., VanWormer, J. J., Flannery, B., Zimmerman, R. K., ... &
Benoit, J. (2015). Illness severity and work productivity loss among working adults with
medically attended acute respiratory illnesses: US influenza vaccine effectiveness
network 2012–2013. Clinical Infectious Diseases, 62(4), 448-455.
4