在访问期间向临床医生和患者推流感疫苗:BE IMMUNE随机临床试验
Shivan J Mehta1, Kimberly J Waddell1, Kristin A Linn1
1Perelman School of Medicine, University of Pennsylvania, Philadelphia.
JAMA internal medicine
|January 6, 2026
概括
一种多组件的推动干预措施在初级保健访问期间显著增加了老年人流感疫苗接种率. 然而,双向短信并没有进一步改善高风险人群的疫苗接种.
科学领域:
- 公共卫生 公共卫生
- 行为经济学是一种行为经济学.
- 预防医学 预防医学
背景情况:
- 对于老年人来说,每年接种流感疫苗至关重要,但接种率低于最佳水平.
- 初级保健访问提供了一个改善疫苗接种完成率的机会.
研究的目的:
- 评估旨在增加50岁及以上的患者在初级保健访问期间完成流感疫苗接种的多组件推动干预措施的有效性.
主要方法:
- 一项实用随机临床试验 (BE IMMUNE) 涉及两个卫生系统的48个初级保健诊所.
- 诊所被随机分配到通常的护理或多组件干预,包括患者的文字提醒,自动悬而未决的订单和同行比较.
- 高风险患者进一步被随机分配到双向或标准文本消息.
主要成果:
- 多组件的推动干预导致流感疫苗接种完成率在统计学上显著增加 (31.4%与26.4%,调整或1.28).
- 该干预表明,疫苗接种率增加了5.1个百分点.
- 高风险患者的双向短信与标准提醒相比没有显示出统计学上显著的改善 (调整后的OR为1.00).
结论:
- 一种多组件的推动干预措施有效地提高了老年人在初级保健机构中的流感疫苗接种率.
- 在本研究中,有针对性的双向短信并没有为高风险人群提供额外的好处.
- 通过推动应用的行为经济学原则,有望改善像疫苗接种活动这样的公共卫生干预措施.
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