Increasing Vaccine Uptake Among Veterans at the Atlanta VA Health Care System

NCT03950986 | Completed

• 1 other identifier: AtlantaVAMC
• Study Type: interventional
• Target: 67,000
• Locations: 1 country
• Sites: 1

Brief Summary

The Office of Evaluation Sciences is collaborating with Emory University and the Atlanta VA Health Care System to increase adult immunizations uptake among veterans. The intervention targets patients of primary care providers (physicians, physician assistants and nurse practitioners) through a modification of the existing reminders in the VA electronic health record system. The team will evaluate the intervention using a randomized controlled trial.

Conditions

Influenza; Tetanus; Diphtheria; Pertussis; Pneumonia

Keywords

Vaccination; EHR Reminders; Nudge; Electronic Medical Records; Behavioral Economics

Outcome Measures

Primary Outcomes (2)

• Percent of patients receiving one of more vaccines of interest when due for these vaccines

  Percent of patients receiving of one or more of the influenza, pneumococcal (PCV13 or PPSV23) or Tdap/Td vaccines during the observation period, conditional on the patient being due for at least one of these vaccines at any appointment during the observation period

  6 months

• Percent of patients receiving the influenza vaccine when due for the vaccine

  Percent of patients receiving the influenza vaccine during the observation period, conditional on the patient being due for the influenza vaccine at any appointment during the observation period

  6 months

Secondary Outcomes (2)

• Percent of patients receiving Tdap/Td or pneumococcal vaccines when due

  6 months

• Cost per additional individual vaccinated

  6 months

Study Arms (2)

Control

NO INTERVENTION

Providers assigned to the control group will receive unmodified vaccine reminders (as they already appear in the VA EHR system). Separate reminders will appear for the different vaccines of interest.

Treatment

EXPERIMENTAL

Providers in the treatment group will receive modified clinical reminders for the vaccines of interest. Reminders for the different vaccines of interest will be bundled into a single reminder, and other changes made to streamline the design and reduce provider burden. Other changes include an immunization dashboard that relays a patient's vaccination status and talking points for providers to use in their dialogues with patients.

Other: Modified clinical reminders

Interventions

Modified clinical reminders OTHER

Clinical reminders for the vaccines of interest will be bundled into a single reminder, and other changes made to streamline the design and reduce provider burden. Other changes include an immunization dashboard that relays a patient's vaccination status and talking points for providers to use in their dialogues with patients.

Treatment

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All patients must have appointments with active primary care providers (physicians, physician assistants and nurse practitioners) in the Atlanta VA Health Care System

Sponsors & Collaborators

• Atlanta VA Medical Center: lead
• General Services Administration (GSA): collaborator
• Emory University: collaborator

Study Sites (1)

Atlanta VA Medical Center

Decatur, Georgia, 30033, United States

Location

Related Publications (1)

• Debroy P, Balu R, Burnett R, Johnson RA, Kappes HB, Wallace JM, Marconi VC. A cluster randomized controlled trial of a modified vaccination clinical reminder for primary care providers. Health Psychol. 2023 Mar;42(3):195-204. doi: 10.1037/hea0001218. Epub 2022 Oct 13.

  PMID: 36227309 DERIVED

Related Links

• Project Analysis Plan

MeSH Terms

Conditions

Influenza, Human; Tetanus; Diphtheria; Whooping Cough; Pneumonia

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Orthomyxoviridae Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Clostridium Infections; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Corynebacterium Infections; Actinomycetales Infections; Bordetella Infections; Gram-Negative Bacterial Infections; Lung Diseases

Study Officials

• Pompa Debroy, MS

  Office of Evaluation Sciences, U.S. General Services Administration

  PRINCIPAL INVESTIGATOR

• Russ Burnett, PhD

  Office of Evaluation Sciences, U.S. General Services Administration

  PRINCIPAL INVESTIGATOR

• Saad Omer, MBBS, MPH, PhD

  Emory University

  PRINCIPAL INVESTIGATOR

• Joseph M Wallace

  Atlanta VA Health Care System

  PRINCIPAL INVESTIGATOR

• Vincent Marconi, MD

  Atlanta VA Health Care System, Emory University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director of Infectious Diseases Research

Model Details: Intervention is designed to target patients of primary care providers (physicians, physician assistants and nurse practitioners) in the Atlanta VA Medical System. Primary care providers will be assigned to a provider-side treatment (modified vaccine reminders in the electronic health record (EHR) system) or to control (existing vaccine reminders). Outcomes will be tracked for patients who have appointments with these providers.

Study Record Dates

• First Submitted: April 25, 2019
• First Posted: May 15, 2019
• Study Start: October 15, 2018
• Primary Completion: May 30, 2019
• Study Completion: June 30, 2019
• Last Updated: January 10, 2020

Record last verified: 2020-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)