A complex intervention on vaccination uptake among older adults (≥ 60 years) in Germany - a study protocol with a mixed methods design.
Sarah A K Uthoff, Anna Zinkevich, Dominika Franiel, Maike Below, Helene Splieth, Julia Iwen, Marc Biedermann, Dorothee Heinemeier, Lena Ansmann
Author Information
Sarah A K Uthoff: Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany. sarah.uthoff@uni-oldenburg.de.
Anna Zinkevich: Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany.
Dominika Franiel: Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany.
Maike Below: Central Research Institute of Ambulatory Health Care in Germany, Salzufer 8, 10587, Berlin, Germany.
Helene Splieth: Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany.
Julia Iwen: Association of Substitute Health Funds (Vdek) e.V, Askanischer Platz 1, 10963, Berlin, Germany.
Marc Biedermann: The National Association of Statutory Health Insurance Physicians, Herbert-Lewin-Platz 2, 10623, Berlin, Germany.
Lena Ansmann: Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Ammerlaender Heerstrasse 140, 29123, Oldenburg, Germany.
BACKGROUND: The current uptake of many vaccinations recommended for persons aged 60 and older is unsatisfactory in Germany. Lack of confidence in the safety and efficacy of vaccinations, lack of knowledge and insecurities about possible side effects, and numerous pragmatic barriers are just some of the reasons to be mentioned. General practitioners (GPs) play a central role in the vaccination process. Therefore, effective interventions in this context are needed to address the various barriers and improve the vaccination uptake rates. METHODS: A complex intervention will be implemented and evaluated in 1057 GPs' practices in two German federal states. The components include trainings for GPs and medical assistants on communication psychology, medical aspects, and organisational vaccination processes. The primary outcome influenza vaccination rate and the secondary outcomes vaccination uptake rate of other vaccinations as well as vaccine literacy of patients will be examined. The intervention will be evaluated in a mixed methods study with a controlled design. Survey data will be analysed descriptively and by using mean comparisons as well as multivariable multilevel analyses. The qualitative data will be analysed with qualitative content analysis. The secondary data will be analysed by using descriptive statistics, a pre-post comparison by performing mean comparisons, cluster analysis, and subgroup analyses. DISCUSSION: In this study, a complex intervention to improve vaccination rates in GP practices for the vaccinations recommended for people aged 60 years and older will be implemented and evaluated. Additionally, improvements in patients' vaccine-related health literacy and knowledge, and patients' intention to get vaccinated are expected. The mixed methods design can deliver results that can be used to improve preventive health care for elderly people and to gain more knowledge on vaccination uptake and the intervention's effectiveness. TRIAL REGISTRATION: Trial registration number: DRKS00027252 (retrospectively registered).
