Nationwide Utilization of Danish Government Electronic letter system for increasing inFLUenza vaccine uptake (NUDGE-FLU): Study protocol for a nationwide randomized implementation trial.


Journal

American heart journal
ISSN: 1097-6744
Titre abrégé: Am Heart J
Pays: United States
ID NLM: 0370465

Informations de publication

Date de publication:
06 2023
Historique:
received: 23 12 2022
revised: 13 02 2023
accepted: 13 02 2023
medline: 8 5 2023
pubmed: 22 2 2023
entrez: 21 2 2023
Statut: ppublish

Résumé

Annual influenza vaccination is widely recommended in older adults and other high-risk groups including patients with cardiovascular disease. The real-world effectiveness of influenza vaccination is limited by suboptimal uptake and effective strategies for increasing vaccination rates are therefore needed. The purpose of this trial is to investigate whether behavioral nudges digitally delivered via the Danish nationwide mandatory governmental electronic letter system can increase influenza vaccination uptake among older adults. The NUDGE-FLU trial is a randomized implementation trial randomizing all Danish citizens aged 65 years and above without an exemption from the Danish mandatory governmental electronic letter system to receive no digitally delivered behavioral nudge (usual care arm) or to receive one of 9 electronic letters (intervention arms) each leveraging different behavioral science strategies. The trial has randomized 964,870 participants with randomization clustered at the household level (n = 691,820 households). Intervention letters were delivered on September 16, 2022, and follow-up is currently ongoing. All trial data are captured using the nationwide Danish administrative health registries. The primary end point is the receipt of an influenza vaccine on or before January 1, 2023. The secondary end point is time to vaccination. Exploratory end points include clinical events such as hospitalization for influenza or pneumonia, cardiovascular events, all-cause hospitalization, and all-cause mortality. The nationwide randomized NUDGE-FLU trial is one of the largest implementation trials ever conducted and will provide important insights into effective communication strategies to maximize vaccination uptake among high-risk groups. Clinicaltrials.gov: NCT05542004, registered September 15, 2022, https://clinicaltrials.gov/ct2/show/NCT05542004.

Sections du résumé

BACKGROUND
Annual influenza vaccination is widely recommended in older adults and other high-risk groups including patients with cardiovascular disease. The real-world effectiveness of influenza vaccination is limited by suboptimal uptake and effective strategies for increasing vaccination rates are therefore needed. The purpose of this trial is to investigate whether behavioral nudges digitally delivered via the Danish nationwide mandatory governmental electronic letter system can increase influenza vaccination uptake among older adults.
METHODS
The NUDGE-FLU trial is a randomized implementation trial randomizing all Danish citizens aged 65 years and above without an exemption from the Danish mandatory governmental electronic letter system to receive no digitally delivered behavioral nudge (usual care arm) or to receive one of 9 electronic letters (intervention arms) each leveraging different behavioral science strategies. The trial has randomized 964,870 participants with randomization clustered at the household level (n = 691,820 households). Intervention letters were delivered on September 16, 2022, and follow-up is currently ongoing. All trial data are captured using the nationwide Danish administrative health registries. The primary end point is the receipt of an influenza vaccine on or before January 1, 2023. The secondary end point is time to vaccination. Exploratory end points include clinical events such as hospitalization for influenza or pneumonia, cardiovascular events, all-cause hospitalization, and all-cause mortality.
DISCUSSION
The nationwide randomized NUDGE-FLU trial is one of the largest implementation trials ever conducted and will provide important insights into effective communication strategies to maximize vaccination uptake among high-risk groups.
TRIAL REGISTRATION
Clinicaltrials.gov: NCT05542004, registered September 15, 2022, https://clinicaltrials.gov/ct2/show/NCT05542004.

Identifiants

pubmed: 36801265
pii: S0002-8703(23)00041-8
doi: 10.1016/j.ahj.2023.02.009
pii:
doi:

Substances chimiques

Influenza Vaccines 0

Banques de données

ClinicalTrials.gov
['NCT05542004']

Types de publication

Clinical Trial Protocol Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

58-71

Subventions

Organisme : NHLBI NIH HHS
ID : T32 HL007604
Pays : United States

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Niklas Dyrby Johansen (ND)

Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Muthiah Vaduganathan (M)

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Cardiometabolic Implementation Science, Brigham and Women's Hospital, Boston, MA.

Ankeet S Bhatt (AS)

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Cardiometabolic Implementation Science, Brigham and Women's Hospital, Boston, MA; Kaiser Permanente Division of Research, Oakland, CA.

Simin Gharib Lee (SG)

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Cardiometabolic Implementation Science, Brigham and Women's Hospital, Boston, MA.

Daniel Modin (D)

Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Brian L Claggett (BL)

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Erica L Dueger (EL)

Sanofi, Lyon, France.

Sandrine Samson (S)

Sanofi, Lyon, France.

Matthew M Loiacono (MM)

Sanofi, Swiftwater, PA.

Lars Køber (L)

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Scott D Solomon (SD)

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Pradeesh Sivapalan (P)

Respiratory Medicine Section, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.

Jens Ulrik Stæhr Jensen (JUS)

Respiratory Medicine Section, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.

Palle Valentiner-Branth (P)

Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.

Tyra Grove Krause (TG)

Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.

Tor Biering-Sørensen (T)

Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address: tor.biering@gmail.com.

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Classifications MeSH