Mail Outreach To Increase Vaccination Acceptance Through Engagement

Study Overview
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Brief Summary
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The aim of this study is to determine whether receiving a core letter signed by the Surgeon General or the Director of the National Vaccine Program that provides only information about influenza, or a core letter signed by the Surgeon General with an added basic or enhanced implementation prompt, will increase rates of influenza vaccination among Medicare beneficiaries when compared to a control group.

Official Title
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Mail Outreach To Increase Vaccination Acceptance Through Engagement

Conditions
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Influenza, Human, Influenza, Human Flu

Intervention / Treatment
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* Behavioral: Core letter signed by Surgeon General
* Behavioral: Core letter signed by the Director of the National Vaccine Program
* Behavioral: Core letter signed by Surgeon General + implementation prompt
* Behavioral: Core letter signed by SG + enhanced implementation prompt


Participation Criteria
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Eligibility Criteria
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Medicare fee-for-service beneficiaries aged 66 and older are eligible for study inclusion. There will be no additional exclusion criteria.

Ages Eligible for Study
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Minimum Age: 66 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: No letter<br>Individuals randomized to the control group who will not receive any of the four letters | |
| Experimental: Core letter signed by Surgeon General<br>Individuals randomized to receive only a core letter signed by the Surgeon General | Behavioral: Core letter signed by Surgeon General<br>* The core letter provides information about influenza and the risks associated with it, incorporating a number of behavioral insights. All four letters evaluated in this study will contain the same tops and bodies that are included in the core letter, but the signature and P.S. tag region will differ among the various intervention groups. In this intervention, the core letter is signed by and includes a picture of the Surgeon General. The letter ends after the signature line and the space beneath the signature line is left blank where a P.S. tag region could be appended.<br>|
| Experimental: Core letter signed by Director of the National Vaccine Program<br>Individuals randomized to receive only a core letter signed by the Director of the National Vaccine Program | Behavioral: Core letter signed by the Director of the National Vaccine Program<br>* The core letter is signed by and includes a picture of the Director of the National Vaccine Program. The letter ends after the signature line and the space beneath the signature line is left blank where a P.S. tag region could be appended.<br>|
| Experimental: Core letter signed by Surgeon General + implementation prompt<br>Individuals randomized to receive a core letter signed by the Surgeon General with an implementation intention prompt added in an appended P.S. tag region below the signature line | Behavioral: Core letter signed by Surgeon General + implementation prompt<br>* The core letter is signed by and includes a picture of the Surgeon General. Below the signature line of the core letter, an implementation intention prompt is provided in the P.S. tag region that invites the recipient to write in the day of week, month, day, and time at which he or she plans to get vaccinated.<br>|
| Experimental: Core letter signed by SG + enhanced implementation prompt<br>Individuals randomized to receive a core letter signed by the Surgeon General (SG) with an enhanced implementation intention prompt added in an appended P.S. tag region below the signature line | Behavioral: Core letter signed by SG + enhanced implementation prompt<br>* The core letter is signed by and includes a picture of the Surgeon General (SG). Below the signature line of the core letter, an enhanced implementation intention prompt is provided in the P.S. tag region that prompts recipients to decide now - by checking one of two boxes - indicating they will or will not get vaccinated. The options use language that highlights the losses incumbent in refusing to vaccinate. In addition, an implementation intention prompt is embedded into the checkbox for indicating a choice to be vaccinated.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of study participants who receive influenza vaccination | Primary outcome of interest, determined from administrative claims data, will be the number of beneficiaries in each experimental group who receive an influenza vaccination between the date letter is mailed in September 2014 and January 31, 2015 | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Letters, Vaccination, Immunization, Randomized Controlled Trial, Prevention & Control, Preventive Measures, Health Promotion, Medicare, Intention Prompts