ORIG (French Geriatric Infection Risk Institute), Charles Foix Hospital, AP-HP (Publicly-owned hospitals of Paris), Ivry-sur-Seine, France.
J Nutr Health Aging. 2011 Feb;15(2):126-32. doi: 10.1007/s12603-011-0025-5.
Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination.
To implement multicenter programs to enhance HCW influenza vaccination.
It was a cluster randomised interventional studies.
43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France.
1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group.
After the failure of a first educational program giving scientific information and. tested during the 2005-06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of "safety zones", and to give personal satisfaction. Program 2 was tested during the 2006-07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs).
The efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters.
Program 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p > 0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p < 0.001) regardless their occupational group but only in the non previous vaccinated subgroup.
In geriatric health care centres in France, an active multicenter program giving personal satisfaction and taking into account the profile of non-vaccinated HCWs was more effective in promoting flu vaccination than a scientifically factual information program. HCW involvement is required in program implementation in order to avoid rejection of top-down information.
由于流感疫苗在老年人群体中的效果不佳，老年保健机构仍经常爆发流感。众所周知，医护人员（HCW）接种流感疫苗可以获得群体免疫，并降低老年人群体中居住在老年保健机构中的流感的影响。然而，法国医护人员的疫苗接种率仍然很低。法国老年感染风险研究所（ORIG）进行了 VESTA 研究，这是一项三阶段的多中心研究，旨在确定限制 HCW 接种疫苗的因素，并制定和实施促进 HCW 接种流感疫苗的积极计划。
实施多中心计划以增强 HCW 接种流感疫苗。
这是一项集群随机干预研究。
法国 43 家老年保健机构（GHCS），长期护理和康复护理机构。
来自 20 家干预组 GHCS 的 1814 名医护人员和来自 23 家对照组 GHCS 的 2435 名医护人员。
在 43 家 HCS 中进行了第一次教育计划后失败，该计划提供了科学信息并在 2005-06 年流感季节进行了测试，之后设计了第二次计划。目标是让 HCW 参与创建“安全区”，并获得个人满足感。在 2006-07 年季节进行了计划 2。参与计划 1 集群的 24 家 HCS 中的 20 家（1814 名 HCW）和控制 1 集群的 19 家 HCS 中的 16 家，以及另外 7 家有兴趣参与的新 HCS，被纳入计划 2 集群（23 家 HCS；2435 名 HCW）。
通过计算和比较所有 HCS 中接种疫苗的 HCW 的百分比，评估每个计划的效果，在计划和对照组集群中。
计划 1 未能提高 HCW 疫苗接种覆盖率（VCR）（计划 1：34%；控制 1：32%；p>0.05）。计划 2 提高了 HCW 的 VCR（计划 2：44%；控制 2：27%；卡方检验，p<0.001），无论其职业群体如何，但仅在未接种过疫苗的亚组中。
在法国老年保健中心，与提供科学事实信息的计划相比，一项积极的多中心计划，给予个人满足感并考虑到未接种疫苗的 HCW 的特征，更能促进流感疫苗接种。在实施计划时需要 HCW 的参与，以避免拒绝自上而下的信息。
