实施基于行为科学的告知信干预措施，以提高在伦敦无法联系到的居民的 COVID-19 疫苗接种率：英国伦敦的一项差分研究。

Implementing behavioural science informed letter interventions to increase COVID-19 vaccination uptake in uncontactable London residents: a difference-in-difference study in London, UK.

机构信息

Department of Surgery and Cancer, Imperial College London, London, UK; Institute of Global Health Innovation, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK.

Imperial College Health Partners, London, UK.

出版信息

Lancet. 2022 Nov;400 Suppl 1:S41. doi: 10.1016/S0140-6736(22)02251-6. Epub 2022 Nov 24.

DOI:10.1016/S0140-6736(22)02251-6

PMID:36929986

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9691047/

Abstract

BACKGROUND

The UK COVID-19 vaccination programme began in December, 2020. By February, 2021, eight North West London Clinical Commissioning Groups (CCGs) had the lowest vaccination rates nationally. This study evaluated the impact of behavioural science-informed (BI) letters on vaccination uptake.

METHODS

Unvaccinated residents of the Central London CCG who were deemed uncontactable (through text messaging and phone calls) were identified with the whole systems integrated care database. BI letters were sent to residents in the intervention CCG between May and June, 2021. Three neighbouring CCGs in London with similar non-responder data were used as control groups. A linear difference-in-difference analysis was undertaken to assess change in vaccine uptake rate across all four CCGs. Percentage point change was adjusted for selected covariates including ethnicity, age, gender, and index of multiple deprivation (IMD) quintiles. Approval was obtained from the quality improvement and audit office of Imperial College Healthcare NHS Trust (London, UK).

FINDINGS

Within the intervention Central London CCG, 10 161 residents received the BI letter. The control CCGs contained 27 383 uncontactable residents. All CCGs showed an increase in vaccination rates in this population. The linear difference-in-difference analysis showed an increase in vaccination uptake in the intervention CCG (relative change 31·9% (95% CI 30·5-33·3; p<0·0001). Residents in IMD quintile 5 (least deprived) showed the largest rate of change (4·1%; p<0·0001). Residents with a mixed or multiple ethnic background were less likely to receive a COVID-19 vaccine (-4·1%, p<0·0001).

INTERPRETATION

BI letters improved the rate of vaccine uptake. The percentage point increase of 31·9% equates to 436 additional previously uncontactable residents being vaccinated. Our data highlighted differences in the effect of BI-informed interventions in population subgroups. BI letters are a cost-effective and trusted communication tool, effectively engaging residents where other communication strategies did not work.

FUNDING

None.

摘要

背景

英国的 COVID-19 疫苗接种计划于 2020 年 12 月开始。到 2021 年 2 月，伦敦西北部的 8 个临床委员会（CCG）的疫苗接种率在全国最低。本研究评估了行为科学知情（BI）信件对疫苗接种率的影响。

方法

通过全系统综合护理数据库，确定中央伦敦 CCG 中未接种疫苗且被认为无法联系（通过短信和电话）的居民。2021 年 5 月至 6 月，向干预 CCG 中的居民发送 BI 信件。伦敦的 3 个相邻 CCG 作为对照组，具有类似的未回复数据。采用线性差异分析评估所有 4 个 CCG 的疫苗接种率变化。调整了包括种族、年龄、性别和多重剥夺指数（IMD）五分位数等选定协变量的百分比变化。获得了帝国理工学院医疗保健 NHS 信托基金（英国伦敦）的质量改进和审计办公室的批准。

结果

在干预中央伦敦 CCG 中，有 10161 名居民收到了 BI 信。对照组 CCG 中有 27383 名无法联系的居民。所有 CCG 都显示出该人群的疫苗接种率有所增加。线性差异分析显示，干预 CCG 的疫苗接种率有所增加（相对变化 31.9%（95%CI 30.5-33.3；p<0.0001）。处于 IMD 五分位数 5 级（最贫困）的居民变化率最大（4.1%（p<0.0001））。具有混合或多种族背景的居民接种 COVID-19 疫苗的可能性较低（-4.1%，p<0.0001）。