Question-behavior effect and flu vaccination in the over 65s

ISRCTN ISRCTN16437731
DOI https://doi.org/10.1186/ISRCTN16437731
Secondary identifying numbers N/A
Submission date
17/03/2016
Registration date
22/03/2016
Last edited
27/04/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Asking questions about a behaviour can change that behaviour – called the Question Behaviour Effect (QBE). The aim of this study is to test the QBE as a simple (and potentially cost effective) way to increase influenza vaccination rates among older adults. We will assess whether sending older adults a questionnaire about influenza vaccination increases vaccination rates.

Who can participate?
Patients who are eligible for an influenza vaccination by being age 65 or over at their next birthday

What does the study involve?
Participants are randomly allocated to one of eight groups: either to receive no questionnaire, or to receive a questionnaire measuring:
1. Demographics (i.e., asking whether they had children, their occupation, marital status, and ethnic origin)
2. Demographics plus items about intentions to get vaccinated and attitudes towards vaccination
3. Demographics plus items about intentions to get vaccinated and attitudes towards vaccination plus a post it note requesting questionnaire completion
4. Demographics plus items about anticipated regret about getting vaccinated, intentions to get vaccinated and attitudes towards vaccination
5. Demographics plus items about anticipated regret about getting vaccinated, intentions to get vaccinated and attitudes towards vaccination, plus a post it note requesting questionnaire completion
6. Demographics plus items about benefits of getting vaccinated, intentions to get vaccinated and attitudes towards vaccination
7. Demographics plus items about benefits of getting vaccinated, intentions to get vaccinated and attitudes towards vaccination, plus a post it note requesting questionnaire completion.
We tested the effects of these different questions on influenza vaccination rates.

What are the possible benefits and risks of participating?
The benefits of participating were helping inform the development of interventions to improve vaccination uptake. There were no risks of participating.

Where is the study run from?
General practices in northern England, Leeds, UK

When is the study starting and how long is it expected to run for?
July 2012 to February 2013

Who is funding the study?
Economic and Social Research Council (UK)

Who is the main contact?
Prof Mark Conner
m.t.conner@leeds.ac.uk

Contact information

Prof Mark Conner
Scientific

University of Leeds
School of Psychology
Leeds
LS2 9JT
United Kingdom

ORCiD logoORCID ID 0000-0002-6229-8143
Phone +44 (0)113 3435720
Email m.t.conner@leeds.ac.uk

Study information

Study designInterventional randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)GP practice
Study typePrevention
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleVarying cognitive targets and response rates to enhance the question-behavior effect: an eight-arm randomized controlled trial on influenza vaccination
Study objectivesAsking questions about a behaviour can change that behaviour - the Question Behaviour Effect (QBE). The present research tested the QBE as a simple (and potentially cost effective) means to increase influenza vaccination rates among older adults. We tested the effects of different questions on influenza vaccination rates.

We also tested the effect of a manipulation (sticky post it note with request for help) designed to increase questionnaire response rates on influenza vaccination rates.
Ethics approval(s)NRES Committee Yorkshire and Humber - Bradford, 19/07/2011, 11/YH/0229
Health condition(s) or problem(s) studiedInfluenza
InterventionThere are eight arms. Participants in the control 1 (no questionnaire) condition did not receive a questionnaire. Participants in the control 2 (demographics questionnaire) condition received a questionnaire tapping whether they had children, their occupation, marital status, and ethnic origin. Participants in the other six conditions received a questionnaire tapping the same demographic questions plus questions about influenza vaccination. The first (intention + attitude condition) questionnaire contained items tapping intentions and attitudes in relation to influenza vaccination; the second (anticipated regret + intention + attitude condition) questionnaire additionally contained anticipated regret questions; the third (beneficence + intention + attitude condition) questionnaire additionally contained beneficence questions. The other three (intervention) questionnaires were the same, but had a sticky note attached to the front that included a message (‘Please take a few minutes to complete this for us. Thank you!’). The message was printed in blue on a yellow (72x72mm) sticky note but with the message appearing to be hand written.
Intervention typeBehavioural
Primary outcome measureReceiving an influenza vaccination in period 28/07/2012 to 07/02/2013 following invitation as indicated by records
Secondary outcome measuresNone
Overall study start date28/07/2012
Completion date07/02/2013

Eligibility

Participant type(s)Patient
Age groupSenior
SexBoth
Target number of participants13,452
Key inclusion criteria1. Participants recruited from General Practices in the northern England, Leeds, UK area who were not taking part in a centralized influenza vaccination invitation scheme in Autumn 2012
2. The study population consisted of all patients in each practice eligible for an influenza vaccination that year by being age 65 years or over at their next birthday
3. A total of 13,806 patients were individually randomly assigned to one of eight conditions using a random number generator. Subsequently, 354 patients were deemed ineligible for vaccination (i.e., due to having left the General Practice, being deceased, unable to have a vaccination due to a medical condition, or having already received a vaccination) and excluded from the study, leaving 13,452 patients who were included in intention-to-treat analyses
4. A total of 4934 completed questionnaires (43.1%) were returned from 11752 sent out. The sample was 56.2% female with a mean age of 75.5 years (SD = 7.88) and mainly lived in areas of low deprivation (Townsend score M = -1.49, SD = 2.93). The eight different conditions were equivalent on gender and age but significantly different on deprivation
Key exclusion criteriaDoes not meet inclusion criteria
Date of first enrolment01/10/2012
Date of final enrolment29/11/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Leeds
c/o Mark Conner, Professor of Applied Social Psychology
School of Psychology
Leeds
LS2 9JT
United Kingdom

Sponsor information

University of Leeds (UK)
University/education

c/o Clare Skinner
Faculty Head of Research Support
Faculty of Medicine and Health
Worsley Building
Leeds
LS2 9LN
England
United Kingdom

ROR logo "ROR" https://ror.org/024mrxd33

Funders

Funder type

Research council

Economic and Social Research Council
Government organisation / National government
Alternative name(s)
ESRC
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planA paper reporting the details of the study and key findings will be prepared during 2016.
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2017 Yes No

Editorial Notes

27/04/2018: Publication reference added.