Older People's Preventive Care Utilization
ConditionHealth Communication
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age70+
SponsorThe University of Hong Kong
About this trial
Objectives: To empower older people's decision making for taking the recommended vaccines including seasonal influenza vaccines, pneumococcal vaccines, and COVID-19 vaccine (if it is recommended annually).
Hypotheses to be tested: The interventions designed using Mental Models Approach and Patient Activation Approach will promote older people's confidence in knowledge and skills regarding vaccination decisions, perceived self-efficacy in self-management of health, positive emotional engagement with vaccination decisions and a positive future time perspective which will subsequently promote their uptake of the recommended vaccines.
Design and subjects: This will be a two-arm randomized control trial. Subjects will be community-dwelling older people aged 70 years or above.
Instruments: A questionnaire will be used to collect baseline data before the interventions and follow-up data 1 months and 4 months, respectively, after the end of interventions.
Interventions: Interventions included one booklet to communicate information about preventive care by bridging expert knowledge and older people's existing mental models, and six patient activation sections conducted over telephone. One patient activation section will be delivered per week by trained medical students.
Main outcome measures: Main outcomes will be participants' uptake of the three recommended vaccines assessed at 1 month and 4 months after the end of interventions.
Data analysis and expected results: Generalized estimating equation logistic regression will be used to assess the intervention effects. The investigators expect that the interventions can promote at least 20% increase in uptake of any one of the three recommended vaccines in the intervention group compared with the control group.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Community-dwelling older persons aged 70 years who did not persistently receive seasonal influenza vaccine over the past three years (2020-2022) and/or have never received the pneumococcal vaccine (one dose of the 23-valent pneumococcal polysaccharide vaccine (23vPPV) or the 13-valent pneumococcal conjugate vaccine (PCV13)).
Being able to communicate with Cantonese, or Mandarin (the two main spoken language in Hong Kong) and being able to read Chinese.
Inclusion criteria for the informant include age above 18 and can understand Cantonese or Mandarin
Disqualifiers
having psychiatric disorders, dementia, or other cognitive difficulties which impede communication or understanding of the intervention and having functional disabilities which impede access to health care services.
subjects who had medical contraindications for immunization.
Trial design
Design model
Parallel
Treatments tested in this trial
MMA and patient activation intervention scheme
BehavioralDesign of booklet for older people's preventive care: We propose that the booklet will include 8 main topics based on what experts and current academic literature believe are important for encouraging older people's preventive care utilization. To add the social norms-related cues for the later three topics of the booklet, one qualitative study on older adults who are active in preventive care is needed. Therefore, we will interview \~20 older adults aged 70 years or above who are active in taking preventive care. We will conduct one-to-one in-depth interview to explore how participants overcome difficulties during decision making for vaccination and their positive feelings after making achievements. We will also explore and identify older adults who have a positive future perspective. Patient activation sections: . Four undergraduate medical students will be trained as the coaches to deliver the patient activation sections over six weeks. Each section will be around 20 min.
Control Group
BehavioralParticipants in the control group will receive a pamphlet about recommendation for influenza, pneumococcal, and COVID-19 vaccines (if appropriate) for older people using information from Hong Kong Department of Health. As a control for the patient activation interviews, the control group will also be informed that they will join our "telephone-based elderly care project" by the end of the baseline assessment but instead of receiving the patient activation interviews, this group will receive six control telephone care visits over six weeks. Each control telephone care visit will be around 5-10 min during which the student helper will give general guidelines about dietary health and exercise for older people. The control messages are mainly educational and designed using information derived from the websites of Hong Kong Department of Health.
Treatment groups
270 Participants
are divided into 2 treatment groupsGroup A: Control GroupActive comparator 1 intervention
Group B: Intervention GroupExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Change of Uptake Rate of the Three Recommended Vaccines from Baseline to within 1 Month and 4 Months after Interventions
Participants' uptake rate of the three recommended vaccines (influenza vaccines, pneumococcal vaccines, and COVID-19 vaccines).
Time frame
Assessed at baseline, within 1 month and 4 months after the end of interventions.Secondary outcomes
1
Changes in Patient Activation Measure from baseline to within 1 month after intervention ends
Patient Activation Measure is a 4-point Likert scale measuring participants' confidence level and views on self-health management.
Time frame
At baseline and within one month after the end of the intervention (in the 1st follow-up assessment)2
Changes in Emotional engagement with vaccination decisions measurement from baseline to within 1 month after intervention ends
Emotional engagement with vaccination decisions will be measured by a 5-point Likert scale on the levels and types of emotions involved with vaccination decisions.
Time frame
At baseline and within one month after the end of the intervention (in the 1st follow-up assessment)3
Changes in Future time perspective measurement from baseline to within 1 month after intervention ends
A 5-point Likert scale measuring participants' future time perspecitve (i.e. participants' views on their future).
Time frame
At baseline and within one month after the end of the intervention (in the 1st follow-up assessment)4
Changes in lifestyle behaviours from baseline to within 1 month and 4 months after intervention ends
A set of questions will be used to measure particiants' lifestyle behaviours in terms of their frequency of smoking, drinking, physical activities, vegetable intake and fruit intake.
Time frame
At baseline and within one month (in the 1st follow-up assessment) and four months (2nd outcome assessment)after the end of the interventionSponsors and contacts
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Source ClinicalTrials.gov