Trial reportVaccine2016
Using the 4 Pillars™ Practice Transformation Program to increase adult Tdap immunization in a randomized controlled cluster trial.
Trial report in Vaccine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01868334 (A Vaccination SOP Toolkit in Diverse Practices Implemented & Tested With RE-AIM), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Vaccination SOP Toolkit in Diverse Practices Implemented & Tested With RE-AIM
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Using the 4 Pillars to increase vaccination among high-risk adults: who benefits?The American journal of managed care · 2017Trial
- Trial
- Utilization of Provider-Patient Communication Tools and Approaches to Facilitate Vaccine Confidence: A Systematic Review.Vaccines · 2025Review
- Adult vaccination coverage in the United States: A database analysis and literature review of improvement strategies.Human vaccines & immunotherapeutics · 2024Review
- Review
- Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review.JMIR medical informatics · 2022Article
- Article
- Article
- Emergency Department influenza vaccination campaign allows increasing influenza vaccination coverage without disrupting time interval quality indicators.Internal and emergency medicine · 2018Observational
- Cost-effectiveness of increasing vaccination in high-risk adults aged 18-64 Years: a model-based decision analysis.BMC infectious diseases · 2018Article
- Cost effectiveness of a practice-based intervention to improve vaccination rates in adults less than 65-years-old.Human vaccines & immunotherapeutics · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
introductionNational adult Tdap vaccination rates are low, reinforcing the need to increase vaccination efforts in primary care offices. The 4 Pillars™ Practice Transformation Program is an evidence-based, step-by-step guide to improving primary care adult vaccination with an online implementation tracking dashboard. This study tested the effectiveness of an intervention to increase adult Tdap vaccination that included the 4 Pillars™ Program, provider education, and one-on-one coaching of practice-based immunization champions.
methods25 primary care practices participated in a randomized controlled cluster trial (RCCT) in Year 1 (6/1/2013-5/31/2014) and a pre-post study in Year 2 (6/1/2014-1/31/2015). Baseline year was 6/1/2012-5/31/2013, with data analyzed in 2016. Demographic and vaccination data were derived from de-identified electronic medical record (EMR) extractions. The primary outcomes were vaccination rates and percentage point (PP) changes/year.
resultsThe cohort consisted of 70,549 patients ⩾18years who were seen in the practices ⩾1 time each year, with a baseline mean age=55years; 35% were men; 56% were non-white; 35% were Hispanic and 20% were on Medicare. Baseline vaccination rate averaged 35%. In the Year 1 RCCT, cumulative Tdap vaccination increased significantly in both intervention and control groups; in both cities, the percentage point increases in the intervention groups (7.7 PP in Pittsburgh and 9.9 PP in Houston) were significantly higher (P<0.001) than in the control groups (6.4 PP in Pittsburgh and 7.6 PP in Houston). In the Year 2 pre-post study, in both cities, active intervention groups increased rates significantly more (6.2 PP for both) than maintenance groups (2.2 PP in Pittsburgh and 4.1 PP in Houston; P<0.001).
conclusionsAn intervention that includes the 4 Pillars™ Practice Transformation Program, staff education and coaching is effective for increasing adult Tdap immunization rates within primary care practices. Clinical Trial Registry Name/Number: NCT01868334.
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