Trial reportJournal of the American Geriatrics Society2017
Using the 4 Pillars Practice Transformation Program to Increase Pneumococcal Immunizations for Older Adults: A Cluster-Randomized Trial.
Trial report in Journal of the American Geriatrics Society, 2017. 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 28 papers, 2 of them syntheses 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
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Pooled it
- Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation.The Cochrane database of systematic reviews · 2021Pooled it
- Using the 4 Pillars to increase vaccination among high-risk adults: who benefits?The American journal of managed care · 2017Trial
- Trial
- Cost-Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older.Journal of the American Geriatrics Society · 2017Trial
- Trial
- Using the 4 pillars™ practice transformation program to increase adult influenza vaccination and reduce missed opportunities in a randomized cluster trial.BMC infectious diseases · 2016Trial
- Trial
- Factors associated with pneumococcal vaccine hesitancy and interventions to improve vaccine uptake in older adults: A narrative review using an established conceptual framework.Human vaccines & immunotherapeutics · 2026Review
- Interventions to improve pneumococcal vaccination coverage: A systematic review and meta-analysis.Infectious medicine · 2026Review
- Vaccination Strategies Against Respiratory Pathogens in the Adult Population: A Narrative Review.Vaccines · 2026Review
- Article
- Utilization of Provider-Patient Communication Tools and Approaches to Facilitate Vaccine Confidence: A Systematic Review.Vaccines · 2025Review
- Review
- Review
- A review of factors influencing vaccination policies and programs for older adults globally.Human vaccines & immunotherapeutics · 2023Review
- Increasing pneumococcal vaccine uptake in older adults: a scoping review of interventions in high-income countries.BMC geriatrics · 2023Article
- An overview of implementing an evidence based program to increase HPV vaccination in HIV community clinics.BMC public health · 2022Article
- Cost-Effectiveness of Newly Recommended Pneumococcal Vaccination Strategies in Older Underserved Minority Adults in the USA.Infectious diseases and therapy · 2022Article
- Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review.JMIR medical informatics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesTo test the effectiveness of a step-by step, evidence-based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination.
designRandomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre-post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions.
settingPrimary care practices (n = 25) stratified according to metropolitan area (Houston, Pittsburgh), location (rural, urban, suburban), and type (family medicine, internal medicine), randomized to receive the intervention in Year 1 (n = 13) or Year 2 (n = 12).
participantsIndividuals aged 65 and older at baseline (N = 18,107; mean age 74.2; 60.7% female, 16.5% non-white, 15.7% Hispanic).
interventionThe 4 Pillars Program, provider education, and one-on-one coaching of practice-based immunization champions. Outcome measures were 23-valent pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV) vaccination rates and percentage point (PP) changes in vaccination rates.
resultsIn the Year 1 RCCT, PPSV vaccination rates increased significantly in all intervention and control groups, with average increases ranging from 6.5 to 8.7 PP (P < .001). The intervention was not related to greater likelihood of PPSV vaccination. In the Year 2 pre-post study, the likelihood of PPSV and PCV vaccination was significantly higher in the active intervention sites than the maintenance sites in Pittsburgh but not in Houston.
conclusionIn a RCCT, PPSV vaccination rates increased in the intervention and control groups in Year 1. In a pre-post study, private primary care practices actively participating in the 4 Pillars Practice Transformation Program improved PPSV and PCV uptake significantly more than practices that were in the maintenance phase of the study.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.