Trial reportBMC infectious diseases2016
Using the 4 pillars™ practice transformation program to increase adult influenza vaccination and reduce missed opportunities in a randomized cluster trial.
Trial report in BMC infectious diseases, 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 21 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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Behavioral interventions for vaccination uptake: A systematic review and meta-analysis.Health policy (Amsterdam, Netherlands) · 2023Pooled it
- Using the 4 Pillars to increase vaccination among high-risk adults: who benefits?The American journal of managed care · 2017Trial
- Trial
- Time-Stamped Annotations in High-Frequency Physiological Data: Evaluating an Approach for Assessing Annotation Plausibility in the CENTER-TBI Dataset.Neurocritical care · 2026Article
- Evaluation of a nurse-led pneumococcal vaccination program in a day hospital.BMC health services research · 2026Observational
- Vaccination Strategies Against Respiratory Pathogens in the Adult Population: A Narrative Review.Vaccines · 2026Review
- Assessing vaccine coverage and delivery strategies for influenza and COVID-19 among Italian healthcare workers: A 2015-2023 case study.Human vaccines & immunotherapeutics · 2025Article
- Co-Administration of BNT162b2 COVID-19 and Influenza Vaccines in Adults: A Global Systematic Review.Vaccines · 2025Review
- Review
- Infectious Disease as a Modifiable Risk Factor for Dementia: A Narrative Review.Pathogens (Basel, Switzerland) · 2024Review
- The Effect of a Quality Improvement Project on Improving Patients' Willingness to Receive an Influenza Vaccination in the Emergency Department.Journal of immigrant and minority health · 2024Article
- Implementing evidence-based practices in rural settings: a scoping review of theories, models, and frameworks.Frontiers in health services · 2024Article
- The need for vaccination in adults with chronic (noncommunicable) diseases in India - lessons from around the world.Human vaccines & immunotherapeutics · 2022Article
- Digital Health Interventions to Enhance Prevention in Primary Care: Scoping Review.JMIR medical informatics · 2022Article
- Systematic review on reducing missed opportunities for vaccinations in Latin America.Revista panamericana de salud publica = Pan American journal of public health · 2022Article
- Improving influenza and pneumococcal vaccination uptake among incident peritoneal dialysis patients: a quality improvement initiative.International urology and nephrology · 2021Article
- Article
- Cost-Effectiveness of Pneumococcal Vaccination and Uptake Improvement Programs in Underserved and General Population Adults Aged < 65 Years.Journal of community health · 2020Article
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAn evidence-based, step-by-step guide, the 4 Pillars™ Practice Transformation Program, was the foundation of an intervention to increase adult immunizations in primary care and was tested in a randomized controlled cluster trial. The purpose of this study is to report changes in influenza immunization rates and on factors related to receipt of influenza vaccine.
methodsTwenty five primary care practices were recruited in 2013, stratified by city (Houston, Pittsburgh), location (rural, urban, suburban) and type (family medicine, internal medicine), and randomized to the intervention (n = 13) or control (n = 12) in Year 1 (2013-14). A follow-up intervention occurred in Year 2 (2014-15). Demographic and vaccination data were derived from de-identified electronic medical record extractions.
resultsA cohort of 70,549 adults seen in their respective practices (n = 24 with 1 drop out) at least once each year was followed. Baseline mean age was 55.1 years, 35 % were men, 21 % were non-white and 35 % were Hispanic. After one year, both intervention and control arms significantly (P < 0.001) increased influenza vaccination, with average increases of 2.7 to 6.5 percentage points. In regression analyses, likelihood of influenza vaccination was significantly higher in sites with lower percentages of patients with missed opportunities (P < 0.001) and, after adjusting for missed opportunities, the intervention further improved vaccination rates in Houston (lower baseline rates) but not Pittsburgh (higher baseline rates). In the follow-up intervention, the likelihood of vaccination increased for both intervention sites and those that reduced missed opportunities (P < 0.005).
conclusionsReducing missed opportunities across the practice increases likelihood of influenza vaccination of adults. The 4 Pillars™ Practice Transformation Program provides strategies for reducing missed opportunities to vaccinate adults.
trial registrationThis study was registered as a clinical trial on 03/20/2013 at ClinicalTrials.gov, Clinical Trial Registry Number: NCT01868334 , with a date of enrollment of the first participant to the trial of April 1, 2013.
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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.