Observational studyJournal of general internal medicine2017
Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates.
Observational study in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04660032 (Randomized Evaluation of Hypertensive Moms), which is not on this map. Cited by 57 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Randomized Evaluation of Hypertensive Moms: Interventional Nudge to Drive Transitions of Care
Who cites it
57 citing papers in PubMed, 7 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Assessing the Impact of Behavioral Sciences Interventions on Chronic Disease Prevention and Management: A Systematic Review of Randomized Controlled Trials.International journal of environmental research and public health · 2024Pooled it
- Behavioral interventions for vaccination uptake: A systematic review and meta-analysis.Health policy (Amsterdam, Netherlands) · 2023Pooled it
- A rapid global review of strategies to improve influenza vaccination uptake in Australia.Human vaccines & immunotherapeutics · 2021Pooled it
- Nudging toward vaccination: a systematic review.BMJ global health · 2021Pooled it
- Interventions on health care providers to improve seasonal influenza vaccination rates among patients: a systematic review and meta-analysis of the evidence since 2000.Family practice · 2021Pooled it
- Pooled it
- The effectiveness of behavioral economics-informed interventions on physician behavioral change: A systematic literature review.PloS one · 2020Pooled it
- Health care providers acceptance of default prescribing of TB preventive treatment for people living with HIV in Malawi: a qualitative study.BMC health services research · 2024Trial
- Effect of Integrating Access to a Prescription Drug Monitoring Program Within the Electronic Health Record on the Frequency of Queries by Primary Care Clinicians: A Cluster Randomized Clinical Trial.JAMA health forum · 2022Trial
- Impact of Behavioral Nudges on the Quality of Serious Illness Conversations Among Patients With Cancer: Secondary Analysis of a Randomized Controlled Trial.JCO oncology practice · 2022Trial
- Effect of Electronic Health Record Reminders for Routine Immunizations and Immunizations Needed for Chronic Medical Conditions.Applied clinical informatics · 2021Trial
- Effect of Targeted Behavioral Science Messages on COVID-19 Vaccination Registration Among Employees of a Large Health System: A Randomized Trial.JAMA network open · 2021Trial
- Architecting Process of Care: A randomized controlled study evaluating the impact of providing nonadherence information and pharmacist assistance to physicians.Health services research · 2020Trial
- Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin Prescribing: The PRESCRIBE Cluster Randomized Clinical Trial.JAMA network open · 2018Trial
- Electronic Health Record Integration of a Calculator for Cesarean Risk During Labor Induction.Learning health systems · 2026Article
- Machine Learning Prediction and Reducing Overdoses With Electronic Health Record Nudges (mPROVEN) in the Primary Care Setting: Protocol for a Cluster Randomized Controlled Trial.JMIR research protocols · 2026Article
- The role of behavioral nudges in sustaining public health engagement through the "Tawakkalna" app: insights from healthcare professionals.Frontiers in public health · 2026Article
- Article
- Choice-architecture TB preventive therapy prescribing for HIV patients in Mozambique.Public health action · 2025Article
- Development and validation of a pragmatic measure of cocreation in research engagement: a study protocol.BMJ open · 2024Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite the benefits of influenza vaccination, each year more than half of adults in the United States do not receive it.
objectiveTo evaluate the association between an active choice intervention in the electronic health record (EHR) and changes in influenza vaccination rates.
designObservational study. PATIENTS: Adults eligible for influenza vaccination with a clinic visit at one of three internal medicine practices at the University of Pennsylvania Health System between September 2010 and March 2013.
interventionThe EHR confirmed patient eligibility during the clinic visit and, upon accessing the patient chart, prompted the physician and their medical assistant to actively choose to "accept" or "cancel" an order for the influenza vaccine. MAIN MEASURES: Change in influenza vaccination order rates at the intervention practice compared to two control practices for the 2012-2013 flu season, comparing trends during the prior two flu seasons adjusting for time trends and patient and clinic visit characteristics. KEY
resultsThe sample (n = 45,926 patients) was 62.9% female, 35.9% white, and 54.4% black, with a mean age of 50.2 years. Trends were similar between practices during the 2 years in the pre-intervention period. Vaccination rates increased in both groups in the post-intervention year, but the intervention practice using active choice had a significantly greater increase than the control (adjusted difference-in-difference: 6.6 percentage points; 95% CI, 5.1-8.1; P < 0.001), representing a 37.3% relative increase compared to the pre-intervention period. More than 99.9% (9938/9941) of orders placed during the study period resulted in vaccination.
conclusionsActive choice through the EHR was associated with a significant increase in influenza vaccination rates.
Indexed as
Identifiers
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.