Behavioral interventions for vaccination uptake: A systematic review and meta-analysis

•Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries.•The highest effect size was associated with Provider Recommendation and Onsite-vaccination.•Behavioral interventions should be employed to increase vaccination rates globally. Human behavior and more spe...

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Published in:Health policy (Amsterdam) Vol. 137; p. 104894
Main Authors: Malik, Amyn A., Ahmed, Noureen, Shafiq, Mehr, Elharake, Jad A., James, Erin, Nyhan, Kate, Paintsil, Elliott, Melchinger, Hannah Camille, Team, Yale Behavioral Interventions, Malik, Fauzia A., Omer, Saad B.
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.11.2023
Subjects:
Behavioral interventions
Databases, Factual
Health Facilities
Humans
Internal Medicine
Meta-analysis
Motivation
Systematic review
Vaccination
Vaccine uptake
Vaccines
Behavioral interventions
Systematic review
Vaccine uptake
Meta-analysis
ISSN:0168-8510, 1872-6054, 1872-6054
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Abstract •Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries.•The highest effect size was associated with Provider Recommendation and Onsite-vaccination.•Behavioral interventions should be employed to increase vaccination rates globally. Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5–4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3–3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. Our findings indicate that “provider recommendation” and “on-site vaccination” along with other behavioral interventions can be employed to increase vaccination rates globally.
AbstractList Highlights•Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries. •The highest effect size was associated with Provider Recommendation and Onsite-vaccination. •Behavioral interventions should be employed to increase vaccination rates globally.
Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries.BACKGROUNDHuman behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries.We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately.METHODSWe included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately.Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes.FINDINGSOur results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes.Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.INTERPRETATIONOur findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
•Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries.•The highest effect size was associated with Provider Recommendation and Onsite-vaccination.•Behavioral interventions should be employed to increase vaccination rates globally. Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5–4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3–3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. Our findings indicate that “provider recommendation” and “on-site vaccination” along with other behavioral interventions can be employed to increase vaccination rates globally.
Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative reviews indexed in Medline on behavioral interventions to increase vaccine uptake, to our knowledge, none have been systematic reviews and meta-analyses covering not just high but also low-and-middle income countries. We included 613 studies from the Medline database in our systematic review and meta-analysis categorizing different behavioral interventions in 9 domains: education campaigns, on-site vaccination, incentives, free vaccination, institutional recommendation, provider recommendation, reminder and recall, message framing, and vaccine champion. Additionally, considering that there is variability in the acceptance of vaccines among different populations, we assessed studies from both high-income countries (HICs) and low- to middle-income countries (LMICs), separately. Our results showed that behavioral interventions can considerably improve vaccine uptake in most settings. All domains that we examined improved vaccine uptake with the highest effect size associated with provider recommendation (OR: 3.4 (95%CI: 2.5-4.6); Domain: motivation) and on-site vaccination (OR: 2.9 (95%CI: 2.3-3.7); Domain: practical issues). While the number of studies conducted in LMICs was smaller, the quality of studies was similar with those conducted in HICs. Nevertheless, there were variations in the observed effect sizes. Our findings indicate that "provider recommendation" and "on-site vaccination" along with other behavioral interventions can be employed to increase vaccination rates globally.
ArticleNumber 104894
Author Ahmed, Noureen
Elharake, Jad A.
Malik, Fauzia A.
James, Erin
Omer, Saad B.
Malik, Amyn A.
Nyhan, Kate
Shafiq, Mehr
Melchinger, Hannah Camille
Team, Yale Behavioral Interventions
Paintsil, Elliott
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  surname: Ahmed
  fullname: Ahmed, Noureen
  organization: UT Southwestern Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, USA
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  surname: Shafiq
  fullname: Shafiq, Mehr
  organization: Yale Institute for Global Health, New Haven, CT 06510, USA
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  surname: Elharake
  fullname: Elharake, Jad A.
  organization: Yale Institute for Global Health, New Haven, CT 06510, USA
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  fullname: James, Erin
  organization: Yale Institute for Global Health, New Haven, CT 06510, USA
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  organization: Yale University, New Haven, CT 06510, USA
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  organization: Yale Institute for Global Health, New Haven, CT 06510, USA
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  givenname: Hannah Camille
  surname: Melchinger
  fullname: Melchinger, Hannah Camille
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  surname: Team
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  organization: Yale Institute for Global Health, New Haven, CT 06510, USA
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  givenname: Fauzia A.
  surname: Malik
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  givenname: Saad B.
  surname: Omer
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  email: saad.omer@utsouthwestern.edu
  organization: UT Southwestern Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/37714082$$D View this record in MEDLINE/PubMed
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Snippet •Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries.•The highest effect size was associated with Provider...
Highlights•Behavioral interventions improve vaccine uptake in high-income and low-middle-income countries. •The highest effect size was associated with...
Human behavior and more specifically behavioral insight-based approaches to vaccine uptake have often been overlooked. While there have been a few narrative...
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SubjectTerms Behavioral interventions
Databases, Factual
Health Facilities
Humans
Internal Medicine
Meta-analysis
Motivation
Systematic review
Vaccination
Vaccine uptake
Vaccines
Title Behavioral interventions for vaccination uptake: A systematic review and meta-analysis
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https://www.clinicalkey.es/playcontent/1-s2.0-S0168851023001793
https://dx.doi.org/10.1016/j.healthpol.2023.104894
https://www.ncbi.nlm.nih.gov/pubmed/37714082
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Volume 137
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