Increasing Vaccine Uptake Through Performance Feedback: A Cluster Randomized Trial

Last registered on December 20, 2019

Pre-Trial

Trial Information

General Information

Title
Increasing Vaccine Uptake Through Performance Feedback: A Cluster Randomized Trial
RCT ID
AEARCTR-0005196
Initial registration date
December 19, 2019
Last updated
December 20, 2019, 11:02 AM EST

Locations

Primary Investigator

Affiliation
Office of Evaluation Sciences / General Services Administration

Other Primary Investigator(s)

PI Affiliation
Atlanta VA Health Care System / Emory University
PI Affiliation
Atlanta VA Health Care System
PI Affiliation
Atlanta VA Health Care System
PI Affiliation
Office of Evaluation Sciences / General Services Administration
PI Affiliation
Office of Evaluation Sciences / General Services Administration
PI Affiliation
Office of Evaluation Sciences / General Services Administration

Additional Trial Information

Status
On going
Start date
2019-10-30
End date
2020-06-30
Secondary IDs
Abstract
The Office of Evaluation Sciences is collaborating with the Atlanta VA Health Care System to increase seasonal flu immunizations among veterans. The intervention targets physicians, advanced practice providers, and nurses. It includes a behaviorally informed performance report card that compares the vaccination rates for the recipient patient aligned care team (PACT) to the top ten percent of PACTs in the Atlanta VA Health Care System. Report cards will be delivered via email. They also include an attached PDF leaflet with evidence-based actionable recommendations for PACTs and a link to frequently asked questions on the intervention, data used and why providers are receiving the report card email. The intervention will be delivered to PACTs monthly in four rounds, from early November through early February. Final, patient-level outcomes data will be pulled from Atlanta VA’s electronic health record system one month after the final delivery of the intervention.
External Link(s)

Registration Citation

Citation
Debroy, Pompa et al. 2019. "Increasing Vaccine Uptake Through Performance Feedback: A Cluster Randomized Trial." AEA RCT Registry. December 20. https://doi.org/10.1257/rct.5196-1.0
Experimental Details

Interventions

Intervention(s)
The provider-based intervention includes a monthly performance feedback embedded in performance report cards (send 4 times in monthly iterations). It includes information about provider team’s current and past vaccination rates, as well as the number of unvaccinated patients in their patient’s panel (all for the 2019-2020 flu season). In addition, vaccination rates -- in the form of social peer feedback - of the “Top 10%” of provider teams at Atlanta’s VA are provided. The report card intervention also highlights the HealthyPeople2020 vaccination target for adults 18-64 (i.e., 70%). Next to the report card, evidence-based recommendations are shared with provider teams to increase flu vaccination rates, as well as a link to a Frequently Asked Questions document that outlines why providers are receiving the report card and how vaccination rates are calculated.
Intervention Start Date
2019-11-04
Intervention End Date
2020-03-31

Primary Outcomes

Primary Outcomes (end points)
Percent of patients receiving the influenza vaccine within the study period (11/4/2019 -- 2/29/2020) [Time Frame: 4 months ]
Primary Outcomes (explanation)
We count influenza vaccine obtained at the Atlanta VA, as well outside of the VA system and reported to the VA (which results in a date-time-stamped record of vaccination in the VA’s EHR system).

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The intervention is designed to target patients of primary care provider teams (physicians, advanced practice providers and nurses) in the Atlanta VA Medical System. Primary care provider teams will be assigned to a provider-side treatment (behaviorally-informed performance feedback embedded in a report card) or to control (business as usual; no report card feedback). Outcomes will be tracked for all patients who are empaneled with provider teams.

The research team will evaluate the intervention using a clustered randomized controlled trial.
Experimental Design Details
Randomization Method
Randomization (blocked by cluster size and geographical location) done by a computer
Randomization Unit
Patient-Aligned Care Teams (PACT)
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
82 PACTs
Sample size: planned number of observations
Approx. 106,000 patients (at intervention implementation of round #1)
Sample size (or number of clusters) by treatment arms
Varies between 152 and 1,652 patients per PACT (at intervention implementation of round #1)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
MDE: 2.69 percentage points
IRB

Institutional Review Boards (IRBs)

IRB Name
IRB Approval Date
IRB Approval Number

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials