Patient education strategies to improve pneumococcal vaccination rates: randomized trial.
BACKGROUND
The pneumococcal vaccine is widely underused. Patient education is one mechanism not widely explored for increasing vaccination rates.


OBJECTIVE
To evaluate the effects of a culturally appropriate patient education videotape on pneumococcal vaccination rates among the clinic population of an inner-city public hospital.


METHODS
Randomized, controlled trial comparing (1) a videotape-brochure group who both viewed the videotape and received a low-literacy brochure, (2) a videotape only group, and (3) a control group.


RESULTS
Of 2,962 charts reviewed, 558 patients were randomized. The study population was 94% black, 73% female, and elderly (mean age 63.0 years) and 64% had less than a high school education. Patients in the videotape-brochure group were 2.5 (1.8, 3.5 95% CI) times more likely to discuss the vaccine with their physician (p < .001) and 3.5 (1.9, 6.5 95% CI) times more likely to receive the vaccine (p < .001) than the control group. The videotape-brochure group was 1.6 (1.2, 2.1 95% CI) times more likely to discuss the vaccine (p < .001) and 2.3 (1.4, 3.8 95% CI) times more likely to receive the vaccine (p = .002) than the video only group. Patients in the video only group were 1.6 (1.1, 2.3 95% CI) times more likely to discuss the vaccine with their physician than the control group (p = .041) but were not more likely to receive the vaccine.


CONCLUSIONS
A culturally appropriate videotape along with a low-literacy brochure significantly increased pneumococcal vaccination rates and physician-patient discussion about the vaccine. These significant outcomes were not observed with use of videotape alone and were likely attributable to the effect of the brochure. We recommend that patient education initiatives to increase vaccination rates not focus solely on audiovisual media.
Thomas
Donna M
DM
Department of Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
Ray
Susan M
SM
Morton
Felicia J
FJ
Drew
Jennifer S
JS
Offutt
Gardiner
G
Whitney
Cynthia G
CG
Jacobson
Terry A
TA
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D022242:Pneumococcal Vaccines; D014611:Vaccination / Q000706:statistics & numerical data*; D014743:Videotape Recording
D022242:Pneumococcal Vaccines