title: Patient education strategies to improve pneumococcal vaccination rates: randomized trial.
abstract: 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.
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Thomas
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ray
authors.forename: Felicia J
authors.initials: FJ
authors.lastname: Morton
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Drew
authors.forename: Gardiner
authors.initials: G
authors.lastname: Offutt
authors.forename: Cynthia G
authors.initials: CG
authors.lastname: Whitney
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
mesh_terms: 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
chemical_list: D022242:Pneumococcal Vaccines