title: Randomised active programs on healthcare workers' flu vaccination in geriatric health care settings in France: the VESTA study.
abstract: BACKGROUND
  Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination.
  
  
  OBJECTIVE
  To implement multicenter programs to enhance HCW influenza vaccination.
  
  
  METHODS
  It was a cluster randomised interventional studies.
  
  
  METHODS
  43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France.
  
  
  METHODS
  1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group.
  
  
  METHODS
  After the failure of a first educational program giving scientific information and. tested during the 2005-06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of "safety zones", and to give personal satisfaction. Program 2 was tested during the 2006-07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs).
  
  
  METHODS
  The efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters.
  
  
  RESULTS
  Program 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p > 0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p < 0.001) regardless their occupational group but only in the non previous vaccinated subgroup.
  
  
  CONCLUSIONS
  In geriatric health care centres in France, an active multicenter program giving personal satisfaction and taking into account the profile of non-vaccinated HCWs was more effective in promoting flu vaccination than a scientifically factual information program. HCW involvement is required in program implementation in order to avoid rejection of top-down information.
authors.affiliation: ORIG (French Geriatric Infection Risk Institute), Charles Foix Hospital, AP-HP (Publicly-owned hospitals of Paris), Ivry-sur-Seine, France. monique.r-tondeur@cfx.ap-hop-paris.fr
authors.forename: M
authors.initials: M
authors.lastname: Rothan-Tondeur
authors.forename: Y
authors.initials: Y
authors.lastname: Filali-Zegzouti
authors.forename: J-L
authors.initials: JL
authors.lastname: Golmard
authors.forename: B
authors.initials: B
authors.lastname: De Wazieres
authors.forename: F
authors.initials: F
authors.lastname: Piette
authors.forename: F
authors.initials: F
authors.lastname: Carrat
authors.forename: B
authors.initials: B
authors.lastname: Lejeune
authors.forename: G
authors.initials: G
authors.lastname: Gavazzi
mesh_terms: D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D016000:Cluster Analysis; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D005602:France; D005853:Geriatrics; D006282:Health Personnel / Q000523:psychology*; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D009784:Occupational Diseases / Q000517:prevention & control; D015397:Program Evaluation; D014611:Vaccination / Q000523:psychology
chemical_list: D007252:Influenza Vaccines