title: How to develop a program to increase influenza vaccine uptake among workers in health care settings?
abstract: BACKGROUND
  Apart from direct protection and reduced productivity loss during epidemics, the main reason to immunize healthcare workers (HCWs) against influenza is to provide indirect protection of frail patients through reduced transmission in healthcare settings. Because the vaccine uptake among HCWs remains far below the health objectives, systematic programs are needed to take full advantage of such vaccination. In an earlier report, we showed a mean 9% increase of vaccine uptake among HCWs in nursing homes that implemented a systematic program compared with control homes, with higher rates in those homes that implemented more program elements. Here, we report in detail the process of the development of the implementation program to enable researchers and practitioners to develop intervention programs tailored to their setting.
  
  
  METHODS
  We applied the intervention mapping (IM) method to develop a theory- and evidence-based intervention program to change vaccination behaviour among HCWs in nursing homes.
  
  
  RESULTS
  After a comprehensive needs assessment, we were able to specify proximal program objectives and selected methods and strategies for inducing behavioural change. By consensus, we decided on planning of three main program components, i.e., an outreach visit to all nursing homes, plenary information meetings, and the appointment of a program coordinator -- preferably a physician -- in each home. Finally, we planned program adoption, implementation, and evaluation.
  
  
  CONCLUSIONS
  The IM methodology resulted in a systematic, comprehensive, and transparent procedure of program development. A potentially effective intervention program to change influenza vaccination behaviour among HCWs was developed, and its impact was assessed in a clustered randomised controlled trial.
authors: University of Groningen, Department of Pharmacy, Pharmacoepidemiology and Pharmacoeconomy, A, Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors: Ingrid
authors: I
authors: Looijmans-van den Akker
authors: Marlies E
authors: ME
authors: Hulscher
authors: Theo Jm
authors: TJ
authors: Verheij
authors: Josien
authors: J
authors: Riphagen-Dalhuisen
authors: Johan Jm
authors: JJ
authors: van Delden
authors: Eelko
authors: E
authors: Hak
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