title: Changing the default to promote influenza vaccination among health care workers.
abstract: BACKGROUND
  The prevention of health care acquired infections is an important objective for patient safety and infection control in all health care settings. Influenza vaccination uptake among health care workers (HCWs) is the most effective method to prevent transmission to patients, but vaccination coverage rates are low among HCWs. Several educational campaigns have been developed to increase the influenza vaccination coverage rates of HCWs, but showed only small effects. The aim of this study was to test an opt-out strategy in promoting uptake among HCWs in a tertiary care center for patients with complex chronic organ failure.
  
  
  METHODS
  HCWs were randomly assigned to one of two conditions. In the opt-out condition (N=61), participants received an e-mail with a pre-scheduled appointment for influenza vaccination, which could be changed or canceled. In the opt-in condition (N=61), participants received an e-mail explaining that they had to schedule an appointment if they wanted to get vaccinated.
  
  
  RESULTS
  The findings show no statistically detectable effect of condition on being vaccinated against influenza. However, HCWs in the opt-out condition were more likely to have an appointment for influenza vaccination, which in turn increased the probability of getting vaccinated.
  
  
  CONCLUSIONS
  To change the default to promote influenza vaccination among HCWs might be an easy and cost-effective alternative to the complex vaccination campaigns that have been proposed in recent years.
authors: Center for Infectious Disease Control, Epidemiology and Surveillance, National Institute for Public Health and the Environment (RIVM), PO Box 1, Bilthoven, BA 3720, The Netherlands. Electronic address: birthe.lehmann@rivm.nl.
authors: Birthe A
authors: BA
authors: Lehmann
authors: Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA. Electronic address: gretchen.chapman@rutgers.edu.
authors: Gretchen B
authors: GB
authors: Chapman
authors: CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, Horn, NM 6085, The Netherlands. Electronic address: fritsfranssen@ciro-horn.nl.
authors: Frits M E
authors: FM
authors: Franssen
authors: Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands. Electronic address: g.kok@maastrichtuniversity.nl.
authors: Gerjo
authors: G
authors: Kok
authors: Department of Work & Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands. Electronic address: r.ruiter@maastrichtuniversity.nl.
authors: Robert A C
authors: RA
authors: Ruiter
mesh_terms: D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control; D034742:Electronic Mail; D005260:Female; D006282:Health Personnel; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D009426:Netherlands; D009784:Occupational Diseases / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Default; Health care workers; Influenza; Intervention; Vaccination