title: Stepwise intervention including 1-on-1 counseling is highly effective in increasing influenza vaccination among health care workers.
abstract: BACKGROUND
  The influenza vaccination rate among health care workers (HCWs) remains suboptimal. We attempted to increase vaccine uptake in HCWs by nonmandatory measures, including 1-on-1 counseling.
  
  
  METHODS
  In 2015 we used a stepwise approach including (1) text messaging on the last day of the vaccination period, (2) extending the vaccination period by 3 days, (3) education for the low uptake group, and (4) 1-on-1 counseling for unvaccinated HCWs after the 3 interventions.
  
  
  RESULTS
  There were 1,433 HCWs included. By the end of the initial 3 days, the uptake rate was 80.0% (1,146/1,433). During an extension for a further 3 days, 33 additional HCWs received the vaccine. One month after starting the vaccination, 90.1% (1,291/1,433) of the HCWs were vaccinated, but this included only 76.1% (210/276) of the doctors (lowest among HCWs). After 3 educational presentations targeted at the unvaccinated doctors, no additional individuals were vaccinated in the following 2 weeks. After 1-on-1 counseling for unvaccinated HCWs, the overall vaccination rate increased to 94.7% (1,357/1,433) in 2015, higher than in the previous year (82.5%, P < .001). Of the unvaccinated doctors, 63.2% (43/68) were vaccinated, therefore achieving 92.4% (255/276) compliance, higher than the 56.5% in the previous year (152/269, P < .001).
  
  
  CONCLUSIONS
  Stepwise intervention including 1-on-1 counseling is effective in increasing influenza vaccination rates among HCWs.
authors.affiliation: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea; Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea. Electronic address: jubaragiy@naver.com.
authors.forename: Younghee
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Konyang University Hospital, Daejeon, Republic of Korea.
authors.forename: Mihye
authors.initials: M
authors.lastname: Kwon
authors.affiliation: Department of Occupational Health Care, Konyang University Hospital, Daejeon, Republic of Korea.
authors.forename: Jeongmi
authors.initials: J
authors.lastname: Song
mesh_terms: D001291:Attitude of Health Personnel; D003376:Counseling / Q000379:methods*; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D016014:Linear Models; D008297:Male; D016272:Occupational Health; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology*
chemical_list: D007252:Influenza Vaccines
keywords: Health care workers; Influenza vaccination