Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 19, 2024
Date Accepted: Mar 3, 2025
Digital Health Intervention On Awareness Of Vaccination Against Influenza Among Adults With Diabetes: A Pragmatic Randomized Follow-up Study
ABSTRACT
Background:
Diabetes mellitus significantly increases the risk of severe complications from influenza, necessitating targeted vaccination efforts. Despite vaccination being the most effective preventive measure, coverage remains below WHO targets, partly due to limited awareness among patients.
Objective:
By utilizing a rigorous study framework for digital health data, this study aimed to demonstrate the effectiveness of digital health platforms in increasing vaccination rates among people with diabetes and to emphasize the impact of tailored messaging frequency on patient engagement and health behavior change. We hypothesized that digital tools providing empirical evidence of increased health risk awareness can effectively drive preventive actions.
Methods:
The study utilized the Dario digital health platform to randomly assign 64,904 users with diabetes into three groups: Group A received previously studied monthly flu nudge messages; Group B received an adapted intervention with 2-3 monthly messages; Group C served as the control with no intervention. Surveys were conducted at baseline, three months, and six months to assess vaccination status, awareness of influenza risks, and recollection of educational content. Statistical analyses, including logistic regression, Chi-square tests, and t-tests, were used to evaluate differences between groups.
Results:
Out of 64,904 users, 8,431 completed the surveys. Vaccination rates were 71.0% in Group A, 71.9% in Group B, and 70.5% in Group C. Group B showed significantly higher awareness of influenza risks compared to the control (OR=1.35, 95% CI: 1.12-1.63, P=.001), while Group A did not (OR=1.10, 95% CI: 0.92-1.32, P=.27). Recollection of educational content was also higher in Groups A (OR=1.29, 95% CI: 1.07-1.56, P=.008) and B (OR=1.92, 95% CI: 1.59-2.33, P<.001) compared to the control. Additionally, a significant correlation between awareness and vaccination rates was found only in Group B (χ2=6.12, P=.01).
Conclusions:
The adapted digital intervention (Group B) effectively increased awareness of influenza risks and recollection of educational content, which correlated with higher trend in vaccination rates. This study demonstrates the potential of digital health tools to enhance influenza vaccination among people with diabetes by improving risk awareness and education. Further research should focus on optimizing these interventions to achieve significant improvements in vaccination uptake and overall public health outcomes. Clinical Trial: NA
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