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Worksite: Seasonal Influenza Vaccinations Using Interventions with Actively Promoted, Off-Site Vaccinations – Healthcare Workers


What the CPSTF Found

About The Systematic Review

The Task Force finding is based on evidence from a systematic review of 1 study (search period through March 2008). The review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to worksite health promotion.


Interventions with actively promoted, off-site influenza vaccinations encourage workers in healthcare worksites to obtain influenza vaccinations in a location other than that in which they normally work using any of a variety of approaches. These include providing vouchers or leave time, conducting health education sessions, and sending reminders about the vaccination. The intervention must be promoted through formal worksite announcements, such as newsletters, e-mails, paycheck inserts, or posters in the worksite and may include additional components.

Summary of Results

Detailed results from the systematic review are available in the Task Force Finding and Rationale Statement pdf icon [PDF - 129 kB].

One study was included in the review.

  • Authors reported small, non-significant findings when comparing the treatment and control groups: 21.9 percent versus 21.0 percent (p=.91) among primary healthcare teams and 10.2 percent versus 5.6 percent (p=.34) among nursing homes.

Summary of Economic Evidence

An economic review of this intervention was not conducted because the Task Force did not have enough information to determine if the intervention works.


Applicability of this intervention across different settings and populations was not assessed because the Task Force did not have enough information to determine if the intervention works.

Evidence Gaps

Each Community Preventive Services Task Force (Task Force) review identifies critical evidence gaps—areas where information is lacking. Evidence gaps can exist whether or not a recommendation is made. In cases when the Task Force finds insufficient evidence to determine whether an intervention strategy works, evidence gaps encourage researchers and program evaluators to conduct more effectiveness studies. When the Task Force recommends an intervention, evidence gaps highlight missing information that would help users determine if the intervention could meet their particular needs. For example, evidence may be needed to determine where the intervention will work, with which populations, how much it will cost to implement, whether it will provide adequate return on investment, or how users should structure or deliver the intervention to ensure effectiveness. Finally, evidence may be missing for outcomes different from those on which the Task Force recommendation is based.

Identified Evidence Gaps

The following outlines evidence gaps for these interventions to promote seasonal influenza vaccinations among healthcare workers: on-site, free, actively promoted vaccinations; and actively promoted off-site vaccinations.

Although the body of evidence is strong, the field would benefit from research into the following questions:

  • How do the observed successes in large hospitals and long-term care facilities translate to coalitions of smaller healthcare facilities that may share health promotion resources or family practice clinics that operate on their own?
  • In what ways do current interventions with on-site, no-cost, actively promoted influenza vaccinations create, add to, reduce, or eliminate disparities among sub-groups of HCP?
  • What additional barriers should implementers address to achieve influenza vaccination coverage of greater than 90% among HCP?

Finally, as was shown in the review for general worksites, the overall body of knowledge for off-site, promoted interventions is weak. With only one study with small and non-significant effect measure, in spite of the study’s use of rigorous methods, in the body of literature that analyzed this approach, we were unable to conclude on its effectiveness.

Study Characteristics

The included study was a randomized, controlled trial that evaluated the effectiveness of health education approaches to increase influenza vaccinations off-site with primary care providers (as opposed to the entire HCW population).