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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>People with diabetes (PWD) have an increased risk of developing influenza-related complications, including pneumonia, abnormal glycemic events, and hospitalization. Annual influenza vaccination is recommended for PWD, but vaccination rates are suboptimal. The study aimed to increase influenza vaccination rate in people with self-reported diabetes. This study was a prospective, 1:1 randomized controlled trial of a 6-month Digital Diabetes Intervention in U.S. adults with diabetes. The intervention group received monthly messages through an online health platform. The control group received no intervention. Difference in self-reported vaccination rates was tested using multivariable logistic regression controlling for demographics and comorbidities. The study was registered at clinicaltrials.gov: NCT03870997. A total of 10,429 participants reported influenza vaccination status (5158 intervention, mean age (\u00b1SD)\u2009=\u200946.8 (11.1), 78.5% female; 5271 control, Mean age (\u00b1SD)\u2009=\u200946.7 (11.2), 79.4% female). After a 6-month intervention, 64.2% of the intervention arm reported influenza vaccination, vers\u2009us 61.1% in the control arm (diff\u2009=\u20093.1, RR\u2009=\u20091.05, 95% CI [1.02, 1.08], <jats:italic>p<\/jats:italic>\u2009=\u20090.0013, number needed to treat\u2009=\u200933 to obtain 1 additional vaccination). Completion of one or more intervention messages was associated with up to an 8% increase in vaccination rate (OR 1.27, 95% CI [1.17, 1.38], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The intervention improved influenza vaccination rates in PWD, suggesting that leveraging new technology to deliver knowledge and information can improve influenza vaccination rates in high-risk populations to reduce public health burden of influenza. Rapid cycle innovation could maximize the effects of these digital interventions in the future with other populations and vaccines.<\/jats:p>","DOI":"10.1038\/s41746-021-00508-2","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T10:04:13Z","timestamp":1631873053000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Digital intervention increases influenza vaccination rates for people with diabetes in a decentralized randomized trial"],"prefix":"10.1038","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1334-7671","authenticated-orcid":false,"given":"J. 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Conflicts of interest to declare: Employed by Evidation, Foschini, Luca, Conflicts of interest to declare: Co-founder and employee of Evidation, Kumar, Shefali, Conflicts of interest to declare: Previously employed by Evidation during conduct of the study, Juusola, Jessie, Conflicts of interest to declare: Previously employed by Evidation during conduct of the study, Liska, Jan, Conflicts of interest to declare: Employed by Sanofi, Mercer, Monica, Conflicts of interest to declare: Employed by Sanofi Pasteur Tai, Caroline, Conflicts of interest to declare: Previously employed by Evidation during conduct of the study, Buzzetti, Raffaella, Conflicts of interest to declare: Personal fees from Eli Lilly, personal fees from Sanofi, personal fees from Novo Nordisk, personal fees from AstraZeneca, personal fees from Abbott, personal fees from Merck Sharp and Dohme, outside the submitted work for invited speaker engagement Clement, Maureen, Conflicts of interest to declare: Personal fees from Sanofi, personal fees from Novo Nordisk, personal fees from Abbott, personal fees from Lilly, outside the submitted work Cos, Xavier, Conflicts of interest to declare: fees as consultant from AstraZeneca, Boehringer Ingelheim, Lilly, Novartis, Novo Nordisk and Sanofi Diabetes, Sanofi Pasteur, Esteve and research support from AstraZeneca, Novartis, Sanofi, Boehringer Ingelheim Speaker\u2019s Bureau: AstraZeneca, Boehringer Ingelheim, Lilly, Novartis, Novo Nordisk, Sanofi Diabetes, Sanofi Pasteur. Ji, Linong, Conflicts of interest to declare: None Kanumilli, Naresh, Conflicts of interest to declare: Personal fees from Sanofi Pasteur, during the conduct of the study, Kerr, David, Conflicts of interest to declare: Received honoraria for participation in Advisory Boards for Sanofi Pasteur and NovoNordisk. He also is in receipt of share options from Glooko and research funding from Lilly and Abbott Montanya, Eduard, Conflicts of interest to declare: Personal fees from AstraZeneca, personal fees from Merck Sharp & Dohme, personal fees from Novartis, personal fees from NovoNordisk, personal fees from Sanofi, personal fees from Servier, grants from Menarini, outside the submitted work M\u00fcller-Wieland, Dirk, Conflicts of interest to declare: Personal fees from Amgen, personal fees from AstraZeneca, personal fees from B\u00f6hringer Ingelheim, personal fees from MSD\/Merck, personal fees from Novo Nordisk, personal fees from Bayer Vital, personal fees from Sanofi, outside the submitted work Ostenson, Claes Goran, Conflicts of interest to declare: None Skolnik, Neil, Conflicts of interest to declare: Advisory Boards -AstraZeneca, Teva, Lilly, Boehringer, Ingelheim, Sanofi, Sanofi Pasteur, Janssen Pharmaceuticals, Intarcia, Mylan, GSK, Merck, Bayer. Speaker - AstraZeneca; Boehringer Ingelheim; Lilly, GSK. Research, Support - Sanofi, AstraZeneca, Boehringer Ingelheim, GSK, Bayer, Woo, Vincent, Conflicts of interest to declare: Serves on advisory board for Sanofi, Burlet, Nansa, Conflicts of interest to declare: Was an employee at Sanofi Aventis Group at the time of study execution and is now employed at Kyowa Kirin International Greenberg, Michael, Conflicts of interest to declare: Employed by Sanofi Pasteur Samson, Sandrine. Conflicts of interest to declare: Employed by Sanofi Pasteur.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"138"}}