{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:45:38Z","timestamp":1779313538370,"version":"3.51.4"},"reference-count":33,"publisher":"American Public Health Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p> Objectives. To evaluate the effectiveness of point-of-care informational interventions in general practitioner clinics to improve influenza and pneumococcal vaccination uptake among elderly patients. <\/jats:p><jats:p> Methods. We conducted a pragmatic, cluster-randomized crossover trial in 22 private general practitioner clinics in Singapore, from November 2017 to July 2018. We included all patients aged 65 years or older. Clinics were assigned to a 3-month intervention (flyers and posters encouraging vaccination) plus 1-month washout period, and a 4-month control period (usual care). Primary outcomes were differences in vaccination uptake rates between periods. Secondary outcomes were identification of other factors associated with vaccination uptake. <\/jats:p><jats:p> Results. A total of 4378 and 4459 patients were included in the intervention and control periods, respectively. Both influenza (5.9% vs 4.8%; P\u2009=\u2009.047) and pneumococcal (5.7% vs 3.7%; P\u2009=\u2009.001) vaccination uptake rates were higher during the intervention period compared with the control period. On multilevel logistic regression analysis, follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 was associated with uptake of both vaccines. <\/jats:p><jats:p> Conclusions. Point-of-care informational interventions likely contributed to increased influenza and pneumococcal vaccination uptake. Patients on follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 were more likely to receive influenza and pneumococcal vaccination and should be actively engaged by physicians. <\/jats:p><jats:p> Trial Registration. ClinicalTrials.gov Identifier: NCT03445117. <\/jats:p>","DOI":"10.2105\/ajph.2019.305328","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T20:00:38Z","timestamp":1571342438000},"page":"1776-1783","source":"Crossref","is-referenced-by-count":42,"title":["Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial"],"prefix":"10.2105","volume":"109","author":[{"given":"Hanley J.","family":"Ho","sequence":"first","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Roe","family":"Tan","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex R.","family":"Cook","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Koh","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tat Yean","family":"Tham","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eve","family":"Anwar","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace Shu","family":"Hui Chiang","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May O.","family":"Lwin","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark I.","family":"Chen","sequence":"additional","affiliation":[{"name":"Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. 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