Does enhanced educational intervention reduce breakthrough infection and mental health problems via improving acceptance of COVID-19 booster shots in Chinese non-healthcare workers: A randomized controlled trial?
Background: Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the a...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-05-01
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| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034125000681 |
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| Summary: | Background: Despite vaccination and booster shots proving more effective than workplace measures in controlling the COVID-19 pandemic, hesitancy towards compulsory booster shots remains. This study aimed to evaluate the effectiveness of an enhanced educational intervention program in improving the acceptance of COVID-19 booster shots and reducing breakthrough infections among non-healthcare workers in Hong Kong. Methods: In this 9-month randomized controlled trial (RCT), workers were randomly allocated to either the intervention or control group. The intervention group received educational sessions at baseline and at 3-month, covering general health and evidence-based information on the efficacy and safety of COVID-19 vaccines and booster shots. The control group received only general health information. All participants were followed up for an additional 6 months. The primary outcomes were intention and acceptance of booster shots, as well as breakthrough infections. The DASS-21 scale was used to evaluate participants’ mental health status, and two-way mixed ANOVA to analyze the group effect. A difference of ≥ 5 % in booster uptake between the intervention and control group indicated a practical significance in infection control. Results: Among 310 consenting workers, 282 (91.0 %) of them completed the trial. At recruitment, the booster uptake rate was similar between the intervention and control groups (62.0 % vs. 62.1 %). After the educational intervention sessions, the intervention group showed a higher booster uptake rate (76.1 % vs. 67.9 %). A lower rate of breakthrough infection was observed in the intervention group during the latest follow-up period (23.2 % vs. 29.5 %); however, no change in the intention to get booster shots were recorded for all subjects. Conclusion: This enhanced educational intervention program significantly improves booster uptake rates and reduces COVID-19 breakthrough infection rates among non-healthcare workers. (Trial registration: ClinicalTrials.gov - NCT05197673) |
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| ISSN: | 1876-0341 |