Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study
BackgroundDiabetes 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 the World Health Organization’s targets, pa...
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JMIR Publications
2025-04-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e68936 |
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| author | Yifat Fundoiano-Hershcovitz Felix Lee Catherine Stanger Inbar Breuer Asher David L Horwitz Omar Manejwala Jan Liska David Kerr |
| author_facet | Yifat Fundoiano-Hershcovitz Felix Lee Catherine Stanger Inbar Breuer Asher David L Horwitz Omar Manejwala Jan Liska David Kerr |
| author_sort | Yifat Fundoiano-Hershcovitz |
| collection | DOAJ |
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BackgroundDiabetes 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 the World Health Organization’s targets, partly due to limited awareness among patients. This study evaluated a digital health intervention aimed at improving influenza vaccination rates among adults with diabetes.
ObjectiveThis 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.
MethodsThe study leveraged the Dario (Dario Health Corp) digital health platform to retrospectively analyze data from 64,904 users with diabetes assigned by the platform into three groups: (1) Group A received previously studied monthly flu nudge messages; (2) Group B received an adapted intervention with 2-3 monthly messages; (3) Group C served as the control with no intervention. Surveys were conducted at baseline, 3 months, and 6 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.
ResultsOut of 64,904 users, 8431 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 with the control group odds ratio (OR; 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 with the control. In addition, a significant correlation between awareness and vaccination rates was found only in group B (χ2(df=1)=6.12, P=.01).
ConclusionsThe adapted digital intervention (group B) effectively increased awareness of influenza risks and recollection of educational content, which correlated with the 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.
Trial RegistrationClinicalTrials.gov NCT06840236; https://clinicaltrials.gov/study/NCT06840236 |
| format | Article |
| id | doaj-art-a096db5f20dd4054bd96b84b2d63a051 |
| institution | DOAJ |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | JMIR Publications |
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| series | Journal of Medical Internet Research |
| spelling | doaj-art-a096db5f20dd4054bd96b84b2d63a0512025-08-20T03:08:37ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-04-0127e6893610.2196/68936Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up StudyYifat Fundoiano-Hershcovitzhttps://orcid.org/0000-0002-8526-0252Felix Leehttps://orcid.org/0009-0006-5588-9283Catherine Stangerhttps://orcid.org/0000-0003-2221-5232Inbar Breuer Asherhttps://orcid.org/0009-0000-4589-3090David L Horwitzhttps://orcid.org/0000-0001-5801-1640Omar Manejwalahttps://orcid.org/0000-0001-5801-1640Jan Liskahttps://orcid.org/0000-0002-7315-1681David Kerrhttps://orcid.org/0000-0003-1335-1857 BackgroundDiabetes 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 the World Health Organization’s targets, partly due to limited awareness among patients. This study evaluated a digital health intervention aimed at improving influenza vaccination rates among adults with diabetes. ObjectiveThis 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. MethodsThe study leveraged the Dario (Dario Health Corp) digital health platform to retrospectively analyze data from 64,904 users with diabetes assigned by the platform into three groups: (1) Group A received previously studied monthly flu nudge messages; (2) Group B received an adapted intervention with 2-3 monthly messages; (3) Group C served as the control with no intervention. Surveys were conducted at baseline, 3 months, and 6 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. ResultsOut of 64,904 users, 8431 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 with the control group odds ratio (OR; 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 with the control. In addition, a significant correlation between awareness and vaccination rates was found only in group B (χ2(df=1)=6.12, P=.01). ConclusionsThe adapted digital intervention (group B) effectively increased awareness of influenza risks and recollection of educational content, which correlated with the 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. Trial RegistrationClinicalTrials.gov NCT06840236; https://clinicaltrials.gov/study/NCT06840236https://www.jmir.org/2025/1/e68936 |
| spellingShingle | Yifat Fundoiano-Hershcovitz Felix Lee Catherine Stanger Inbar Breuer Asher David L Horwitz Omar Manejwala Jan Liska David Kerr Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study Journal of Medical Internet Research |
| title | Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study |
| title_full | Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study |
| title_fullStr | Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study |
| title_full_unstemmed | Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study |
| title_short | Digital Health Intervention on Awareness of Vaccination Against Influenza Among Adults With Diabetes: Pragmatic Randomized Follow-Up Study |
| title_sort | digital health intervention on awareness of vaccination against influenza among adults with diabetes pragmatic randomized follow up study |
| url | https://www.jmir.org/2025/1/e68936 |
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