The Effect of Proximity on Flu-Shot Participation

Using desk location information and employees' building entry/exit swipe card data from a company that offered a free 2-day worksite influenza vaccination clinic, we separately identify the vaccination effects of base proximity-the inverse of walking distance between one's desk and the clinic-and functional proximity-the likelihood of passing near the clinic during the course of a normal work day (ie, days when the clinic is not open).

Study Overview

• Status: Completed
• Conditions: Influenza; Human
• Intervention / Treatment: Other: Functional Proximity; Other: Base Proximity

Detailed Description

We study the 2011 influenza vaccine uptake of employees at the headquarters of a health benefits administrator in the United States. These employees are generally not health care personnel. All of them have health insurance. Of the company's total workforce (including those not based at the headquarters), 26% are African Americans and 37% are racial minorities.

There are 2 main buildings at the company headquarters. Building One houses 520 employees and is the site of the vaccination clinic; Building Two houses 1281 employees. The 2 buildings are 131 meters apart and connected by an enclosed passageway. The clinic was located near the cafeteria in Building One and adjacent to the passageway connecting the 2 buildings. The clinic was conducted from October 19 to 20, 2011, and it was advertised during the 3 weeks prior.

The company requires employees to swipe a personalized electronic badge to open the external doors of its buildings, which include the doors to the passageway between the buildings. The company provided us data on the date and time of each swipe in September and October 2011. If an employee swipes her badge and holds the door open for another employee, we do not observe that other employee. The badge swipe data are therefore an incomplete measure of all movements between the buildings. The company also gave us data on employee characteristics and vaccination uptake, scaled architectural plans of the buildings, and employee desk maps.

• Study Type: Observational
• Enrollment (Actual): 1801

Contacts and Locations

Study Locations

• United States
  • Missouri
    • Saint Louis, Missouri, United States, 63121
      • Express Scripts

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Employees at the headquarters of a health benefits administrator in the US. These employees are generally not health care personnel. All of them have health insurance.

Of HQ employees, 520 are housed in Building 1 (the site of the vaccination clinic) and 1,281 are housed in Building 2. The two buildings are 131 meters apart and connected by an enclosed passageway. The clinic was located near the cafeteria in Building 1 and adjacent to the passageway connecting the two buildings.

Description

Inclusion Criteria:

• Employee of Express Scripts.
• Eligible to receive a flu shot at Express Scripts.
• Over 18 years of age.

Exclusion Criteria:

• Children
• Non Express Scripts employees

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Employees; A total of 1,801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic.

Other: Functional Proximity; Using each employee's building entry/exit swipe card data, we test whether functional proximity-the likelihood that the employee walks by the clinic for reasons other than vaccination-predicts whether the employee gets vaccinated at the clinic.; Other: Base Proximity; We also test whether base proximity-the inverse of walking distance from the employee's desk to the clinic-predicts vaccination probability.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Receipt of influenza vaccine	The investigators will measure whether proximity to a flu shot clinic effected whether an employee received an influenza vaccine.	One week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Absenteeism	The investigators will measure absenteeism in employees who received a flu shot versus employees who did not receive a flu shot.	The investigators will follow employees' absenteeism for five to six months
Demographic characteristics on flu shot participation	The investigators will explore how demographic characteristics correlate to employees receiving an influenza vaccination.	Up to 3 years

Collaborators and Investigators

• Sponsor: National Bureau of Economic Research, Inc.
• Collaborators: National Institute on Aging (NIA)

Publications and helpful links

General Publications

• Beshears J, Choi JJ, Laibson DI, Madrian BC, Reynolds GI. Vaccination Rates are Associated With Functional Proximity But Not Base Proximity of Vaccination Clinics. Med Care. 2016 Jun;54(6):578-83. doi: 10.1097/MLR.0000000000000523.

Study record dates

Study Major Dates

• Study Start: October 1, 2011
• Primary Completion (Actual): May 1, 2012
• Study Completion (Actual): May 1, 2012

Study Registration Dates

• First Submitted: October 12, 2011
• First Submitted That Met QC Criteria: October 19, 2011
• First Posted (Estimate): October 20, 2011

Study Record Updates

• Last Update Posted (Actual): December 18, 2017
• Last Update Submitted That Met QC Criteria: December 14, 2017
• Last Verified: December 1, 2017

More Information

Terms related to this study

• Keywords: Influenza; Proximity
• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Orthomyxoviridae Infections; Influenza, Human
• Other Study ID Numbers: 0006; P30AG034532 (U.S. NIH Grant/Contract); P01AG005842 (U.S. NIH Grant/Contract)