01.03.2012 Flu prevention: objectives not (yet) achieved
Evaluation. The communication objectives relating to seasonal flu 2008–2012 have not yet been achieved. This is due more to scarcity of resources (compared with the very ambitious objectives) than to the choice and implementation of measures.
The Department for Political Science (IPZ) and the Institute of Mass Communication and Media Research at the University of Zurich have evaluated the “Communication strategy for the prevention of seasonal flu 2008–2012” on behalf of the Federal Office of Public Health (FOPH). This strategy seeks on the one hand to directly encourage target groups to undergo vaccination for their own protection (groups at risk: over 65 year olds, infants, pregnant women and the chronically ill) or to protect others (people working in health care and people in close contact with members of risk groups). On the other hand, it seeks to exert an indirect influence through the use of multipliers (doctors, health-care and home-care institutions and the mass media) in order to communicate the FOPH’s messages to the general public and the immediate target groups. A key concern of the evaluation was the effectiveness of the communication strategy towards the immediate target groups and the multipliers.
Low vaccination rates in the risk groups
The goal of the flu campaign was to achieve, by the end of 2012, a vaccination rate of 75% in the risk groups, 50% among medical and healthcare professionals and 50% among individuals in close contact with members of risk groups. These rates are still far from being achieved: following the 2010/11 flu season, the vaccination rate was only 42% in the risk groups, 22% among medical and healthcare professionals and 26% among the close contacts group. Only the 79% vaccination rate among doctors in non-institutional practice was above target. There is an overall downward trend in vaccination. Comparable data from surveys conducted in the past ten years show that vaccination rates have declined markedly in the risk groups.
Multiplication of messages works
Achievement of objectives was better with regard to the multipliers. The surveys suggest that dissemination of the flu prevention messages by doctors and health/home-care institutions worked well to very well. The majority of these people and organisations play an active role in flu prevention and regard the FOPH’s communication material as helpful and also use it. Just under half the 20 major Swiss employers surveyed use the FOPH campaign material and give it a largely positive rating.
The multiplier effect among the media worked less well. Though coverage of the messages by the mainstream media surveyed was neutral to positive, the level of response was low. The media representatives interviewed criticised the accessibility of FOPH specialists and identified considerable scope for improving the FOPH’s media work in terms of content. The survey of the general public did not yield only positive findings either: for instance, less than a third of interviewees recognised the campaign, and only slightly more than half of these felt personally addressed by it.
What recommendations are directed at the FOPH?
The campaign largely failed to achieve its quantitative objectives by a clear margin. According to the evaluators, this was due less to the choice and execution of measures than to shortage of resources. For the follow-up strategy to be applied to the 2013/14 and subsequent flu seasons, the objectives should be reviewed and brought more effectively into line with the available resources. This will very probably mean having to define clearer priorities. For instance, they rather advise against conducting an advertisement and poster campaign on the same scale as before because shortage of resources will mean it is unlikely to have the desired efficacy and efficiency. To bring about the necessary change of trend in the vaccination behaviour of the target groups, better media work is certainly needed, as is continuation of a dual communication strategy, i.e. exerting both a direct and an indirect influence on the risk groups. In particular, new methods and an increase in the intensity of the campaign are needed if the strong resistance of medical and healthcare professionals to vaccination is to be overcome. However, the flu campaign has a strong cornerstone in the efficient multiplier approach, which is functioning well. This now needs to be consolidated and improved.
Immediate FOPH measures to improve the current communication strategy for the prevention of seasonal flu
The brochure “Grippe? Impfen macht Sinn.“ [Flu? Vaccination makes sense.] aimed at healthcare professionals was updated for the 2011–2012 flu season, and a new flyer entitled “Grippeschutz während der Schwangerschaft: Impfen macht Sinn.“ [Flu protection during pregnancy: vaccination makes sense] has been produced as a source of information for both healthcare professionals and pregnant women. In addition, under the new slogan “Vaccinate against the flu“, the website www.impfengegengrippe.ch (formerly www.gemeinsamgegengrippe.ch) has been revised and furnished with full information material on seasonal flu. During the present flu season, the cantons were also called upon to participate in the FOPH’s web pages, set up a site of their own and link it to their cantonal website. Additional material (e.g. stickers for doctors’ practices) was provided to promote National Flu Vaccination Day on 4 November 2011. All measures had to be executed within the constraints of the limited financial resources available.
A round-table meeting with healthcare professionals and representatives of the FOPH is planned for spring 2012 in order to promote exchanges between these parties and find a way of providing even more effective support for the work of the healthcare professionals and of persuading them that flu vaccination not only of people at risk but also of the medical and healthcare staff who have contact with patients is a “normal” part of annual prevention activities.
The findings of the evaluation and particularly the recommendations will be taken into account when the FOPH considers what the focus of the follow-up strategy is to be.
The “Evaluation of the Communication Strategy for the Prevention of Seasonal Flu 2008–2012“ carried out by the Department for Political Science (IPZ) and the Institute of Mass Communication and Media Research at the University of Zurich can be downloaded from http://www.bag.admin.ch/evaluation/01759/02073/index.html?lang=d.