Digital Intervention is Effective in Increasing Influenza Vaccination in People Living with Diabetes


Foschini L, Lee J.L., Buzzetti R, Clement M, Cos X, Ji L, Kanumilli N, Kerr D, Martinez L, Montanya E, Müller-Wieland D, Östenson C.-G, Skolnik N, Woo V, Samson S

Evidation partnered with Sanofi to conduct a large scale study to evaluate the effectiveness of a digitally administered intervention for increasing the influenza vaccination rate for people living with diabetes. Our research was presented at the European Association for the Study of Diabetes’ annual meeting showcasing that personalized messaging for those living with chronic conditions, specifically diabetes, makes them more likely to receive vaccinations. Increasing flu vaccination is essential to protect vulnerable individuals, including those with chronic conditions, and communities while reducing strain on our health care system. Through our cohort of nearly 4 million individuals, Evidation was able to engage individuals – digitally, at scale – with evidence-based, personalized interventions to achieve meaningful behavioral change.

BACKGROUND: Each year, 5-20% of the population of the United States contracts seasonal influenza. People living with diabetes have a greater risk of developing influenza-related complications, such as cardiovascular events and death. Annual influenza vaccination is recommended for people with diabetes, but less than two-thirds receive the vaccine. In this study, the impact of a digital intervention designed to increase influenza vaccination rates in people living with diabetes was assessed.

METHODS: We conducted a virtual, prospective, 1:1 randomized controlled trial of a Diabetes Digital Intervention over 6 months, designed for adults with diabetes. Participants were blinded to study participation. The intervention group received the Diabetes Digital Intervention, which consisted of monthly messages delivered through an online health platform, with information on the importance of influenza vaccination in people living with diabetes, geolocation of where to get the vaccine, and incentives to perform follow-up actions such as setting a date to get vaccinated or taking a knowledge test (in the form of points, redeemable for monetary rewards). The intervention was developed using a combination of patient focus groups and expert input. The control group received no intervention. Self-reported influenza vaccination status at months 3 and 6 was collected. The difference in influenza vaccination rates between groups after the intervention was tested using multivariable logistic regression controlling for demographics and comorbidities.

RESULTS: A total of 10,429 participants were included and reported influenza vaccination status (5,158 intervention; 5,271 control). At the end of the 6-month intervention, 64.2% of people in the intervention arm reported receiving the influenza vaccination, versus 61.1% in the control arm (diff=3.1, OR=1.14, p<0.01).

CONCLUSION: The Diabetes Digital Intervention improved influenza vaccination rates in people living with diabetes, confirming that leveraging new technology to deliver knowledge and information can improve influenza vaccination rates in high-risk populations and reduce public health burden of influenza. Rapid cycle innovation could be used to determine how to maximize the effects of these digital interventions in the future.