Intervention Strategies for Healthcare Workers to Promote Vaccine Uptake in Ethnic Minority Populations: A Systematic Review of Behaviour Change Techniques

Abstract

Background/Objectives: Healthcare workers (HCWs) have a crucial role in addressing vaccine hesitancy in ethnic minority populations as they are a trusted source of information. The aim of this systematic review is to synthesise and evaluate behaviour change techniques (BCTs) and strategies in interventions aimed at HCWs to promote vaccine uptake among ethnic minority populations. Methods: The literature was systematically searched in peer-reviewed databases and the grey literature. Studies were included if they reported interventions for respiratory and routinely recommended vaccine-preventable diseases which were delivered by HCWs to increase vaccine uptake in ethnic minority groups. Interventions were coded using the Behaviour Change Wheel (BCW) and BCT Taxonomy. Results: From 7250 records identified, 14 studies were included in the review. Vaccines targeted by interventions included influenza, pneumococcal disease, pertussis, tetanus, diphtheria, meningitis and hepatitis B. Seven BCW intervention types, six policy options and 22 BCTs were identified. Main intervention types used were persuasion, enablement and education. Effective interventions had multi-components and were tailored to specific populations. Staff training to improve vaccine recommendation and dialogue with patients, and prompts/cues were associated with positive effects, but there was no strong evidence to recommend one specific intervention strategy over another as effectiveness was linked to a multitude of BCTs and intervention types. Conclusions: Several strategies aimed at HCWs can be used and tailored to increase vaccine uptake among ethnic minority communities; however, this does not address all issues related to low vaccine uptake. While HCWs are necessary, without system-level enablement, they cannot fully address barriers to vaccine uptake.