Effectiveness of stage-of-change (SOC)-tailored interventions in increasing uptake of any type of vaccination: A systematic review and meta-analysis

Abstract

Vaccine hesitancy remains a significant public health challenge globally, requiring innovative, evidence-based approaches to improve uptake. This systematic review and meta-analysis evaluated the effectiveness of stage-of-change (SOC)-tailored interventions, the customized strategies based on an individual's readiness for behavioral changes, in promoting vaccination uptake. Data were synthesized from randomized controlled trials (RCTs), quasi-experimental, and non-experimental studies identified through MEDLINE, PubMed, Web of Science, Embase, Global Health, and APA PsycInfo databases. Five eligible studies published between 2004 and 2023 were included, with three RCTs and one quasi-experimental study contributing to the meta-analysis. The pooled standard mean difference (SMD) for vaccination uptake was 0.54 (95% confidence interval [CI]: 0.49, 0.59, p < .001), indicating a significant medium effect size with no heterogeneity (I² = 0%, p = .88). Subgroup analyses showed SOC-tailored interventions were particularly effective for older adults (SMD = 0.57, 95% CI: 0.22 to 0.92, p = .03) and for parents or caregivers to increase children's vaccination uptake (SMD = 0.53, 95% CI: 0.32 to 0.74, p = .02). These findings provided preliminary evidence on the effectiveness of SOC-tailored interventions in addressing vaccine hesitancy. Future research should explore geographically diverse settings and cost-effective delivery methods to maximize the impact.