<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03239665</url>
  </required_header>
  <id_info>
    <org_study_id>Pro20170000208</org_study_id>
    <nct_id>NCT03239665</nct_id>
  </id_info>
  <brief_title>Vaccination Education Through Pharmacists and Senior Centers (VEPSC)</brief_title>
  <acronym>VEPSC</acronym>
  <official_title>Randomized Trial of Peer-to-Peer Versus Pharmacist Education to Improve Older Adults' Vaccination Knowledge Through the Senior Center Model of Care</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Rutgers, The State University of New Jersey</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Merck Sharp &amp; Dohme LLC</agency>
      <agency_class>Industry</agency_class>
    </collaborator>
    <collaborator>
      <agency>Thomas Jefferson University</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Rutgers, The State University of New Jersey</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The study consists of two arms (PHARM and PEER) designed to educate participants about three&#xD;
      vaccine-preventable diseases (zoster, pneumonia, and influenza) and vaccination. PHARM will&#xD;
      consist of a 60-minute presentation about the three vaccine-preventable diseases and their&#xD;
      vaccinations delivered by a pharmacist, featuring a didactic lecture and discussion&#xD;
      supplemented by video clips of community members discussing their experiences around&#xD;
      vaccination, as well as physicians underscoring the importance of vaccination. PEER will&#xD;
      consist of a 60-minute small-group session led by a peer educator which includes scripted&#xD;
      roleplaying exercises designed to reinforce learnings pertaining to these three&#xD;
      vaccine-preventable diseases and their vaccinations. The components of these interventions&#xD;
      will be designed to address specific barriers to vaccination identified by literature search&#xD;
      and our prior work in the area of community-based vaccine education. Both arms will focus&#xD;
      primarily on pneumococcal disease and zoster but will include limited content on influenza&#xD;
      because participants are likely to have questions about how the flu and its vaccination&#xD;
      differ from pneumococcal diseases and zoster. The study will be implemented in an older,&#xD;
      predominantly African-American (AA) population, consistent with our prior work in this area.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      In the pharmacist-led (&quot;PHARM&quot;) intervention group, participants will be given a 60-minute&#xD;
      formal didactic presentation on vaccine-preventable diseases and vaccination. This&#xD;
      presentation will be designed to address knowledge and beliefs related to zoster, pneumonia,&#xD;
      and influenza, as well as barriers to receiving vaccination. It will be delivered by a&#xD;
      pharmacist, will be appropriate for the participants' educational level, and will aim to&#xD;
      establish an understanding of vaccine-preventable illnesses. The presentation will&#xD;
      specifically discuss the following: causes, symptoms and potential complications of&#xD;
      infections in the three diseases of interest (pneumococcal disease, zoster, and influenza);&#xD;
      risk factors for developing the infections; incidence and prevalence of each disease of&#xD;
      interest; modes of transmission; and disease prevention through vaccination. To improve the&#xD;
      interactivity of the presentation, brief 30-60 second video clips excerpted from interviews&#xD;
      with community members and physicians will be shown. Community member clips will consist of&#xD;
      older adults from the African-American (AA) population who have experienced&#xD;
      vaccine-preventable infections. These clips will provide culturally relevant testimony to the&#xD;
      program audience and reinforce participant understanding of concepts introduced during&#xD;
      didactic teaching.&#xD;
&#xD;
      In the peer-led (&quot;PEER&quot;) intervention, peer educators will be recruited from an experienced&#xD;
      cohort of peer educators at our senior center partner site. A pharmacist will train the peer&#xD;
      educators about vaccine-preventable diseases over the course of two didactic sessions.&#xD;
      Following this training, a third session will be held to train the peer educators on the&#xD;
      script that they will deliver to participants. The script will include the key learning&#xD;
      points to be taught by the peer educators to participants about vaccine preventable diseases&#xD;
      and vaccination. The script will also include roleplay exercises. In the roleplay exercises,&#xD;
      3 scripted vaccination-related scenarios (one for each disease of interest) will be acted out&#xD;
      by participants to illustrate scenarios participants might encounter when interacting with&#xD;
      healthcare providers or friends/family. The skit and roleplay exercises will be practiced as&#xD;
      needed, under the leadership of the senior center's project manager, to ensure that the peer&#xD;
      educators are confident and consistent when delivering PEER. After completing the training,&#xD;
      peer educators' competency on PEER program content will be assessed through a formal&#xD;
      multiple-choice knowledge test. Each peer educator must achieve a minimum score of 80%&#xD;
      correct over all items assessed, and 100% correct for all items deemed &quot;core&quot; knowledge. Once&#xD;
      peer educator competency has been established, each peer educator will deliver PEER through a&#xD;
      60-minute small group session. During this session, peer educators will deliver the&#xD;
      educational objectives through an informal discussion and will lead the group through the&#xD;
      roleplay exercises. Participants will then be asked what key points they learned about&#xD;
      vaccine-preventable diseases and vaccines. Finally, the peer educator will engage in a&#xD;
      dialogue to clarify and summarize these key points.&#xD;
&#xD;
      Objectives are:&#xD;
&#xD;
        1. Compare the efficacy of PHARM vs. PEER at improving participant's knowledge regarding&#xD;
           vaccine-preventable diseases&#xD;
&#xD;
        2. Compare the efficacy of PHARM vs. PEER at improving participants' beliefs about&#xD;
           vaccination&#xD;
&#xD;
        3. Measure the costs of PHARM and PEER from the senior center perspective&#xD;
&#xD;
        4. Compare the percent of participants taking activation step(s) to get vaccinated&#xD;
           following receipt of PHARM vs. PEER&#xD;
&#xD;
        5. Determine the extent to which participants are satisfied with and trust the PHARM vs.&#xD;
           PEER interventions&#xD;
&#xD;
      Hypotheses supporting these objective are:&#xD;
&#xD;
        1. PHARM and PEER will achieve similar improvements in older adults' knowledge of vaccine&#xD;
           preventable diseases (primary hypothesis)&#xD;
&#xD;
        2. PHARM and PEER will improved beliefs about vaccine-preventable disease&#xD;
&#xD;
        3. PEER will be a lower cost approach to educating participants in the senior center&#xD;
           compared to PHARM&#xD;
&#xD;
        4. PHARM and PEER will result in similar rates of participants taking one or more&#xD;
           activation step(s) to obtain vaccination&#xD;
&#xD;
        5. Participants will be highly satisfied with the PHARM and PEER interventions&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">October 10, 2017</start_date>
  <completion_date type="Actual">August 31, 2019</completion_date>
  <primary_completion_date type="Actual">September 28, 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>The design is a randomized trial with randomization to PHARM or PEER performed at the program date level.</intervention_model_description>
    <primary_purpose>Prevention</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Mean Change in Knowledge and Awareness About Vaccine-Preventable Diseases</measure>
    <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
    <description>Knowledge and awareness about the target vaccine-preventable diseases was assessed at each timepoint using the VEPSC Knowledge Instrument, a 3-section, 22-item instrument categorical response instrument. Scores consist of number of correct responses to the questions on the knowledge instrument, thus a higher score indicates better performance. Four scores are possible: three disease-specific subscores (one each for pneumonia, influenza, and zoster) and one total score (equaling the sum of the three disease-specific subscores). Possible score ranges are as follows: pneumonia 0-7; influenza 0-7; zoster 0-8; total 0-22. For each score type, pairwise score differences were calculated between all 3 timepoints (baseline, post-test, and one-month follow-up). Positive values indicate increased knowledge among participants; negative values indicate decreased knowledge.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Within-Group Changes in Beliefs About Vaccine-Preventable Diseases and Vaccines</measure>
    <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
    <description>Beliefs about vaccine-preventable diseases and vaccination were assessed via agreement with 5 statements scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree) at each timepoint. The changes in beliefs between baseline, post-intervention, and the one-month follow-up were assessed in both PHARM and PEER groups. Pairwise Wilcoxon Signed-Rank tests were run comparing within-group changes in beliefs across timepoints and applying the Bonferroni correction (α=0.05/3=0.0167).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Cost Analysis</measure>
    <time_frame>Measured after completion of all programs in both groups (an average of one year).</time_frame>
    <description>Measure the program costs of PHARM and PEER from the senior center perspective. Costs were measured in total for each group, and per-participant costs were calculated by dividing total group cost by group sample size. Outcome measure type is thus reported as &quot;number&quot; rather than choosing measures of central tendency and dispersion/precision (i.e., there are no standard deviations, confidence intervals, or ranges with this methodology).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Reporting Program Satisfaction</measure>
    <time_frame>Measured immediately post-intervention (PT) and at 1 month follow-up (1M)</time_frame>
    <description>Satisfaction was assessed on the post-intervention and one-month follow-up surveys using two statements that were each scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree). The statements were: 1) &quot;The educational program kept me interested or engaged&quot; and 2) &quot;I was satisfied with the content of the educational program&quot;. At each timepoint, responses were dichotomized as &quot;agree&quot; (comprising the &quot;Somewhat agree&quot; and &quot;Completely agree&quot; response options) and &quot;disagree&quot; (comprising the &quot;Somewhat disagree&quot; and &quot;Completely disagree&quot; response options), and these dichotomous responses were compared between PHARM and PEER via Fisher's exact test.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Planning to Receive Each Vaccine</measure>
    <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
    <description>Compare the number of participants planning to receive vaccine in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Reporting Positive Vaccination Status at Each Timepoint</measure>
    <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
    <description>Compare the number participants reporting positive vaccination status in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Planning to Discuss Vaccines With Others as Assessed by the Activation Questionnaire</measure>
    <time_frame>Baseline, immediately post-intervention, and 1 month follow-up</time_frame>
    <description>Compare the number of participants planning to discuss vaccines with doctor, pharmacist, or family/friends in PHARM vs. PEER at each timepoint</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Number of Participants Having Discussed Vaccines With Others at One-month Follow-up as Assessed by the Activation Questionnaire</measure>
    <time_frame>One-month follow-up (1M)</time_frame>
    <description>Compare the number of participants reporting that they have discussed vaccines with their doctor, pharmacist, or family/friends at the one-month follow-up for PHARM vs. PEER</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">335</enrollment>
  <condition>Infectious Disease</condition>
  <condition>Pneumonia, Bacterial</condition>
  <condition>Influenza</condition>
  <condition>Zoster; Herpes</condition>
  <arm_group>
    <arm_group_label>Pharmacist-led Intervention (PHARM)</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Peer-led Intervention (PEER)</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Pharmacist-led Intervention (PHARM)</intervention_name>
    <description>60 minute didactic lecture about vaccinations.</description>
    <arm_group_label>Pharmacist-led Intervention (PHARM)</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>Peer-led Intervention (PEER)</intervention_name>
    <description>60 minute peer led small group intervention including skits and other educational material</description>
    <arm_group_label>Peer-led Intervention (PEER)</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Age ≥50;&#xD;
&#xD;
          -  Can attend a 2-hour session (though both PHARM and PEER entail 60 minutes of&#xD;
             intervention, an additional hour is needed to allow for informed consent and data&#xD;
             collection);&#xD;
&#xD;
          -  Speak and read English at ≥4th grade level as determined by a brief reading passage;&#xD;
&#xD;
          -  Cognitively intact as evidenced by an Abbreviated Mental Status Test score ≥7.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Failure to meet inclusion criteria&#xD;
&#xD;
          -  Failure to give informed consent to participate in the study&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>50 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Laura T Pizzi, PharmD, MPH</last_name>
    <role>Principal Investigator</role>
    <affiliation>Rutgers University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Rutgers University</name>
      <address>
        <city>Piscataway</city>
        <state>New Jersey</state>
        <zip>08854</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <link>
    <url>http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201406.pdf</url>
    <description>National Center for Health Statistics. Early Release of Selected Estimates Based on Data From the National Health Interview Survey.</description>
  </link>
  <link>
    <url>https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases</url>
    <description>U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC.</description>
  </link>
  <link>
    <url>https://www.cdc.gov/vaccines/hcp/vis/vis-statements/ppv.pdf</url>
    <description>Centers for Disease Control and Prevention. Pneumococcal Polysaccharide Vaccine: What You Need to Know.</description>
  </link>
  <link>
    <url>http://www.immunize.org/catg.d/p4213.pdf</url>
    <description>Immunization Action Coalition. Pneumococcal Polysaccharide Vaccination Pocket Guide.</description>
  </link>
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    <citation>Zimmerman RK, Santibanez TA, Fine MJ, Janosky JE, Nowalk MP, Bardella IJ, Raymund M, Wilson SA. Barriers and facilitators of pneumococcal vaccination among the elderly. Vaccine. 2003 Mar 28;21(13-14):1510-7. doi: 10.1016/s0264-410x(02)00698-9.</citation>
    <PMID>12615448</PMID>
  </reference>
  <reference>
    <citation>Harris LM, Chin NP, Fiscella K, Humiston S. Barrier to pneumococcal and influenza vaccinations in Black elderly communities: mistrust. J Natl Med Assoc. 2006 Oct;98(10):1678-84.</citation>
    <PMID>17052061</PMID>
  </reference>
  <reference>
    <citation>Nowalk MP, Zimmerman RK, Shen S, Jewell IK, Raymund M. Barriers to pneumococcal and influenza vaccination in older community-dwelling adults (2000-2001). J Am Geriatr Soc. 2004 Jan;52(1):25-30. doi: 10.1111/j.1532-5415.2004.52006.x.</citation>
    <PMID>14687311</PMID>
  </reference>
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    <citation>Hoffmann S, Caro FG, Gottlieb AS, Kesternich I, Winter JK. Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. Med Decis Making. 2014 Jul;34(5):603-14. doi: 10.1177/0272989X14527796. Epub 2014 Apr 16.</citation>
    <PMID>24739534</PMID>
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    <citation>Ubel PA, Jepson C, Baron J. The inclusion of patient testimonials in decision aids: effects on treatment choices. Med Decis Making. 2001 Jan-Feb;21(1):60-8. doi: 10.1177/0272989X0102100108.</citation>
    <PMID>11206948</PMID>
  </reference>
  <reference>
    <citation>Singleton JA, Santibanez TA, Wortley PM. Influenza and pneumococcal vaccination of adults aged &gt; or = 65: racial/ethnic differences. Am J Prev Med. 2005 Dec;29(5):412-20. doi: 10.1016/j.amepre.2005.08.012.</citation>
    <PMID>16376704</PMID>
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    <citation>Mieczkowski TA, Wilson SA. Adult pneumococcal vaccination: a review of physician and patient barriers. Vaccine. 2002 Jan 31;20(9-10):1383-92. doi: 10.1016/s0264-410x(01)00463-7.</citation>
    <PMID>11818157</PMID>
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    <citation>Jones LG, Zhang Y, Ahmed MI, Ekundayo OJ, Akhter S, Sawyer P, Aban I, Sims RV, Ahmed A. Understanding the reasons for the underuse of pneumococcal vaccination by community-dwelling older African Americans. J Am Geriatr Soc. 2010 Dec;58(12):2323-8. doi: 10.1111/j.1532-5415.2010.03181.x.</citation>
    <PMID>21143440</PMID>
  </reference>
  <reference>
    <citation>Santibanez TA, Nowalk MP, Zimmerman RK, Jewell IK, Bardella IJ, Wilson SA, Terry MA. Knowledge and beliefs about influenza, pneumococcal disease, and immunizations among older people. J Am Geriatr Soc. 2002 Oct;50(10):1711-6. doi: 10.1046/j.1532-5415.2002.50466.x.</citation>
    <PMID>12366627</PMID>
  </reference>
  <verification_date>June 2020</verification_date>
  <study_first_submitted>July 20, 2017</study_first_submitted>
  <study_first_submitted_qc>August 2, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 4, 2017</study_first_posted>
  <results_first_submitted>March 12, 2020</results_first_submitted>
  <results_first_submitted_qc>June 15, 2020</results_first_submitted_qc>
  <results_first_posted type="Actual">July 1, 2020</results_first_posted>
  <last_update_submitted>June 15, 2020</last_update_submitted>
  <last_update_submitted_qc>June 15, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">July 1, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Rutgers, The State University of New Jersey</investigator_affiliation>
    <investigator_full_name>Laura T. Pizzi, PharmD, MPH</investigator_full_name>
    <investigator_title>Professor and Director, Center for Health Outcomes, Policy, &amp; Economics</investigator_title>
  </responsible_party>
  <keyword>Vaccine</keyword>
  <keyword>Educational intervention</keyword>
  <keyword>Senior Center Model of Care</keyword>
  <keyword>Older adults</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Communicable Diseases</mesh_term>
    <mesh_term>Infections</mesh_term>
    <mesh_term>Pneumonia, Bacterial</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
    <ipd_description>No IPD will be made available to any researchers external to this study.</ipd_description>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>May 1, 2017</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/65/NCT03239665/Prot_000.pdf</document_url>
    </provided_document>
    <provided_document>
      <document_type>Statistical Analysis Plan</document_type>
      <document_has_protocol>No</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>March 6, 2020</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/65/NCT03239665/SAP_001.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <group_list>
        <group group_id="P1">
          <title>Pharmacist-led Intervention (PHARM)</title>
          <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
        </group>
        <group group_id="P2">
          <title>Peer-led Intervention (PEER)</title>
          <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="175"/>
                <participants group_id="P2" count="160"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>Met Inclusion Criteria</title>
              <participants_list>
                <participants group_id="P1" count="150"/>
                <participants group_id="P2" count="144"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>Submitted Survey Data</title>
              <participants_list>
                <participants group_id="P1" count="147"/>
                <participants group_id="P2" count="140"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="147"/>
                <participants group_id="P2" count="140"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="28"/>
                <participants group_id="P2" count="20"/>
              </participants_list>
            </milestone>
          </milestone_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>Pharmacist-led Intervention (PHARM)</title>
          <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
        </group>
        <group group_id="B2">
          <title>Peer-led Intervention (PEER)</title>
          <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
        </group>
        <group group_id="B3">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="147"/>
            <count group_id="B2" value="140"/>
            <count group_id="B3" value="287"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="75.2" spread="9.17"/>
                    <measurement group_id="B2" value="73.9" spread="8.67"/>
                    <measurement group_id="B3" value="74.5" spread="8.94"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex/Gender, Customized</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="118"/>
                    <measurement group_id="B2" value="113"/>
                    <measurement group_id="B3" value="231"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="25"/>
                    <measurement group_id="B2" value="26"/>
                    <measurement group_id="B3" value="51"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I prefer not to answer / No response</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race/Ethnicity, Customized</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Black</title>
                  <measurement_list>
                    <measurement group_id="B1" value="68"/>
                    <measurement group_id="B2" value="115"/>
                    <measurement group_id="B3" value="183"/>
                  </measurement_list>
                </category>
                <category>
                  <title>White</title>
                  <measurement_list>
                    <measurement group_id="B1" value="61"/>
                    <measurement group_id="B2" value="16"/>
                    <measurement group_id="B3" value="77"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Asian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="7"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="8"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="3"/>
                    <measurement group_id="B3" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Other</title>
                  <measurement_list>
                    <measurement group_id="B1" value="5"/>
                    <measurement group_id="B2" value="2"/>
                    <measurement group_id="B3" value="7"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I don't know / Not sure</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I prefer not to answer / No response</title>
                  <measurement_list>
                    <measurement group_id="B1" value="5"/>
                    <measurement group_id="B2" value="3"/>
                    <measurement group_id="B3" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Region of Enrollment</title>
          <units>participants</units>
          <param>Number</param>
          <class_list>
            <class>
              <title>United States</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="147"/>
                    <measurement group_id="B2" value="140"/>
                    <measurement group_id="B3" value="287"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Highest degree of education achieved</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>High school graduate or GED</title>
                  <measurement_list>
                    <measurement group_id="B1" value="61"/>
                    <measurement group_id="B2" value="55"/>
                    <measurement group_id="B3" value="116"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Some college or vocational school</title>
                  <measurement_list>
                    <measurement group_id="B1" value="35"/>
                    <measurement group_id="B2" value="41"/>
                    <measurement group_id="B3" value="76"/>
                  </measurement_list>
                </category>
                <category>
                  <title>College graduate</title>
                  <measurement_list>
                    <measurement group_id="B1" value="30"/>
                    <measurement group_id="B2" value="32"/>
                    <measurement group_id="B3" value="62"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I prefer not to answer / No response</title>
                  <measurement_list>
                    <measurement group_id="B1" value="21"/>
                    <measurement group_id="B2" value="12"/>
                    <measurement group_id="B3" value="33"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Marital Status</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Never married</title>
                  <measurement_list>
                    <measurement group_id="B1" value="26"/>
                    <measurement group_id="B2" value="22"/>
                    <measurement group_id="B3" value="48"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Married or living as married</title>
                  <measurement_list>
                    <measurement group_id="B1" value="21"/>
                    <measurement group_id="B2" value="25"/>
                    <measurement group_id="B3" value="46"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Widowed, not currently married</title>
                  <measurement_list>
                    <measurement group_id="B1" value="62"/>
                    <measurement group_id="B2" value="49"/>
                    <measurement group_id="B3" value="111"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Divorced, not currently married</title>
                  <measurement_list>
                    <measurement group_id="B1" value="25"/>
                    <measurement group_id="B2" value="29"/>
                    <measurement group_id="B3" value="54"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Separated</title>
                  <measurement_list>
                    <measurement group_id="B1" value="6"/>
                    <measurement group_id="B2" value="10"/>
                    <measurement group_id="B3" value="16"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I don't know / Not sure</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I prefer not to answer / No response</title>
                  <measurement_list>
                    <measurement group_id="B1" value="6"/>
                    <measurement group_id="B2" value="5"/>
                    <measurement group_id="B3" value="11"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Difficulty paying for basic necessities</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Not difficult at all</title>
                  <measurement_list>
                    <measurement group_id="B1" value="57"/>
                    <measurement group_id="B2" value="61"/>
                    <measurement group_id="B3" value="118"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not very difficult</title>
                  <measurement_list>
                    <measurement group_id="B1" value="33"/>
                    <measurement group_id="B2" value="31"/>
                    <measurement group_id="B3" value="64"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat difficult</title>
                  <measurement_list>
                    <measurement group_id="B1" value="31"/>
                    <measurement group_id="B2" value="29"/>
                    <measurement group_id="B3" value="60"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Very difficult</title>
                  <measurement_list>
                    <measurement group_id="B1" value="8"/>
                    <measurement group_id="B2" value="11"/>
                    <measurement group_id="B3" value="19"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I don't know / not sure</title>
                  <measurement_list>
                    <measurement group_id="B1" value="3"/>
                    <measurement group_id="B2" value="2"/>
                    <measurement group_id="B3" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>I prefer not to answer / No response</title>
                  <measurement_list>
                    <measurement group_id="B1" value="15"/>
                    <measurement group_id="B2" value="6"/>
                    <measurement group_id="B3" value="21"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Baseline Knowledge Scores</title>
          <description>Knowledge and awareness about the target vaccine-preventable diseases was assessed at baseline using the Knowledge Instrument, a 3-section, 22-item instrument categorical response instrument. Scores consist of number of correct responses to the questions on the knowledge instrument; a higher score indicates better performance. Four scores are possible: 3 disease-specific subscores (1 each for pneumonia, influenza, and zoster) and 1 total score (equaling the sum of the 3 disease-specific subscores). Possible score ranges are as follows: pneumonia 0-7; influenza 0-7; zoster 0-8; total 0-22.</description>
          <units>Scores on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <title>Total Knowledge Score (number correct out of 22)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="11.6" spread="4.80"/>
                    <measurement group_id="B2" value="12.0" spread="4.82"/>
                    <measurement group_id="B3" value="11.8" spread="4.81"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Zoster Knowledge Score (number correct out of 8)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.8" spread="1.99"/>
                    <measurement group_id="B2" value="3.9" spread="1.96"/>
                    <measurement group_id="B3" value="3.85" spread="1.97"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pneumonia Knowledge Score (# correct out of 7)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="3.1" spread="2.03"/>
                    <measurement group_id="B2" value="3.4" spread="2.05"/>
                    <measurement group_id="B3" value="3.3" spread="2.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Influenza Knowledge Score (# correct out of 7)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="4.8" spread="1.69"/>
                    <measurement group_id="B2" value="4.8" spread="1.63"/>
                    <measurement group_id="B3" value="4.8" spread="1.66"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Mean Change in Knowledge and Awareness About Vaccine-Preventable Diseases</title>
        <description>Knowledge and awareness about the target vaccine-preventable diseases was assessed at each timepoint using the VEPSC Knowledge Instrument, a 3-section, 22-item instrument categorical response instrument. Scores consist of number of correct responses to the questions on the knowledge instrument, thus a higher score indicates better performance. Four scores are possible: three disease-specific subscores (one each for pneumonia, influenza, and zoster) and one total score (equaling the sum of the three disease-specific subscores). Possible score ranges are as follows: pneumonia 0-7; influenza 0-7; zoster 0-8; total 0-22. For each score type, pairwise score differences were calculated between all 3 timepoints (baseline, post-test, and one-month follow-up). Positive values indicate increased knowledge among participants; negative values indicate decreased knowledge.</description>
        <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Mean Change in Knowledge and Awareness About Vaccine-Preventable Diseases</title>
          <description>Knowledge and awareness about the target vaccine-preventable diseases was assessed at each timepoint using the VEPSC Knowledge Instrument, a 3-section, 22-item instrument categorical response instrument. Scores consist of number of correct responses to the questions on the knowledge instrument, thus a higher score indicates better performance. Four scores are possible: three disease-specific subscores (one each for pneumonia, influenza, and zoster) and one total score (equaling the sum of the three disease-specific subscores). Possible score ranges are as follows: pneumonia 0-7; influenza 0-7; zoster 0-8; total 0-22. For each score type, pairwise score differences were calculated between all 3 timepoints (baseline, post-test, and one-month follow-up). Positive values indicate increased knowledge among participants; negative values indicate decreased knowledge.</description>
          <units>Scores on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Baseline to Post Test score change - Total</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.5" spread="4.03"/>
                    <measurement group_id="O2" value="4.9" spread="4.25"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to Post Test score change - Zoster</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.3" spread="1.85"/>
                    <measurement group_id="O2" value="1.8" spread="1.86"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to Post Test score change - Pneumonia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.5" spread="1.89"/>
                    <measurement group_id="O2" value="1.9" spread="1.97"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to Post Test change - Influenza</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.5" spread="1.38"/>
                    <measurement group_id="O2" value="1.1" spread="1.58"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to 1 month follow up change - Total</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.4" spread="4.22"/>
                    <measurement group_id="O2" value="4.3" spread="4.82"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to 1 month follow up change - Zoster</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.3" spread="1.97"/>
                    <measurement group_id="O2" value="1.5" spread="2.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to 1 month follow up change - Pneumonia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.5" spread="1.83"/>
                    <measurement group_id="O2" value="1.5" spread="2.22"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Baseline to 1 month follow up change - Influenza</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.5" spread="1.49"/>
                    <measurement group_id="O2" value="1.2" spread="1.83"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Post test to 1 month follow up change - Total</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="-0.15" spread="2.26"/>
                    <measurement group_id="O2" value="-0.6" spread="3.51"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Post test to 1 month follow up change - Zoster</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="-0.03" spread="0.90"/>
                    <measurement group_id="O2" value="-0.2" spread="1.46"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Post test to 1 month follow up change - Pneumonia</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="-0.09" spread="1.94"/>
                    <measurement group_id="O2" value="-0.4" spread="1.76"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Post test to 1 month follow up change - Influenza</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="-0.03" spread="0.89"/>
                    <measurement group_id="O2" value="0.04" spread="0.6973"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing total knowledge score change between groups from baseline to post intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0081</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing zoster knowledge score change between groups from baseline to post intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0243</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing pneumonia knowledge score change between groups from baseline to post intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0710</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing influenza knowledge score change between groups from baseline to post intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0008</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing total knowledge score change between groups from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.1094</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing zoster knowledge score change between groups from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.2029</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing pneumonia knowledge score change between groups from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.8599</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing influenza knowledge score change between groups from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0007</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing total knowledge score change between groups from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0246</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing zoster knowledge score change between groups from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0780</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing pneumonia knowledge score change between groups from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0167</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing influenza knowledge score change between groups from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.9417</p_value>
            <p_value_desc>Two-sided Wilcoxon Rank-Sum test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Wilcoxon (Mann-Whitney)</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Within-Group Changes in Beliefs About Vaccine-Preventable Diseases and Vaccines</title>
        <description>Beliefs about vaccine-preventable diseases and vaccination were assessed via agreement with 5 statements scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree) at each timepoint. The changes in beliefs between baseline, post-intervention, and the one-month follow-up were assessed in both PHARM and PEER groups. Pairwise Wilcoxon Signed-Rank tests were run comparing within-group changes in beliefs across timepoints and applying the Bonferroni correction (α=0.05/3=0.0167).</description>
        <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Within-Group Changes in Beliefs About Vaccine-Preventable Diseases and Vaccines</title>
          <description>Beliefs about vaccine-preventable diseases and vaccination were assessed via agreement with 5 statements scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree) at each timepoint. The changes in beliefs between baseline, post-intervention, and the one-month follow-up were assessed in both PHARM and PEER groups. Pairwise Wilcoxon Signed-Rank tests were run comparing within-group changes in beliefs across timepoints and applying the Bonferroni correction (α=0.05/3=0.0167).</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Vaccinations are important for health (BL to PT)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="108"/>
                    <measurement group_id="O2" value="97"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="19"/>
                    <measurement group_id="O2" value="27"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vaccinations are important for health (BL to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="107"/>
                    <measurement group_id="O2" value="94"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="19"/>
                    <measurement group_id="O2" value="28"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vaccinations are important for health (PT to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="139"/>
                    <measurement group_id="O2" value="122"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vaccines are harmful to health (BL to PT)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="13"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                    <measurement group_id="O2" value="12"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="79"/>
                    <measurement group_id="O2" value="53"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="40"/>
                    <measurement group_id="O2" value="47"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vaccines are harmful to health (BL to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="13"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="21"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="70"/>
                    <measurement group_id="O2" value="38"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="11"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="40"/>
                    <measurement group_id="O2" value="47"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Vaccines are harmful to health (PT to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="111"/>
                    <measurement group_id="O2" value="83"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                    <measurement group_id="O2" value="15"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                    <measurement group_id="O2" value="14"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in doctors as vaccine info source (BL to PT)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="117"/>
                    <measurement group_id="O2" value="102"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                    <measurement group_id="O2" value="19"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in doctors as vaccine info source (BL to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="112"/>
                    <measurement group_id="O2" value="98"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                    <measurement group_id="O2" value="20"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in doctors as vaccine info source (PT to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="137"/>
                    <measurement group_id="O2" value="115"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in pharmacists for vaccine info (BL to PT)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="11"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="112"/>
                    <measurement group_id="O2" value="96"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="21"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="15"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in pharmacists for vaccine info (BL to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="13"/>
                    <measurement group_id="O2" value="14"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="99"/>
                    <measurement group_id="O2" value="84"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="28"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="15"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in pharmacists for vaccine info (PT to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="13"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="129"/>
                    <measurement group_id="O2" value="98"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="19"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in peer educators for vaccine info(BL to PT)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="12"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="86"/>
                    <measurement group_id="O2" value="77"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="19"/>
                    <measurement group_id="O2" value="27"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="23"/>
                    <measurement group_id="O2" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in peer educators for vaccine info(BL to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="11"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="12"/>
                    <measurement group_id="O2" value="11"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="74"/>
                    <measurement group_id="O2" value="55"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="19"/>
                    <measurement group_id="O2" value="37"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="23"/>
                    <measurement group_id="O2" value="16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Trust in peer educators for vaccine info(PT to 1M)</title>
              <category_list>
                <category>
                  <title>Strongly decreased agreement (3-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat decreased agreement (2-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="9"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly decreased agreement (1-point decrease)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No change in agreement</title>
                  <measurement_list>
                    <measurement group_id="O1" value="114"/>
                    <measurement group_id="O2" value="73"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Slightly improved agreement (1-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="4"/>
                    <measurement group_id="O2" value="19"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Somewhat improved agreement (2-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="9"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Strongly improved agreement (3-point increase)</title>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                    <measurement group_id="O2" value="9"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0011</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>&lt;0.0001</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0028</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>&lt;0.0001</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>1.0</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations is important to my health&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.6430</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.1193</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>&lt;0.0001</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.4861</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0002</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.3247</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;Getting vaccinations can be harmful to my health&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.4627</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.1244</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0575</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.7489</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0098</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.1797</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my doctor to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.3613</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.5972</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0240</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.2437</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0631</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0540</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust my pharmacist to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.7298</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.4218</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from baseline to post-intervention</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.2282</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.8711</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from baseline to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.0027</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.7579</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing within-group changes in beliefs for the statement &quot;I trust a peer educator to give me information about vaccines and the diseases they prevent&quot; from post-intervention to one-month follow-up</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</non_inferiority_desc>
            <p_value>0.1299</p_value>
            <p_value_desc>Wilcoxon Signed-Rank test with a Bonferroni-corrected significance threshold of alpha = 0.0167 (3 comparisons)</p_value_desc>
            <method>Sign test</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Cost Analysis</title>
        <description>Measure the program costs of PHARM and PEER from the senior center perspective. Costs were measured in total for each group, and per-participant costs were calculated by dividing total group cost by group sample size. Outcome measure type is thus reported as &quot;number&quot; rather than choosing measures of central tendency and dispersion/precision (i.e., there are no standard deviations, confidence intervals, or ranges with this methodology).</description>
        <time_frame>Measured after completion of all programs in both groups (an average of one year).</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Cost Analysis</title>
          <description>Measure the program costs of PHARM and PEER from the senior center perspective. Costs were measured in total for each group, and per-participant costs were calculated by dividing total group cost by group sample size. Outcome measure type is thus reported as &quot;number&quot; rather than choosing measures of central tendency and dispersion/precision (i.e., there are no standard deviations, confidence intervals, or ranges with this methodology).</description>
          <units>Dollars</units>
          <param>Number</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Total cost in dollars</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7392.94"/>
                    <measurement group_id="O2" value="14887.45"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total cost per participant</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="50.29"/>
                    <measurement group_id="O2" value="106.34"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total cost per session</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1232.16"/>
                    <measurement group_id="O2" value="1240.62"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total senior center cost</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2488.98"/>
                    <measurement group_id="O2" value="5548.25"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total senior center cost per participant</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="16.93"/>
                    <measurement group_id="O2" value="39.63"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Staff cost (community health worker)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="417.49"/>
                    <measurement group_id="O2" value="1938.04"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Staff cost (PEER Leaders/Pharmacists)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1109.14"/>
                    <measurement group_id="O2" value="1960.00"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Staff cost (Program Director)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="327.33"/>
                    <measurement group_id="O2" value="769.92"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Staff cost (Senior center director)</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0"/>
                    <measurement group_id="O2" value="281.24"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total staff cost</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1853.96"/>
                    <measurement group_id="O2" value="4949.20"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total staff cost per participant</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="12.61"/>
                    <measurement group_id="O2" value="35.35"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Total staff cost per session</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="308.99"/>
                    <measurement group_id="O2" value="412.43"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Travel costs</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="378.89"/>
                    <measurement group_id="O2" value="342.92"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Space costs</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1500"/>
                    <measurement group_id="O2" value="3000"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Supplies cost</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="256.13"/>
                    <measurement group_id="O2" value="256.13"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Refreshment costs</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1550.00"/>
                    <measurement group_id="O2" value="1390.00"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Number of Participants Reporting Program Satisfaction</title>
        <description>Satisfaction was assessed on the post-intervention and one-month follow-up surveys using two statements that were each scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree). The statements were: 1) &quot;The educational program kept me interested or engaged&quot; and 2) &quot;I was satisfied with the content of the educational program&quot;. At each timepoint, responses were dichotomized as &quot;agree&quot; (comprising the &quot;Somewhat agree&quot; and &quot;Completely agree&quot; response options) and &quot;disagree&quot; (comprising the &quot;Somewhat disagree&quot; and &quot;Completely disagree&quot; response options), and these dichotomous responses were compared between PHARM and PEER via Fisher's exact test.</description>
        <time_frame>Measured immediately post-intervention (PT) and at 1 month follow-up (1M)</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Participants Reporting Program Satisfaction</title>
          <description>Satisfaction was assessed on the post-intervention and one-month follow-up surveys using two statements that were each scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree). The statements were: 1) &quot;The educational program kept me interested or engaged&quot; and 2) &quot;I was satisfied with the content of the educational program&quot;. At each timepoint, responses were dichotomized as &quot;agree&quot; (comprising the &quot;Somewhat agree&quot; and &quot;Completely agree&quot; response options) and &quot;disagree&quot; (comprising the &quot;Somewhat disagree&quot; and &quot;Completely disagree&quot; response options), and these dichotomous responses were compared between PHARM and PEER via Fisher's exact test.</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>The program kept me interested or engaged - PT</title>
              <category_list>
                <category>
                  <title>Completely or somewhat agree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="124"/>
                    <measurement group_id="O2" value="127"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Completely or somewhat disagree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="2"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="21"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>The program kept me interested or engaged - 1M</title>
              <category_list>
                <category>
                  <title>Completely or somewhat agree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="130"/>
                    <measurement group_id="O2" value="135"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Completely or somewhat disagree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>I was satisfied with program content - PT</title>
              <category_list>
                <category>
                  <title>Completely or somewhat agree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="125"/>
                    <measurement group_id="O2" value="125"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Completely or somewhat disagree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="21"/>
                    <measurement group_id="O2" value="13"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>I was satisfied with program content - 1M</title>
              <category_list>
                <category>
                  <title>Completely or somewhat agree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="132"/>
                    <measurement group_id="O2" value="138"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Completely or somewhat disagree</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in dichotomous engagement in the program immediately post-intervention via Fisher's Exact test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>1.0</p_value>
            <p_value_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</p_value_desc>
            <method>Fisher Exact</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in dichotomous engagement in the program at the one-month follow-up via Fisher's Exact test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6806</p_value>
            <p_value_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</p_value_desc>
            <method>Fisher Exact</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in dichotomous satisfaction with the program's content immediately post-intervention via Fisher's Exact test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>1.0</p_value>
            <p_value_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</p_value_desc>
            <method>Fisher Exact</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in dichotomous satisfaction with the program's content at the one-month follow-up via Fisher's Exact test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.4908</p_value>
            <p_value_desc>Fisher's Exact test was used (2 x 2) with a significance threshold of 0.05.</p_value_desc>
            <method>Fisher Exact</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Number of Participants Planning to Receive Each Vaccine</title>
        <description>Compare the number of participants planning to receive vaccine in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
        <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
        <population>Rows labeled &quot;Those without history of [...] vaccine&quot; contain a subgroup analysis of those participants not reporting a positive vaccination history at post-test.</population>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Participants Planning to Receive Each Vaccine</title>
          <description>Compare the number of participants planning to receive vaccine in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
          <population>Rows labeled &quot;Those without history of [...] vaccine&quot; contain a subgroup analysis of those participants not reporting a positive vaccination history at post-test.</population>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Planning to receive zoster vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="26"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="46"/>
                    <measurement group_id="O2" value="58"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="75"/>
                    <measurement group_id="O2" value="46"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive zoster vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="44"/>
                    <measurement group_id="O2" value="60"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="38"/>
                    <measurement group_id="O2" value="46"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="65"/>
                    <measurement group_id="O2" value="34"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive zoster vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="46"/>
                    <measurement group_id="O2" value="56"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="44"/>
                    <measurement group_id="O2" value="57"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="57"/>
                    <measurement group_id="O2" value="27"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive influenza vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="22"/>
                    <measurement group_id="O2" value="30"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="25"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="100"/>
                    <measurement group_id="O2" value="74"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive influenza vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="35"/>
                    <measurement group_id="O2" value="44"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="26"/>
                    <measurement group_id="O2" value="30"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="86"/>
                    <measurement group_id="O2" value="66"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive influenza vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="36"/>
                    <measurement group_id="O2" value="45"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="27"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="84"/>
                    <measurement group_id="O2" value="59"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive pneumonia vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="26"/>
                    <measurement group_id="O2" value="35"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="35"/>
                    <measurement group_id="O2" value="35"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="86"/>
                    <measurement group_id="O2" value="70"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive pneumonia vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="40"/>
                    <measurement group_id="O2" value="55"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="32"/>
                    <measurement group_id="O2" value="28"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="75"/>
                    <measurement group_id="O2" value="57"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to receive pneumonia vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="45"/>
                    <measurement group_id="O2" value="54"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="37"/>
                    <measurement group_id="O2" value="40"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="65"/>
                    <measurement group_id="O2" value="46"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of zoster vaccine (PT)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="93"/>
                    <count group_id="O2" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="42"/>
                    <measurement group_id="O2" value="59"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="37"/>
                    <measurement group_id="O2" value="45"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of zoster vaccine (1M)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="93"/>
                    <count group_id="O2" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="39"/>
                    <measurement group_id="O2" value="53"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="43"/>
                    <measurement group_id="O2" value="54"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="11"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of influenza vaccine (PT)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="61"/>
                    <count group_id="O2" value="69"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="32"/>
                    <measurement group_id="O2" value="40"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="26"/>
                    <measurement group_id="O2" value="28"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of influenza vaccine (1M)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="61"/>
                    <count group_id="O2" value="69"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="31"/>
                    <measurement group_id="O2" value="38"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="27"/>
                    <measurement group_id="O2" value="31"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of pneumonia vaccine (PT)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="75"/>
                    <count group_id="O2" value="71"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="35"/>
                    <measurement group_id="O2" value="43"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="29"/>
                    <measurement group_id="O2" value="25"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="11"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without history of pneumonia vaccine (1M)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="75"/>
                    <count group_id="O2" value="71"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="34"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not planning to receive vaccine</title>
                  <measurement_list>
                    <measurement group_id="O1" value="33"/>
                    <measurement group_id="O2" value="32"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="8"/>
                    <measurement group_id="O2" value="3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive zoster vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.7728</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive zoster vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6871</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive zoster vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8259</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive influenza vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8868</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive influenza vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8069</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive influenza vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8489</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive pneumonia vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.3985</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive pneumonia vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.1722</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to receive pneumonia vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.7318</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive zoster vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6309</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive zoster vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.7881</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive influenza vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6798</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive influenza vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8548</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive pneumonia vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.3182</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants planning to receive pneumonia vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.7986</p_value>
            <method>Chi-squared</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Number of Participants Reporting Positive Vaccination Status at Each Timepoint</title>
        <description>Compare the number participants reporting positive vaccination status in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
        <time_frame>Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)</time_frame>
        <population>Rows labeled &quot;without previous [...] vaccine&quot;, contain a subgroup analysis of those participants not reporting a positive vaccination history at post-test.</population>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Participants Reporting Positive Vaccination Status at Each Timepoint</title>
          <description>Compare the number participants reporting positive vaccination status in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire</description>
          <population>Rows labeled &quot;without previous [...] vaccine&quot;, contain a subgroup analysis of those participants not reporting a positive vaccination history at post-test.</population>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Reporting history of zoster vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="50"/>
                    <measurement group_id="O2" value="32"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="80"/>
                    <measurement group_id="O2" value="98"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="17"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of zoster vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="54"/>
                    <measurement group_id="O2" value="30"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="85"/>
                    <measurement group_id="O2" value="105"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="8"/>
                    <measurement group_id="O2" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of zoster vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="52"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="88"/>
                    <measurement group_id="O2" value="103"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of influenza vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="86"/>
                    <measurement group_id="O2" value="70"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="51"/>
                    <measurement group_id="O2" value="66"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="10"/>
                    <measurement group_id="O2" value="4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of influenza vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="86"/>
                    <measurement group_id="O2" value="71"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="60"/>
                    <measurement group_id="O2" value="68"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of influenza vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="89"/>
                    <measurement group_id="O2" value="81"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="57"/>
                    <measurement group_id="O2" value="59"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of pneumonia vaccine at BL</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="65"/>
                    <measurement group_id="O2" value="59"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="67"/>
                    <measurement group_id="O2" value="75"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="15"/>
                    <measurement group_id="O2" value="6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of pneumonia vaccine at PT</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="72"/>
                    <measurement group_id="O2" value="69"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="70"/>
                    <measurement group_id="O2" value="69"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                    <measurement group_id="O2" value="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Reporting history of pneumonia vaccine at 1M</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="147"/>
                    <count group_id="O2" value="140"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="69"/>
                    <measurement group_id="O2" value="67"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="75"/>
                    <measurement group_id="O2" value="72"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without zoster vaccine at PT (1M status)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="93"/>
                    <count group_id="O2" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="10"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="83"/>
                    <measurement group_id="O2" value="99"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without influenza vaccine at PT (1M status)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="61"/>
                    <count group_id="O2" value="69"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="5"/>
                    <measurement group_id="O2" value="17"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="55"/>
                    <measurement group_id="O2" value="52"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="1"/>
                    <measurement group_id="O2" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Those without pneumonia vaccine at PT (1M status)</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="75"/>
                    <count group_id="O2" value="71"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="6"/>
                    <measurement group_id="O2" value="14"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No</title>
                  <measurement_list>
                    <measurement group_id="O1" value="66"/>
                    <measurement group_id="O2" value="56"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="3"/>
                    <measurement group_id="O2" value="1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of zoster vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0163</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of zoster vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0028</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of zoster vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0433</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of influenza vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0592</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of influenza vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.1843</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of influenza vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.5933</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of pneumonia vaccine at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.3942</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of pneumonia vaccine post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.9062</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants reporting positive history of pneumonia vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.9618</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants reporting positive history of zoster vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.1140</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants reporting positive history of influenza vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0141</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Among those without positive vaccination history at post-test, testing between-group differences in number of participants reporting positive history of pneumonia vaccine at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0457</p_value>
            <method>Chi-squared</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Number of Participants Planning to Discuss Vaccines With Others as Assessed by the Activation Questionnaire</title>
        <description>Compare the number of participants planning to discuss vaccines with doctor, pharmacist, or family/friends in PHARM vs. PEER at each timepoint</description>
        <time_frame>Baseline, immediately post-intervention, and 1 month follow-up</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Participants Planning to Discuss Vaccines With Others as Assessed by the Activation Questionnaire</title>
          <description>Compare the number of participants planning to discuss vaccines with doctor, pharmacist, or family/friends in PHARM vs. PEER at each timepoint</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Planning to discuss with doctor at BL</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="66"/>
                    <measurement group_id="O2" value="67"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="81"/>
                    <measurement group_id="O2" value="73"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with doctor at PT</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="98"/>
                    <measurement group_id="O2" value="95"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="49"/>
                    <measurement group_id="O2" value="45"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with doctor at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="112"/>
                    <measurement group_id="O2" value="120"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="35"/>
                    <measurement group_id="O2" value="20"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with pharmacist at BL</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="15"/>
                    <measurement group_id="O2" value="19"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="132"/>
                    <measurement group_id="O2" value="121"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with pharmacist at PT</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="30"/>
                    <measurement group_id="O2" value="36"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="117"/>
                    <measurement group_id="O2" value="104"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with pharmacist at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="38"/>
                    <measurement group_id="O2" value="61"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="109"/>
                    <measurement group_id="O2" value="79"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with family/friends at BL</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="14"/>
                    <measurement group_id="O2" value="13"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="133"/>
                    <measurement group_id="O2" value="127"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with family/friends at PT</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="30"/>
                    <measurement group_id="O2" value="32"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="117"/>
                    <measurement group_id="O2" value="108"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Planning to discuss with family/friends at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="39"/>
                    <measurement group_id="O2" value="60"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="108"/>
                    <measurement group_id="O2" value="80"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their doctor at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6153</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their doctor post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.8299</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their doctor at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0405</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their pharmacist at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.3776</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their pharmacist post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.2856</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their pharmacist at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0016</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their family/friends at baseline via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.9449</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their family/friends post-intervention via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.6143</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants planning to discuss vaccines with their family/friends at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0036</p_value>
            <method>Chi-squared</method>
          </analysis>
        </analysis_list>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Number of Participants Having Discussed Vaccines With Others at One-month Follow-up as Assessed by the Activation Questionnaire</title>
        <description>Compare the number of participants reporting that they have discussed vaccines with their doctor, pharmacist, or family/friends at the one-month follow-up for PHARM vs. PEER</description>
        <time_frame>One-month follow-up (1M)</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pharmacist-led Intervention (PHARM)</title>
            <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
          </group>
          <group group_id="O2">
            <title>Peer-led Intervention (PEER)</title>
            <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
          </group>
        </group_list>
        <measure>
          <title>Number of Participants Having Discussed Vaccines With Others at One-month Follow-up as Assessed by the Activation Questionnaire</title>
          <description>Compare the number of participants reporting that they have discussed vaccines with their doctor, pharmacist, or family/friends at the one-month follow-up for PHARM vs. PEER</description>
          <units>Participants</units>
          <param>Count of Participants</param>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="147"/>
                <count group_id="O2" value="140"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Discussed with doctor at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="22"/>
                    <measurement group_id="O2" value="62"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="125"/>
                    <measurement group_id="O2" value="78"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Discussed with pharmacist at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="7"/>
                    <measurement group_id="O2" value="23"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="140"/>
                    <measurement group_id="O2" value="117"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Discussed with family/friends at 1M</title>
              <category_list>
                <category>
                  <title>Yes</title>
                  <measurement_list>
                    <measurement group_id="O1" value="9"/>
                    <measurement group_id="O2" value="24"/>
                  </measurement_list>
                </category>
                <category>
                  <title>No response</title>
                  <measurement_list>
                    <measurement group_id="O1" value="138"/>
                    <measurement group_id="O2" value="116"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <analysis_list>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants having discussed vaccines with their doctor at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>&lt;0.0001</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants having discussed vaccines with their pharmacist at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0012</p_value>
            <method>Chi-squared</method>
          </analysis>
          <analysis>
            <group_id_list>
              <group_id>O1</group_id>
              <group_id>O2</group_id>
            </group_id_list>
            <groups_desc>Testing between-group differences in number of participants having discussed vaccines with their family/friends at one-month follow-up via Chi-squared test</groups_desc>
            <non_inferiority_type>Equivalence</non_inferiority_type>
            <non_inferiority_desc>Chi-squared test was used with a significance threshold of 0.05.</non_inferiority_desc>
            <p_value>0.0034</p_value>
            <method>Chi-squared</method>
          </analysis>
        </analysis_list>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>Not Applicable - Study was a minimal-risk educational intervention.</time_frame>
      <desc>The study was an educational intervention deemed to present minimal risk to subjects. No adverse events were possible with this study. All-cause mortality, serious and other (not including serious) adverse events were not monitored.</desc>
      <group_list>
        <group group_id="E1">
          <title>Pharmacist-led Intervention (PHARM)</title>
          <description>In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.&#xD;
Pharmacist-led Intervention (PHARM): 60 minute didactic lecture about vaccinations.</description>
        </group>
        <group group_id="E2">
          <title>Peer-led Intervention (PEER)</title>
          <description>A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.&#xD;
Peer-led Intervention (PEER): 60 minute peer led small group intervention including skits and other educational material</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="0"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="0"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="0"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>Principal Investigators are NOT employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <limitations_and_caveats>Study results may not be generalizable to non-Black subpopulations. Real number receiving the vaccination could be either higher or lower than reported due to self-report. Peer leader trust might have already been established prior to the study.</limitations_and_caveats>
    <point_of_contact>
      <name_or_title>Laura T. Pizzi, PharmD, MPH</name_or_title>
      <organization>Rutgers University Center for Health Outcomes, Policy, &amp; Economics</organization>
      <phone>8484456825</phone>
      <email>laura.pizzi@rutgers.edu</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03239665
org study id: Pro20170000208
nct id: NCT03239665
lead sponsor: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The study consists of two arms (PHARM and PEER) designed to educate participants about three
      vaccine-preventable diseases (zoster, pneumonia, and influenza) and vaccination. PHARM will
      consist of a 60-minute presentation about the three vaccine-preventable diseases and their
      vaccinations delivered by a pharmacist, featuring a didactic lecture and discussion
      supplemented by video clips of community members discussing their experiences around
      vaccination, as well as physicians underscoring the importance of vaccination. PEER will
      consist of a 60-minute small-group session led by a peer educator which includes scripted
      roleplaying exercises designed to reinforce learnings pertaining to these three
      vaccine-preventable diseases and their vaccinations. The components of these interventions
      will be designed to address specific barriers to vaccination identified by literature search
      and our prior work in the area of community-based vaccine education. Both arms will focus
      primarily on pneumococcal disease and zoster but will include limited content on influenza
      because participants are likely to have questions about how the flu and its vaccination
      differ from pneumococcal diseases and zoster. The study will be implemented in an older,
      predominantly African-American (AA) population, consistent with our prior work in this area.
In the pharmacist-led ("PHARM") intervention group, participants will be given a 60-minute
      formal didactic presentation on vaccine-preventable diseases and vaccination. This
      presentation will be designed to address knowledge and beliefs related to zoster, pneumonia,
      and influenza, as well as barriers to receiving vaccination. It will be delivered by a
      pharmacist, will be appropriate for the participants' educational level, and will aim to
      establish an understanding of vaccine-preventable illnesses. The presentation will
      specifically discuss the following: causes, symptoms and potential complications of
      infections in the three diseases of interest (pneumococcal disease, zoster, and influenza);
      risk factors for developing the infections; incidence and prevalence of each disease of
      interest; modes of transmission; and disease prevention through vaccination. To improve the
      interactivity of the presentation, brief 30-60 second video clips excerpted from interviews
      with community members and physicians will be shown. Community member clips will consist of
      older adults from the African-American (AA) population who have experienced
      vaccine-preventable infections. These clips will provide culturally relevant testimony to the
      program audience and reinforce participant understanding of concepts introduced during
      didactic teaching.

      In the peer-led ("PEER") intervention, peer educators will be recruited from an experienced
      cohort of peer educators at our senior center partner site. A pharmacist will train the peer
      educators about vaccine-preventable diseases over the course of two didactic sessions.
      Following this training, a third session will be held to train the peer educators on the
      script that they will deliver to participants. The script will include the key learning
      points to be taught by the peer educators to participants about vaccine preventable diseases
      and vaccination. The script will also include roleplay exercises. In the roleplay exercises,
      3 scripted vaccination-related scenarios (one for each disease of interest) will be acted out
      by participants to illustrate scenarios participants might encounter when interacting with
      healthcare providers or friends/family. The skit and roleplay exercises will be practiced as
      needed, under the leadership of the senior center's project manager, to ensure that the peer
      educators are confident and consistent when delivering PEER. After completing the training,
      peer educators' competency on PEER program content will be assessed through a formal
      multiple-choice knowledge test. Each peer educator must achieve a minimum score of 80%
      correct over all items assessed, and 100% correct for all items deemed "core" knowledge. Once
      peer educator competency has been established, each peer educator will deliver PEER through a
      60-minute small group session. During this session, peer educators will deliver the
      educational objectives through an informal discussion and will lead the group through the
      roleplay exercises. Participants will then be asked what key points they learned about
      vaccine-preventable diseases and vaccines. Finally, the peer educator will engage in a
      dialogue to clarify and summarize these key points.

      Objectives are:

        1. Compare the efficacy of PHARM vs. PEER at improving participant's knowledge regarding
           vaccine-preventable diseases

        2. Compare the efficacy of PHARM vs. PEER at improving participants' beliefs about
           vaccination

        3. Measure the costs of PHARM and PEER from the senior center perspective

        4. Compare the percent of participants taking activation step(s) to get vaccinated
           following receipt of PHARM vs. PEER

        5. Determine the extent to which participants are satisfied with and trust the PHARM vs.
           PEER interventions

      Hypotheses supporting these objective are:

        1. PHARM and PEER will achieve similar improvements in older adults' knowledge of vaccine
           preventable diseases (primary hypothesis)

        2. PHARM and PEER will improved beliefs about vaccine-preventable disease

        3. PEER will be a lower cost approach to educating participants in the senior center
           compared to PHARM

        4. PHARM and PEER will result in similar rates of participants taking one or more
           activation step(s) to obtain vaccination

        5. Participants will be highly satisfied with the PHARM and PEER interventions
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: The design is a randomized trial with randomization to PHARM or PEER performed at the program date level.
primary purpose: Prevention
masking: None (Open Label)
measure: Mean Change in Knowledge and Awareness About Vaccine-Preventable Diseases
time frame: Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)
description: Knowledge and awareness about the target vaccine-preventable diseases was assessed at each timepoint using the VEPSC Knowledge Instrument, a 3-section, 22-item instrument categorical response instrument. Scores consist of number of correct responses to the questions on the knowledge instrument, thus a higher score indicates better performance. Four scores are possible: three disease-specific subscores (one each for pneumonia, influenza, and zoster) and one total score (equaling the sum of the three disease-specific subscores). Possible score ranges are as follows: pneumonia 0-7; influenza 0-7; zoster 0-8; total 0-22. For each score type, pairwise score differences were calculated between all 3 timepoints (baseline, post-test, and one-month follow-up). Positive values indicate increased knowledge among participants; negative values indicate decreased knowledge.
measure: Within-Group Changes in Beliefs About Vaccine-Preventable Diseases and Vaccines
time frame: Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)
description: Beliefs about vaccine-preventable diseases and vaccination were assessed via agreement with 5 statements scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree) at each timepoint. The changes in beliefs between baseline, post-intervention, and the one-month follow-up were assessed in both PHARM and PEER groups. Pairwise Wilcoxon Signed-Rank tests were run comparing within-group changes in beliefs across timepoints and applying the Bonferroni correction (α=0.05/3=0.0167).
measure: Cost Analysis
time frame: Measured after completion of all programs in both groups (an average of one year).
description: Measure the program costs of PHARM and PEER from the senior center perspective. Costs were measured in total for each group, and per-participant costs were calculated by dividing total group cost by group sample size. Outcome measure type is thus reported as "number" rather than choosing measures of central tendency and dispersion/precision (i.e., there are no standard deviations, confidence intervals, or ranges with this methodology).
measure: Number of Participants Reporting Program Satisfaction
time frame: Measured immediately post-intervention (PT) and at 1 month follow-up (1M)
description: Satisfaction was assessed on the post-intervention and one-month follow-up surveys using two statements that were each scored on a 4-point Likert scale (1-Completely disagree, 2-Somewhat disagree, 3-Somewhat agree, 4-Completely agree). The statements were: 1) "The educational program kept me interested or engaged" and 2) "I was satisfied with the content of the educational program". At each timepoint, responses were dichotomized as "agree" (comprising the "Somewhat agree" and "Completely agree" response options) and "disagree" (comprising the "Somewhat disagree" and "Completely disagree" response options), and these dichotomous responses were compared between PHARM and PEER via Fisher's exact test.
measure: Number of Participants Planning to Receive Each Vaccine
time frame: Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)
description: Compare the number of participants planning to receive vaccine in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire
measure: Number of Participants Reporting Positive Vaccination Status at Each Timepoint
time frame: Measured at baseline (BL), immediately post-intervention (PT), and 1 month follow-up (1M)
description: Compare the number participants reporting positive vaccination status in PHARM vs. PEER at each timepoint as assessed by the activation questionnaire
measure: Number of Participants Planning to Discuss Vaccines With Others as Assessed by the Activation Questionnaire
time frame: Baseline, immediately post-intervention, and 1 month follow-up
description: Compare the number of participants planning to discuss vaccines with doctor, pharmacist, or family/friends in PHARM vs. PEER at each timepoint
measure: Number of Participants Having Discussed Vaccines With Others at One-month Follow-up as Assessed by the Activation Questionnaire
time frame: One-month follow-up (1M)
description: Compare the number of participants reporting that they have discussed vaccines with their doctor, pharmacist, or family/friends at the one-month follow-up for PHARM vs. PEER
arm group label: Pharmacist-led Intervention (PHARM)
arm group type: Active Comparator
description: In the PHARM intervention group, participants will be given a 60-minute formal presentation on vaccine-preventable diseases to address knowledge and beliefs related to zoster, pneumonia, and influenza and to address barriers to receiving vaccination. In several studies, it has been demonstrated that those who believe it is wise to receive vaccinations and those that have discussed vaccination with their healthcare provider are more likely to receive a vaccine.
arm group label: Peer-led Intervention (PEER)
arm group type: Experimental
description: A pharmacist will train the peer educators about vaccine-preventable diseases over the course of two didactic sessions. Following this training, a third session will be held to train the peer educators on the script that they will deliver to participants. The script will include the key learning points to be taught by the peer educators to participants about vaccine preventable diseases and vaccination. The script will also include role-play exercises. In the role-play exercises, 3 vaccination-related scenarios (one for each disease- zoster, pneumonia, and influenza) will be delivered to illustrate situations participants might encounter when interacting with healthcare providers or friends/family.
intervention type: Behavioral
intervention name: Pharmacist-led Intervention (PHARM)
description: 60 minute didactic lecture about vaccinations.
arm group label: Pharmacist-led Intervention (PHARM)
intervention type: Behavioral
intervention name: Peer-led Intervention (PEER)
description: 60 minute peer led small group intervention including skits and other educational material
arm group label: Peer-led Intervention (PEER)
criteria: 
gender: All
minimum age: 50 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Laura T Pizzi, PharmD, MPH
role: Principal Investigator
affiliation: Rutgers University
facility: 
country: United States
url: http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201406.pdf
description: National Center for Health Statistics. Early Release of Selected Estimates Based on Data From the National Health Interview Survey.
url: https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases
description: U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC.
url: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/ppv.pdf
description: Centers for Disease Control and Prevention. Pneumococcal Polysaccharide Vaccine: What You Need to Know.
url: http://www.immunize.org/catg.d/p4213.pdf
description: Immunization Action Coalition. Pneumococcal Polysaccharide Vaccination Pocket Guide.
citation: Prioli K, Schafer J, Fields Harris L, McCoy M, Barber E, Marthol-Clark M, Pizzi LT. Awareness and beliefs about pneumococcal and influenza vaccination among older African Americans: Results from a survey of community-dwelling participants at an urban senior center. Poster presented at: The 18th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research; May 20, 2013; New Orleans, Louisiana.
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PMID: 25233284
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PMID: 17976353
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PMID: 20863322
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PMID: 25654611
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citation: Gitlin LN, Harris LF, McCoy MC, Chernett NL, Pizzi LT, Jutkowitz E, Hess E, Hauck WW. A home-based intervention to reduce depressive symptoms and improve quality of life in older African Americans: a randomized trial. Ann Intern Med. 2013 Aug 20;159(4):243-52. doi: 10.7326/0003-4819-159-4-201308200-00005.
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citation: Hark L, Waisbourd M, Myers JS, Henderer J, Crews JE, Saaddine JB, Molineaux J, Johnson D, Sembhi H, Stratford S, Suleiman A, Pizzi L, Spaeth GL, Katz LJ. Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project. Ophthalmic Epidemiol. 2016;23(2):122-130. doi: 10.3109/09286586.2015.1099683. Epub 2016 Mar 7.
PMID: 26950056
citation: Waisbourd M, Shafa A, Delvadia R, Sembhi H, Molineaux J, Henderer J, Pizzi LT, Myers JS, Hark LA, Katz LJ. Bilateral Same-day Laser Peripheral Iridotomy in the Philadelphia Glaucoma Detection and Treatment Project. J Glaucoma. 2016 Oct;25(10):e821-e825. doi: 10.1097/IJG.0000000000000409.
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responsible party type: Principal Investigator
investigator affiliation: Rutgers, The State University of New Jersey
investigator full name: Laura T. Pizzi, PharmD, MPH
investigator title: Professor and Director, Center for Health Outcomes, Policy, & Economics
mesh term: Communicable Diseases
mesh term: Infections
mesh term: Pneumonia, Bacterial
sharing ipd: No
ipd description: No IPD will be made available to any researchers external to this study.
provided document: 
provided document: 
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
limitations and caveats: Study results may not be generalizable to non-Black subpopulations. Real number receiving the vaccination could be either higher or lower than reported due to self-report. Peer leader trust might have already been established prior to the study.
point of contact: 