Enrollment in participatory surveillance programs and influenza vaccination uptake: A systematic review protocol

Background: Despite the availability of effective vaccines, seasonal influenza remains a substantial global public health concern. Suboptimal influenza vaccination uptake is found across many populations. Using digital platforms, individuals can self-report health information through participatory surveillance programs. Though they are mainly used for infectious disease monitoring, their potential association with preventive behaviors such as influenza vaccination uptake has not been systematically evaluated. This review is necessary and urgent given the recurrent influenza outbreaks and the severity of illness due to low vaccination rates. Objective: This protocol details the design and methodology of a systematic review that will assess whether enrollment in participatory surveillance programs is associated with differences in seasonal influenza vaccination uptake compared with non-participation. Methods: This systematic review protocol follows the Cochrane guidelines, is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P), and is registered in PROSPERO (CRD420251274024). Eligible studies will include quantitative comparative designs, including randomized controlled trials, as well as observational and quasi-experimental studies with appropriate comparators. The population will comprise individuals eligible for influenza vaccination in settings where participatory surveillance programs are available. The primary outcome is influenza vaccination uptake. Searches will be conducted in PubMed, Embase, Cochrane CENTRAL, Scopus, CABI Global Health, and CINAHL, alongside selected grey literature sources, without restrictions on language, geography, or publication date. Two reviewers will independently screen studies, extract data using Covidence, and assess risk of bias using ROB 2 and ROBINS-I. Where appropriate, data will be synthesized using meta-analysis or narrative methods. Heterogeneity will be described using I2, and certainty assessed using GRADE. Conclusions: This systematic review will provide an urgently needed summary of evidence regarding the association between participatory surveillance enrollment and influenza vaccination uptake. Findings will inform future research and the development of digital public health strategies that integrate disease surveillance and health promotion.