Flu vaccinations nearly doubled among workers at Seattle restaurants taking part in a workplace intervention tested by the University of Washington School of Public Health.

Researchers from Washington’s Health Promotion Research Center worked with managers at 11 Seattle restaurants to promote the events, providing fliers, posters and templates for emails and texts. Employers were encouraged to make group announcements and to talk with employees individually. The vaccines were free.

The effort boosted the overall vaccination rates among workers from 26 percent to 46 percent. For about one-third of the workers, and for half of the Hispanic employees, it was the first flu vaccine they had ever received. Results were published in the American Journal of Health Promotion.

“These were casual dining restaurants where you would go to have a sit-down meal,” said first author Meredith Cook Graves, who conducted the research while a PhD student in the Department of Health Services. She is now a health-services analyst at the VA Puget Sound Health Care System. Jeffrey Harris, chair of the school’s Department of Health Services, led the study.

In a related study, researchers conducted focus group interviews with 70 people from the restaurant industry, including owners and Spanish- and English-speaking workers. The goal was to determine the feasibility of workplace health promotion for restaurant workers.

Restaurant workers are difficult to reach through typical health-care interventions, but are at high risk for smoking, obesity and influenza, researchers said. Nationally, only 14 percent of restaurant workers have employer-provided health insurance.

Led by Claire Allen, a research scientist for the Health Promotion Research Center, researchers found that tobacco cessation and influenza vaccinations provide opportunities for health promotion among restaurant workers, whereas physical activity interventions face greater challenges.

Many participants said they felt exhausted at the end of the day and didn’t have the energy to exercise. Others said they thought restaurants gave an inconsistent message by selling unhealthy food while promoting physical activity. Owners and workers alike said workers would prefer health insurance or paid vacation to gym memberships.

The study was published in the October issue of Preventing Chronic Disease.