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Guevara JP, Jimenez ME, Jenssen BP, Luethke M, Doyle R, Buttenheim A. Early Literacy Promotion Using Automated Hovering Among Young Minority Children. Acad Pediatr 2024; 24:900-904. [PMID: 37956737 DOI: 10.1016/j.acap.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To determine feasibility, acceptability, and explore outcomes of behavioral economic (BE) strategies to increase parent-child shared reading within a Reach Out and Read program. METHODS We conducted rapid-cycle interviews with 10 parents to assess text messages followed by an 8-week randomized controlled trial of 3 BE strategies at 2 urban primary care practices: daily text messages (texting); daily text messages and regret messaging (regret); or daily text messages, regret messaging, and lottery participation (lottery). Parent-child dyads were eligible if children were <24 months old, Medicaid-eligible, and had access to phones capable of receiving and sending text messages. Parents completed the Read Subscale of the StimQ and Parenting Stress Index-short form (PSI-SF) pre- and postintervention, MacArthur Communicative Development Inventory (CDI), Devereux Early Childhood Assessment (DECA), and a satisfaction measure postintervention. Differences between groups were assessed using intention-to-treat analysis. RESULTS Of 45 dyads randomized, 41 (91%) completed the study. Most participants were Black with incomes <$55,000. Parents reported reading on average 4 d/wk with no change in the reading frequency over time. StimQ scores increased over time, but there were no significant differences in StimQ, PSI-SF, CDI, and DECA scores between groups. Parents in all 3 groups reported satisfaction (3.8/5.0) with the intervention. CONCLUSIONS Implementation of BE strategies in 2 Reach Out and Read programs was feasible, near acceptable, and improved home reading environment scores. Future study should investigate BE strategies vis-à-vis usual care and be of sufficient duration and intensity to engage participants to assess its impact on patient and parent outcomes.
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Affiliation(s)
- James P Guevara
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia; Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia; Department of Biostatistics, Epidemiology, and Biostatistics (JP Guevara), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
| | - Manuel E Jimenez
- Department of Pediatrics (ME Jimenez), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Brian P Jenssen
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia; Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia
| | - Michael Luethke
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia
| | - Rebecca Doyle
- Department of Family and Community Health (R Doyle and A Buttenheim), School of Nursing, University of Pennsylvania, Philadelphia
| | - Alison Buttenheim
- Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia; Department of Family and Community Health (R Doyle and A Buttenheim), School of Nursing, University of Pennsylvania, Philadelphia
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2
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Currie GE, McLeod C, Waddington C, Snelling TL. SMS-based interventions for improving child and adolescent vaccine coverage and timeliness: a systematic review. BMC Public Health 2024; 24:1753. [PMID: 38956527 PMCID: PMC11218178 DOI: 10.1186/s12889-024-18900-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The aim of this review was to investigate the impact of short message service (SMS)-based interventions on childhood and adolescent vaccine coverage and timeliness. METHODS A pre-defined search strategy was used to identify all relevant publications up until July 2022 from electronic databases. Reports of randomised trials written in English and involving children and adolescents less than 18 years old were included. The review was conducted in accordance with PRISMA guidelines. RESULTS Thirty randomised trials were identified. Most trials were conducted in high-income countries. There was marked heterogeneity between studies. SMS-based interventions were associated with small to moderate improvements in vaccine coverage and timeliness compared to no SMS reminder. Reminders with embedded education or which were combined with monetary incentives performed better than simple reminders in some settings. CONCLUSION Some SMS-based interventions appear effective for improving child vaccine coverage and timeliness in some settings. Future studies should focus on identifying which features of SMS-based strategies, including the message content and timing, are determinants of effectiveness.
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Affiliation(s)
- G E Currie
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, WA, Australia
| | - C McLeod
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, WA, Australia
| | - C Waddington
- Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - T L Snelling
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, WA, Australia.
- School of Public Health, Curtin University, Bentley, WA, Australia.
- Menzies School of Health Research and Charles Darwin University, Casuarina, NT, Australia.
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3
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Fisher CL, Mullis MD, McFarlane A, Hansen MD, Vilaro MJ, Bylund CL, Wiggins L, Corbitt H, Staras SAS. Promoting Rural-Residing Parents' Receptivity to HPV Vaccination: Targeting Messages and Mobile Clinic Implementation. Vaccines (Basel) 2024; 12:712. [PMID: 39066350 PMCID: PMC11281438 DOI: 10.3390/vaccines12070712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Interventions are needed to increase low HPV vaccination rates within rural areas in the United States, particularly in the state of Florida, which has the seventh highest number of HPV-related cancers. Florida also ranks low compared to other states in terms of HPV vaccination. Rural-residing parents may benefit from two evidence-based strategies to increase vaccination rates: reminder messages informing and prompting vaccination appointments and mobile clinics to reduce transportation barriers. We sought to identify parental attitudes towards (1) message features that promote rural-residing parents' receptivity to HPV vaccination; (2) parents' acceptability of three reminder message modalities (text, postcard, phone); and (3) implementation factors that promote parents' acceptability of using a mobile clinic for vaccination. We recruited 28 rural-residing parents of 9- to 12-year-old children (unvaccinated for HPV) for focus group and individual interviews and thematically analyzed transcripts. Three features promoted parents' receptivity to HPV vaccination messages: source credibility, specific information coverage, and personalization (name and birthday wishes). Parents most preferred text messages and identified three factors promoting parents' mobile clinic use: convenience and feasibility, trustworthiness, and detailed information. The findings indicate rural-residing parents' acceptability of reminder messages and mobile clinics as well as the importance of trust and feasibility when implementing these evidence-based strategies for rural-residing parents.
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Affiliation(s)
- Carla L. Fisher
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - M. Devyn Mullis
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Antionette McFarlane
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA;
| | - Marta D. Hansen
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Melissa J. Vilaro
- Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA;
| | - Carma L. Bylund
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
| | - Lori Wiggins
- Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA; (L.W.); (H.C.)
| | - Halie Corbitt
- Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA; (L.W.); (H.C.)
| | - Stephanie A. S. Staras
- Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (M.D.M.); (M.D.H.); (C.L.B.); (S.A.S.S.)
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Debinski B, Daniel SS, Rigdon J, Mayfield A, Tzintzun T, Poehling KA. A Pilot Randomized Controlled Trial of Text Messages to Improve Well-Child Visit Attendance After No-Show. Acad Pediatr 2024:S1876-2859(24)00168-2. [PMID: 38852906 DOI: 10.1016/j.acap.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 05/19/2024] [Accepted: 06/02/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE Evaluate the effectiveness of text messages to systematically engage parents/guardians ("caregivers") to reschedule a well-child visit (WCV) that was missed ("no-show") and attend that rescheduled WCV visits. METHODS Patients <18 years in one of five pediatrics or family medicine clinics, in one health system in the Southeast US, were eligible. Patients without a rescheduled WCV after a no-show were randomized into intervention (text messages) or care-as-usual comparison, stratified by language (English/Spanish). Enrollment occurred May-July 2022. Up to three text messages were sent to caregivers one week apart via REDCap and Twilio, advising how to reschedule the missed appointment by phone or health portal. Primary outcomes were 1) rescheduling a WCV within 6 weeks of no-show and 2) completing a rescheduled WCV within 6 weeks. Risk differences (RD) and odds ratios (OR) were used to evaluate the effect of text messages. RESULTS Seven hundred and twenty patients were randomized and analyzed (texts: 361, comparison: 359). The proportion rescheduling WCV after text versus usual care was English: 18.85% versus 15.02%, respectively, and Spanish: 5.94% versus 8.14%, with overall RD+ 1.98% (95% CI: -1.85, 5.81) and OR 1.21 (95% CI: 0.79, 1.84; P-value .38). Completed WCV rates in text or usual care were English: 13.08% versus 6.59%, and Spanish: 5.81% versus 5.94% with texts associated with RD+ 2.83% (95% CI: 1.66, 4.00) and OR 1.86 (95% CI: 1.09, 3.19). CONCLUSION Text message follow-up after a no-show WCV may positively impact attendance at WCVs rescheduled in the subsequent 6 weeks. TRIAL REGISTRATION ClinicalTrials.gov NCT05086237.
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Affiliation(s)
- Beata Debinski
- Department of Family and Community Medicine (B Debinski, SS Daniel, and A Mayfield), Wake Forest University School of Medicine, Winston Salem, NC.
| | - Stephanie S Daniel
- Department of Family and Community Medicine (B Debinski, SS Daniel, and A Mayfield), Wake Forest University School of Medicine, Winston Salem, NC
| | - Joseph Rigdon
- Department of Biostatistics and Data Science (J Rigdon), Wake Forest University School of Medicine, Winston Salem, NC
| | - Andrew Mayfield
- Department of Family and Community Medicine (B Debinski, SS Daniel, and A Mayfield), Wake Forest University School of Medicine, Winston Salem, NC
| | - Tiffany Tzintzun
- Public Health Corps (T Tzintzun), Wake Forest University, Winston Salem, NC
| | - Katherine A Poehling
- Department of Pediatrics (KA Poehling), Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC
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Meriggi NF, Voors M, Levine M, Ramakrishna V, Kangbai DM, Rozelle M, Tyler E, Kallon S, Nabieu J, Cundy S, Mobarak AM. Last-mile delivery increases vaccine uptake in Sierra Leone. Nature 2024; 627:612-619. [PMID: 38480877 PMCID: PMC10954551 DOI: 10.1038/s41586-024-07158-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2024] [Indexed: 03/20/2024]
Abstract
Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development1. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties2, we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48-72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services3.
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Affiliation(s)
- Niccolò F Meriggi
- International Growth Centre, Freetown, Sierra Leone.
- Wageningen University and Research, Wageningen, The Netherlands.
- Centre for the Study of African Economies, Department of Economics, University of Oxford, Oxford, UK.
| | - Maarten Voors
- Wageningen University and Research, Wageningen, The Netherlands
| | | | | | | | - Michael Rozelle
- Wageningen University and Research, Wageningen, The Netherlands
| | - Ella Tyler
- Wageningen University and Research, Wageningen, The Netherlands
| | - Sellu Kallon
- Wageningen University and Research, Wageningen, The Netherlands
- University of Sierra Leone, Freetown, Sierra Leone
| | - Junisa Nabieu
- Wageningen University and Research, Wageningen, The Netherlands
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Wynn CS, Fiks AG, Localio R, Shults J, Nekrasova E, Shone LP, Torres A, Griffith M, Unger R, Ware LA, Kelly MK, Stockwell MS. Examination of Text Message Plans and Baseline Usage of Families Enrolled in a Text Message Influenza Vaccine Reminder Trial: Survey Study. JMIR Form Res 2023; 7:e39576. [PMID: 37389945 PMCID: PMC10365607 DOI: 10.2196/39576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) is quickly expanding as a method of health promotion, but some interventions may not be familiar or comfortable for potential users. SMS text messaging has been investigated as a low-cost, accessible way to provide vaccine reminders. Most (97%) US adults own a cellphone and of those adults most use SMS text messaging. However, understanding patterns of SMS text message plan type and use in diverse primary care populations needs more investigation. OBJECTIVE We sought to use a survey to examine baseline SMS text messaging and data plan patterns among families willing to accept SMS text message vaccine reminders. METHODS As part of a National Institutes of Health (NIH)-funded national study (Flu2Text) conducted during the 2017-2018 and 2018-2019 influenza seasons, families of children needing a second seasonal influenza vaccine dose were recruited in pediatric primary care offices at the time of their first dose. Practices were from the American Academy of Pediatrics' (AAP) Pediatric Research in Office Settings (PROS) research network, the Children's Hospital of Philadelphia, and Columbia University. A survey was administered via telephone (Season 1) or electronically (Season 2) at enrollment. Standardized (adjusted) proportions for SMS text message plan type and texting frequency were calculated using logistic regression that was adjusted for child and caregiver demographics. RESULTS Responses were collected from 1439 participants (69% of enrolled). The mean caregiver age was 32 (SD 6) years, and most children (n=1355, 94.2%) were aged 6-23 months. Most (n=1357, 94.3%) families were English-speaking. Most (n=1331, 92.8%) but not all participants had an unlimited SMS text messaging plan and sent or received texts at least once daily (n=1313, 91.5%). SMS text messaging plan type and use at baseline was uniform across most but not all subgroups. However, there were some differences in the study population's SMS text messaging plan type and usage. Caregivers who wanted Spanish SMS text messages were less likely than those who chose English to have an unlimited SMS text messaging plan (n=61, 86.7% vs n=1270, 94%; risk difference -7.2%, 95% CI -27.1 to -1.8). There were no significant differences in having an unlimited plan associated with child's race, ethnicity, age, health status, insurance type, or caregiver education level. SMS text messaging use at baseline was not uniform across all subgroups. Nearly three-quarters (n=1030, 71.9%) of participants had received some form of SMS text message from their doctor's office; most common were appointment reminders (n=1014, 98.4%), prescription (n=300, 29.1%), and laboratory notifications (n=117, 11.4%). Even the majority (n=64, 61.5%) of those who did not have unlimited plans and who texted less than daily (n=72, 59%) reported receipt of these SMS text messages. CONCLUSIONS In this study, most participants had access to unlimited SMS text messaging plans and texted at least once daily. However, infrequent texting and lack of access to an unlimited SMS text messaging plan did not preclude enrolling to receive SMS text message reminders in pediatric primary care settings.
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Affiliation(s)
- Chelsea S Wynn
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Alexander G Fiks
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Russell Localio
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Justine Shults
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Ekaterina Nekrasova
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Laura P Shone
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Alessandra Torres
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Miranda Griffith
- Primary Care Research, American Academy of Pediatrics, Itasca, IL, United States
| | - Rebecca Unger
- Northwestern Children's Practice, Chicago, IL, United States
| | - Leigh Ann Ware
- Building Blocks Pediatrics, Pleasanton, TX, United States
| | - Mary Kate Kelly
- Department of Pediatrics, Clinical Futures & PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
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Currie GE, Totterdell J, Bowland G, Leeb A, Peters I, Blyth CC, Waddington C, Marsh JA, Snelling TL. The AuTOMATIC trial: a study protocol for a multi-arm Bayesian adaptive randomised controlled trial of text messaging to improve childhood immunisation coverage. Trials 2023; 24:97. [PMID: 36750833 PMCID: PMC9904255 DOI: 10.1186/s13063-023-07097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND While most Australian children are vaccinated, delays in vaccination can put them at risk from preventable infections. Widespread mobile phone ownership in Australia could allow automated short message service (SMS) reminders to be used as a low-cost strategy to effectively 'nudge' parents towards vaccinating their children on time. METHODS AuTOMATIC is an adaptive randomised trial which aims to both evaluate and optimise the use of SMS reminders for improving the timely vaccination of children at primary care clinics across Australia. The trial will utilise high levels of digital automation to effect, including eligibility assessment, randomisation, delivery of intervention, data extraction and analysis, thereby allowing healthcare-embedded trial delivery. Up to 10,000 parents attending participating primary care clinics will be randomised to one of 12 different active SMS vaccine reminder content and timing arms or usual practice only (no SMS reminder). The primary outcome is vaccine receipt within 28 days of the scheduled date for the index vaccine (the first scheduled vaccine after randomisation). Secondary analyses will assess receipt and timeliness for all vaccine occasions in all children. Regular scheduled analyses will be performed using Bayesian inference and pre-specified trial decision rules, enabling response adaptive randomisation, suspension of any poorly performing arms and early stopping if a single best message is identified. DISCUSSION This study will aim to optimise SMS reminders for childhood vaccination in primary care clinics, directly comparing alternative message framing and message timing. We anticipate that the trial will be an exemplar in using Bayesian adaptive methodology to assess a readily implementable strategy in a wide population, capable of delivery due to the levels of digital automation. Methods and findings from this study will help to inform strategies for implementing reminders and embedding analytics in primary health care settings. TRIAL REGISTRATION ANZCTR: ACTRN12618000789268 .
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Affiliation(s)
- Grace E. Currie
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia
| | - James Totterdell
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia
| | - Grahame Bowland
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia
| | - Alan Leeb
- SmartVax, c/o Illawarra Medical Centre, Perth, WA Australia
| | - Ian Peters
- SmartVax, c/o Illawarra Medical Centre, Perth, WA Australia
| | - Chris C. Blyth
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.410667.20000 0004 0625 8600Department of Infectious Diseases, Perth Children’s Hospital, Perth, WA Australia ,grid.1012.20000 0004 1936 7910School of Medicine, University of Western Australia, Perth, WA Australia
| | - Claire Waddington
- grid.5335.00000000121885934Department of Medicine, University of Cambridge, Cambridge, UK
| | - Julie A. Marsh
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia
| | - Thomas L. Snelling
- grid.414659.b0000 0000 8828 1230Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006 Australia ,grid.410667.20000 0004 0625 8600Department of Infectious Diseases, Perth Children’s Hospital, Perth, WA Australia ,grid.1032.00000 0004 0375 4078School of Public Health, Curtin University, Perth, WA Australia ,Menzies School of Public Health, Darwin, NT Australia
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Burkhardt MC, Berset AE, Xu Y, Mescher A, Brinkman WB. Effect of Outreach Messages on Adolescent Well-Child Visits and Coronavirus Disease 2019 Vaccine Rates: A Randomized, Controlled Trial. J Pediatr 2023; 253:158-164.e1. [PMID: 36202236 PMCID: PMC9529346 DOI: 10.1016/j.jpeds.2022.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/26/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine effectiveness of text/telephone outreach messages, with and without coronavirus disease 2019 (COVID-19) vaccine information. STUDY DESIGN We conducted an intent-to-treat, multiarm, randomized clinical trial with adolescents aged 12-17 years. Eligible patients did not have an adolescent well-care visit in the past year or scheduled in the next 45 days or an active electronic health record portal account. We randomized participants to the standard message, COVID-19 vaccine message, or no message (control) group and delivered 2 text messages or telephone calls (per family preference) to the message groups. The primary outcome was adolescent well-care visit completion within 8 weeks, and secondary outcomes were adolescent well-care visit scheduled within 2 weeks and receiving COVID-19 vaccine within 8 weeks. RESULTS We randomized 1235 adolescents (mean age, 14 ± 1.5 years; 51.6% male; 76.7% Black; 4.1% Hispanic/Latinx; 88.3% publicly insured). The standard message group had higher odds of scheduling an adolescent well-care visit compared with the control group (OR, 2.07; 95% CI, 1.21-3.52) and COVID-19 vaccine message group (OR, 1.66; 95% CI, 1.00-2.74). The odds of completing an adolescent well-care visit did not differ significantly (standard message group vs control group; OR, 1.35; 95% CI, 0.88-2.06; COVID-19 vaccine message group vs control group, OR, 1.33; 95% CI, 0.87-2.03). In per-protocol analyses, adolescents in the standard message group were twice as likely as the control group to receive the COVID-19 vaccine (OR, 2.48; 95% CI, 1.05-5.86). CONCLUSIONS Outreach messages were minimally effective. Efforts are needed to address widening disparities. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT04904744.
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Affiliation(s)
- Mary Carol Burkhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Anne E Berset
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Yingying Xu
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Anne Mescher
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - William B Brinkman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Staras SAS, Bylund CL, Mullis MD, Thompson LA, Hall JM, Hansen MD, Fisher CL. Messaging preferences among Florida caregivers participating in focus groups who had not yet accepted the HPV vaccine for their 11- to 12-year-old child. BMC Public Health 2022; 22:2413. [PMID: 36550434 PMCID: PMC9779937 DOI: 10.1186/s12889-022-14852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In the United States, human papillomavirus (HPV) vaccination rates remain low. The President's Cancer Panel suggests that effective messaging about the HPV vaccination focus on the vaccine's safety, efficacy, ability to prevent cancer, and recommendation at ages 11- to 12-years. We aimed to develop messages about HPV vaccine that include the President Cancer Panel's suggestions and were acceptable to caregivers of adolescents. METHODS From August to October 2020, we conducted one-hour, Zoom videoconference focus groups with caregivers who lived in Florida, had an 11- to 12-year-old child, and had not had any of their children receive the HPV vaccine. Focus group moderators asked caregivers to react to three videos of clinician (i.e., MD, DO, APRN, PA) recommendations and three text message reminders. Thematic analysis was conducted using the constant comparative method and led by one author with qualitative analysis expertise. Two additional authors validated findings. RESULTS Caregivers (n = 25 in six groups) were primarily non-Hispanic white (84%) and educated (64% had at least an Associate's degree). Approximately a third of caregivers had delayed (44%) or decided against a vaccine for their child (36%). Caregivers described six preferred message approaches: recognize caregivers' autonomy, balanced benefits and risks, trustworthy sources, increased feasibility of appointment scheduling, information prior to decision point, and preferred personalized information. Caregivers expressed a desire to have the follow-up doses mentioned in the introduction. CONCLUSIONS HPV vaccine messages, whether delivered by a clinician or via text message, will be more acceptable to caregivers if they approach HPV vaccination as the caregivers' decision, and include information from trusted sources to help caregivers make an informed choice.
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Affiliation(s)
- Stephanie A. S. Staras
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Carma L. Bylund
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Michaela D. Mullis
- grid.15276.370000 0004 1936 8091Department of Advertising, College of Journalism and Communications, University of Florida, 2096 Weimer Hall 1885 Stadium Rd, PO BOX 118400, Gainesville, FL 32611 USA
| | - Lindsay A. Thompson
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Department of Pediatrics, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610 USA
| | - Jaclyn M. Hall
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA ,grid.15276.370000 0004 1936 8091Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Marta D. Hansen
- grid.15276.370000 0004 1936 8091Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610 USA
| | - Carla L. Fisher
- grid.15276.370000 0004 1936 8091Department of Advertising, College of Journalism and Communications, University of Florida, 2096 Weimer Hall 1885 Stadium Rd, PO BOX 118400, Gainesville, FL 32611 USA
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10
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Stockwell MS, Shone LP, Nekrasova E, Wynn C, Torres A, Griffith M, Shults J, Unger R, Ware LA, Kolff C, Harris D, Berrigan L, Montague H, Localio AR, Fiks AG. Text Message Reminders for the Second Dose of Influenza Vaccine for Children: An RCT. Pediatrics 2022; 150:e2022056967. [PMID: 35965283 PMCID: PMC9592065 DOI: 10.1542/peds.2022-056967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Among children requiring 2 influenza doses in a given season, second dose receipt nearly halves the odds of influenza. Nationally, many children do not receive both needed doses. This study sought to compare the effectiveness of text message reminders with embedded interactive educational information versus usual care on receipt and timeliness of the second dose of influenza vaccine. METHODS This trial took place over the 2017 to 2018 and 2018 to 2019 influenza seasons among 50 pediatric primary care offices across 24 states primarily from the American Academy of Pediatrics' Pediatric Research in Office Settings practice-based research network. Caregiver-child dyads of children 6 months to 8 years in need of a second influenza vaccination that season were individually randomized 1:1 into intervention versus usual care, stratified by age and language within each practice. Intervention caregivers received automated, personalized text messages, including educational information. Second dose receipt by April 30 (season end) and by day 42 (2 weeks after second dose due date) were assessed using Mantel Haenszel methods by practice and language. Analyses were intention to treat. RESULTS Among 2086 dyads enrolled, most children were 6 to 23 months and half publicly insured. Intervention children were more likely to receive a second dose by season end (83.8% versus 80.9%; adjusted risk difference (ARD) 3.8%; 95% confidence interval [0.1 to 7.5]) and day 42 (62.4% versus 55.7%; ARD 8.3% [3.6 to 13.0]). CONCLUSIONS In this large-scale trial of primary care pediatric practices across the United States, text message reminders were effective in promoting increased and timelier second dose influenza vaccine receipt.
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Affiliation(s)
- Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University, New York, NY
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY
| | - Laura P Shone
- Primary Care Research, American Academy of Pediatrics, Itasca, IL
| | - Ekaterina Nekrasova
- Department of Pediatrics, Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Chelsea Wynn
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University, New York, NY
| | | | - Miranda Griffith
- Primary Care Research, American Academy of Pediatrics, Itasca, IL
| | - Justine Shults
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | - Chelsea Kolff
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University, New York, NY
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY
| | - Donna Harris
- Primary Care Research, American Academy of Pediatrics, Itasca, IL
| | - Lindsay Berrigan
- Department of Pediatrics, Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Heather Montague
- Primary Care Research, American Academy of Pediatrics, Itasca, IL
- American Academy of Dental Sleep Medicine, Lisle, IL
| | - A Russell Localio
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alexander G Fiks
- Department of Pediatrics, Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, PA
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11
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Siddiqui FA, Padhani ZA, Salam RA, Aliani R, Lassi ZS, Das JK, Bhutta ZA. Interventions to Improve Immunization Coverage Among Children and Adolescents: A Meta-analysis. Pediatrics 2022; 149:186948. [PMID: 35503337 DOI: 10.1542/peds.2021-053852d] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Vaccinations are recognized as a feasible, cost-effective public health intervention for reducing the burden and associated mortality of many infectious diseases. The purpose of this study was to evaluate the effectiveness of potential interventions to improve the uptake of vaccines among children and adolescents. METHODS We performed a literature search until December 2020. Eligible studies were identified using Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, and other sources. We included studies conducted on children and adolescents aged 5 to 19 years. Studies comprised of hospitalized children and those with comorbid conditions were excluded. Two authors independently performed the meta-analysis. RESULTS Findings from 120 studies (123 articles), of which 95 were meta-analyzed, reveal that vaccination education may increase overall vaccination coverage by 19% (risk ratio [RR], 1.19; 95% confidence interval [CI], 1.12-1.26), reminders by 15% (RR, 1.15; 95% CI, 1.11-1.18), interventions for providers by 13% (RR, 1.13; 95% CI, 1.07-1.19), financial incentives by 67% (RR, 1.67; 95% CI, 1.40-1.99), and multilevel interventions by 25% (RR, 1.25; 95% CI, 1.10-1.41). The impact of school-based clinics and policy and legislation on overall vaccination coverage is still uncertain, and no impact of a multicomponent intervention on overall vaccination coverage was found. CONCLUSIONS Educational interventions, reminders, provider-directed interventions, financial incentives, and multilevel interventions may improve vaccination coverage among school-aged children and adolescents.
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Affiliation(s)
- Faareha A Siddiqui
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zahra A Padhani
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Razia Aliani
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada
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12
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Akumbom AM, Lee JJ, Reynolds NR, Thayer W, Wang J, Slade E. Cost and effectiveness of HPV vaccine delivery strategies: A systematic review. Prev Med Rep 2022; 26:101734. [PMID: 35251910 PMCID: PMC8889236 DOI: 10.1016/j.pmedr.2022.101734] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/06/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022] Open
Abstract
This review focused on implemented HPV vaccine delivery strategies and their costs. Insights on the costs and effectiveness of HPV vaccination strategies are provided. Access was improved by increasing the availability and the uptake of HPV vaccines. Costs varied by vaccine delivery strategy and target population. Lessons learned can inform efficient and equitable allocation of vaccine resources.
Fifteen years following the approval of the first human papillomavirus (HPV) vaccine, cervical cancer continues to be a significant source of morbidity and mortality among women in low-resource settings. It is the second-leading cause of cancer-related deaths in women globally and the leading cause of cancer-related deaths in Sub-Saharan Africa. Vaccine delivery and programmatic costs may hinder the distribution of HPV vaccines in low-resource settings, and ultimately influence access to HPV vaccines. While reviews have been conducted on the cost-effectiveness of HPV vaccines, little is known about the cost and effectiveness of vaccination strategies. The purpose of this systematic review was to synthesize evidence on the cost and cost-effectiveness of vaccination strategies utilized to increase access to HPV vaccines. Search queries were created for CINAHL Plus, Embase, and PubMed. Our search strategy focused on articles that contained information on HPV vaccine uptake/reach, HPV vaccination costs, or the cost-effectiveness of HPV vaccination programs. We retrieved 773 articles from the databases, assessed 251 full-texts, and included 15 articles in our final synthesis. Countries without national HPV vaccination programs aimed to identify and adopt sustainable strategies to make HPV vaccines available to adolescents through demonstration programs. In contrast, countries with national vaccination programs focused on identifying cost-effective interventions to increase vaccination rates to meet nationally recommended standards. There is a dire need for HPV vaccination programs and intervention studies tailored to settings in low- and middle-income countries to increase access to HPV vaccines. Future studies should also evaluate the cost-effectiveness of implemented strategies.
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13
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Wynn CS, Catallozzi M, Kolff CA, Holleran S, Meyer D, Ramakrishnan R, Stockwell MS. Personalized Reminders for Immunization Using Short Messaging Systems to Improve Human Papillomavirus Vaccination Series Completion: Parallel-Group Randomized Trial. JMIR Mhealth Uhealth 2021; 9:e26356. [PMID: 34958306 PMCID: PMC8749571 DOI: 10.2196/26356] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/09/2021] [Accepted: 10/13/2021] [Indexed: 11/15/2022] Open
Abstract
Background Completion rates among adolescents who initiate the human papillomavirus (HPV) vaccine 3-dose series are low. SMS text message vaccine reminders are effective, but less is known about the best types for HPV series completion or the ability to assess and target vaccine decision-making stage. Objective The aim of this study is to compare the effectiveness of HPV vaccine series completion in minority adolescents who received precision and educational versus conventional SMS text message reminders. Methods Enrolled parents of adolescents aged 9-17 years who received the first HPV vaccine dose at 1 of the 4 academic-affiliated community health clinics in New York City were randomized 1:1 to 1 of the 2 parallel, unblinded arms: precision SMS text messages (which included stage-targeted educational information, next dose due date, and site-specific walk-in hours) or conventional SMS text messages without educational information. Randomization was stratified according to gender, age, and language. The primary outcome was series completion within 12 months. In post hoc analysis, enrollees were compared with concurrent nonenrollees and historical controls. Results Overall, 956 parents were enrolled in the study. The precision (475 families) and conventional (481 families) SMS text message arms had similarly high series completion rates (344/475, 72.4% vs 364/481, 75.7%). A total of 42 days after the first dose, two-thirds of families, not initially in the preparation stage, moved to preparation or vaccinated stage. Those in either SMS text message arm had significantly higher completion rates than nonenrollees (708/1503, 47.1% vs 679/1503, 45.17%; P<.001). Even after removing those needing only 2 HPV doses, adolescents receiving any SMS text messages had higher completion rates than historical controls (337/2823, 11.93% vs 981/2823, 34.75%; P<.001). A population-wide effect was seen from 2014 to 2016, above historical trends. Conclusions SMS text message reminders led to timely HPV vaccine series completion in a low-income, urban, minority study population and also led to population-wide effects. Educational information did not provide an added benefit to this population. Trial Registration ClinicalTrials.gov NCT02236273; https://clinicaltrials.gov/ct2/show/NCT02236273
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Affiliation(s)
- Chelsea S Wynn
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Marina Catallozzi
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States.,Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States.,NewYork-Presbyterian Hospital, New York, NY, United States
| | - Chelsea A Kolff
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States.,Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
| | - Stephen Holleran
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Dodi Meyer
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States.,NewYork-Presbyterian Hospital, New York, NY, United States
| | - Rajasekhar Ramakrishnan
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, United States.,Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States.,NewYork-Presbyterian Hospital, New York, NY, United States
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14
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Yemeke TT, Mitgang E, Wedlock PT, Higgins C, Chen HH, Pallas SW, Abimbola T, Wallace A, Bartsch SM, Lee BY, Ozawa S. Promoting, seeking, and reaching vaccination services: A systematic review of costs to immunization programs, beneficiaries, and caregivers. Vaccine 2021; 39:4437-4449. [PMID: 34218959 PMCID: PMC10711749 DOI: 10.1016/j.vaccine.2021.05.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Understanding the costs to increase vaccination demand among under-vaccinated populations, as well as costs incurred by beneficiaries and caregivers for reaching vaccination sites, is essential to improving vaccination coverage. However, there have not been systematic analyses documenting such costs for beneficiaries and caregivers seeking vaccination. METHODS We searched PubMed, Scopus, and the Immunization Delivery Cost Catalogue (IDCC) in 2019 for the costs for beneficiaries and caregivers to 1) seek and know how to access vaccination (i.e., costs to immunization programs for social mobilization and interventions to increase vaccination demand), 2) take time off from work, chores, or school for vaccination (i.e., productivity costs), and 3) travel to vaccination sites. We assessed if these costs were specific to populations that faced other non-cost barriers, based on a framework for defining hard-to-reach and hard-to-vaccinate populations for vaccination. RESULTS We found 57 studies describing information, education, and communication (IEC) costs, social mobilization costs, and the costs of interventions to increase vaccination demand, with mean costs per dose at $0.41 (standard deviation (SD) $0.83), $18.86 (SD $50.65) and $28.23 (SD $76.09) in low-, middle-, and high-income countries, respectively. Five studies described productivity losses incurred by beneficiaries and caregivers seeking vaccination ($38.33 per person; SD $14.72; n = 3). We identified six studies on travel costs incurred by beneficiaries and caregivers attending vaccination sites ($11.25 per person; SD $9.54; n = 4). Two studies reported social mobilization costs per dose specific to hard-to-reach populations, which were 2-3.5 times higher than costs for the general population. Eight studies described barriers to vaccination among hard-to-reach populations. CONCLUSION Social mobilization/IEC costs are well-characterized, but evidence is limited on costs incurred by beneficiaries and caregivers getting to vaccination sites. Understanding the potential incremental costs for populations facing barriers to reach vaccination sites is essential to improving vaccine program financing and planning.
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Affiliation(s)
- Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Elizabeth Mitgang
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY 10027, USA
| | - Patrick T Wedlock
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY 10027, USA
| | - Colleen Higgins
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Hui-Han Chen
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah W Pallas
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Taiwo Abimbola
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Aaron Wallace
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY 10027, USA
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York City, NY 10027, USA
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
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15
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Kempe A, Stockwell MS, Szilagyi P. The Contribution of Reminder-Recall to Vaccine Delivery Efforts: A Narrative Review. Acad Pediatr 2021; 21:S17-S23. [PMID: 33958086 DOI: 10.1016/j.acap.2021.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 12/27/2022]
Abstract
Reminders, alerting patients to the need for vaccines that will be due in the future, and recall messages, informing patients about vaccines that are overdue, have been shown to improve immunization rates for children and adolescents in numerous systematic reviews. Therefore, reminder and recall interventions (R/R) are recommended by the Task Force on Community Preventive Services for increasing immunization rates on the basis of strong evidence. R/R messages can be delivered by mail (letter or postcard), via personal or auto-dialer phone calls, by text or e-mail or via patient-portals and can simply be alerts to action or can include educational material with the aim of motivating patients to seek vaccination. R/R has also been shown to be a relatively low-cost intervention with high cost-effectiveness compared with other recommended strategies. However, although R/R as a strategy is consistently effective and cost-effective overall, there is wide variation in the impact of R/R by 1) modality of how it is delivered, 2) the targeted vaccine, 3) the age group, and 4) whether the R/R is conducted centrally by a health system or Immunization Information System or by individual practices. This narrative review summarizes the literature about effectiveness of R/R within each of these categories. We also discuss limitations of R/R, with a focus on the potential impact of parental vaccine hesitancy in blunting its effectiveness and problems with data integrity, on which R/R relies. We also discuss challenges to sustaining R/R efforts, including potential methods of funding for R/R efforts.
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Affiliation(s)
- Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado (A Kempe), Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine (A Kempe), Aurora, Colo.
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center (MS Stockwell), New York, NY; Department of Population and Family Health, Columbia University Irving Medical Center (MS Stockwell), New York, NY
| | - Peter Szilagyi
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles (P Szilagyi)
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16
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Hong K, Leidner AJ, Tsai Y, Tang Z, Cho BH, Stokley S. Costs of Interventions to Increase Vaccination Coverage Among Children in the United States: A Systematic Review. Acad Pediatr 2021; 21:S67-S77. [PMID: 33958096 PMCID: PMC9998236 DOI: 10.1016/j.acap.2020.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 11/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Community Preventive Services Task Force (CPSTF) has recommended several interventions that have been demonstrated to be effective at increasing vaccination coverage. OBJECTIVE Conduct a systematic review to examine the costs of interventions designed to increase vaccination coverage among children and adolescents in the United States. DATA SOURCES PubMed, EconLit, Embase, and Cochrane. STUDY ELIGIBILITY, PARTICIPANTS, AND INTERVENTIONS Peer-reviewed articles from January 1, 2009 to August 31, 2019. APPRAISAL AND SYNTHESIS METHODS Studies were identified with systematic searches of the literature, reviewed for inclusion criteria, abstracted for data on intervention, target population, costs, and risk of bias. Cost measures were reported as costs per child in the target population, costs per vaccinated child, incremental costs per vaccinated child, and costs per vaccine dose administered. Results were stratified by intervention type, vaccine, and age group. RESULTS Thirty-seven studies were identified for full-text review. Across all interventions and age groups, the cost per child ranged from $0.10 to $537.38, and the incremental cost per vaccinated child ranged from $6.52 to $5,098.57. Provider assessment and feedback interventions had the lowest (median) cost per child ($0.17) and a healthcare system-based combined intervention with multiple components had the lowest (median) incremental cost per vaccinated child ($26.65). A community-based combined intervention with multiple components had the highest median cost per child ($537.38) and the highest median incremental cost per vaccinated child ($5,098.57). LIMITATIONS A small number of included intervention types and inconsistent cost definition. CONCLUSIONS There is substantial variability in the costs of CPSTF-recommended interventions.
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Affiliation(s)
- Kai Hong
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga.
| | - Andrew J Leidner
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Yuping Tsai
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Zhaoli Tang
- Berry Technology Solutions (Z Tang), Atlanta, Ga
| | - Bo-Hyun Cho
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
| | - Shannon Stokley
- Immunization Service Division, National Center for Immunization and Respiratory Diseases (NCIRD) (K Hong, AJ Leidner, Y Tsai, B-H Cho, and S Stokley), Centers for Disease Control and Prevention (CDC), Atlanta, Ga
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17
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Fiks AG, Nekrasova E, Hambidge SJ. Health Systems as a Catalyst for Immunization Delivery. Acad Pediatr 2021; 21:S40-S47. [PMID: 33958091 DOI: 10.1016/j.acap.2021.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Alexander G Fiks
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania School and Children's Hospital of Philadelphia (AG Fiks), Philadelphia, Pa; Center for Pediatric Clinical Effectiveness (CPCE) and the Possibilities Project, Children's Hospital of Philadelphia (AG Fiks and E Nekrasova), Philadelphia, Pa.
| | - Ekaterina Nekrasova
- Center for Pediatric Clinical Effectiveness (CPCE) and the Possibilities Project, Children's Hospital of Philadelphia (AG Fiks and E Nekrasova), Philadelphia, Pa
| | - Simon J Hambidge
- Community Health Services, Denver Health (SJ Hambidge), Denver, Colo; Department of Pediatrics, University of Colorado School of Medicine (SJ Hambidge), Denver, Colo
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18
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Staras SAS, Richardson E, Merlo LJ, Bian J, Thompson LA, Krieger JL, Gurka MJ, Sanders AH, Shenkman EA. A feasibility trial of parent HPV vaccine reminders and phone-based motivational interviewing. BMC Public Health 2021; 21:109. [PMID: 33422047 PMCID: PMC7797089 DOI: 10.1186/s12889-020-10132-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/25/2020] [Indexed: 11/28/2022] Open
Abstract
Background We assessed the feasibility and acceptability of a sequential approach of parent-targeted HPV vaccine reminders and phone-based Motivation Interviewing (MI). Methods In 2016, we selected all 11- to 12-year-old boys and girls seen in one clinic whose vaccine records did not include the HPV vaccine (n=286). By gender, we individually randomized parents of adolescents to an interactive text message (74 girls and 45 boys), postcard reminder (46 boys and no girls because of previously demonstrated efficacy), or standard care group (75 girls and 46 boys). Reminders were sent with medical director permission and a HIPAA waiver. Two months after reminders, among the adolescents whose vaccine records still did not include the HPV vaccine, we selected a gender-stratified random sample of 20 parents for phone-based MI. We assessed the percentage of deliverable messages, the percentage of parents’ responding to the interactive text message, parent acceptability of receiving a text message, and MI parent responsiveness and interviewer competence (MI Treatment Integrity Coding system). Results Nearly all messages were deliverable (98% of postcards and 74% of text messages). Six of the 88 parents (7%) receiving text messages scheduled an appointment through our interactive system. The acceptability survey response rate was 37% (38/102). Respondents were favorable toward vaccine reminders for all parents (82%). Among 20 sampled parents, 17 were reached by phone of whom 7 completed MI, 4 had or were getting the HPV vaccine for their child, and 5 expressed disinterest. Across the 7 MI calls, the interviewer was rated 100% MI adherent and scored an average 4.19 rating for Global Spirit. Conclusion Without providing explicit consent to receive vaccine-related messages, parents nonetheless found postcards and interactive text messages acceptable. Centralizing MI to phone calls with trained staff was acceptable to parents and resulted in highly MI-adherent interviews. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10132-6.
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Affiliation(s)
- Stephanie A S Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA. .,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Eric Richardson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Lisa J Merlo
- The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.,Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA.,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Janice L Krieger
- Department of Advertising, College of Journalism and Communication, University of Florida, Gainesville, FL, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ashley H Sanders
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.,The Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA
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19
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Yunusa U, Garba SN, Umar AB, Idris SH, Bello UL, Abdulrashid I, Mohammed J. Mobile phone reminders for enhancing uptake, completeness and timeliness of routine childhood immunization in low and middle income countries: A systematic review and meta-analysis. Vaccine 2020; 39:209-221. [PMID: 33277058 DOI: 10.1016/j.vaccine.2020.11.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/14/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
Immunization remains one of the most effective public health interventions offering protection for children from vaccine preventable diseases. However, many children living in low- and- middle income countries do not get adequate immunization due to several factors. Mobile phone reminder interventions have shown great potential in enhancing a number of immunization outcomes. However, the evidence supporting its use in these countries is vague. This systematic review was conducted to provide evidence for mobile phone reminder in enhancing immunization uptake, completeness and timeliness. This review was conducted in accordance to the PRISMA recommendations. Three online databases; PubMed, Cochrane Library and African Journals Online, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done using Covidence. Meta-analyses were conducted using the Cochrane Collaboration Review Manager (v5.4). The GRADEpro was used to evaluate the certainty of evidence/summary of findings. Eleven RCTs assessing immunization uptake, completeness and/or timeliness by means of SMS, phone calls or a combination of voice message and SMS were included in both quantitative and qualitative synthesis. Overall, the included studies were of moderate quality. Majority of the included studies indicated that mobile phone reminders were beneficial. Meta-analyses indicated that using mobile phone reminder interventions for the review outcomes was of variable effect with high level of heterogeneity. A combination of voice message and SMS has a greater effect followed by phone calls then SMS reminders for immunization completeness. The use of SMS for immunization uptake and timeliness were largely insignificant (p > 0.05). Furthermore, evidence to support the efficacy of mobile phone reminder from the GRADE synthesis was between low and moderate. Mobile phone reminders, particularly a combination of voice message + SMS and perhaps phone calls appears to be more effective in enhancing immunization outcomes. However, more studies are required in view of methodological inadequacies in existing studies.
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Affiliation(s)
- Umar Yunusa
- Department of Nursing Sciences, Bayero University, Kano, Kano State, Nigeria.
| | - Saleh Ngaski Garba
- Department of Nursing Sciences, Bayero University, Kano, Kano State, Nigeria
| | - Addakano Bello Umar
- Department of Nursing Sciences, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Suleiman Hadejia Idris
- Department of Community Medicine, Ahmadu Bello University Zaria, Kaduna State, Nigeria; Department of Community Medicine, Federal Medical Center, Birnin Kudu, Jigawa State, Nigeria
| | - Umar Lawal Bello
- Department of Nursing Sciences, Bayero University, Kano, Kano State, Nigeria
| | - Idris Abdulrashid
- Department of Nursing Sciences, Bayero University, Kano, Kano State, Nigeria
| | - Jibril Mohammed
- Department of Physiotherapy, Bayero University, Kano, Kano State, Nigeria
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20
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Staras SAS, Vadaparampil ST, Thompson LA, Scherr C, Gurka MJ, Filipp SL, Shenkman EA. Postcard reminders for HPV vaccination mainly primed parents for providers' recommendations. Prev Med Rep 2020; 20:101188. [PMID: 32953426 PMCID: PMC7486613 DOI: 10.1016/j.pmedr.2020.101188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023] Open
Abstract
Postcard reminders increased vaccination rates during preventive care visits. Postcards may prime parents for provider recommendations. Reminders may be most effective if combined with provider-targeted interventions.
Parent-targeted reminders increase human papillomavirus (HPV) vaccination rates. Our postcard reminders increased HPV vaccine initiation (receipt of at least one dose) by 60% among girls, but not substantially among boys. To select a complementary intervention that would maximize the effect of reminders, we assessed the percentage increase in HPV vaccine initiation from reminders increasing preventive care visits or increasing the likelihood of vaccine receipt during preventive care. We conducted a secondary analysis of the postcard reminders from a quasi-experimental, factorial designed, feasibility trial conducted in 2013–2014 among 2,470 11- to 17-year-old girls enrolled in Florida’s Medicaid or Children’s Health Insurance Programs. We used log-linear models and a 4-way decomposition method to estimate the mediating and interacting effects of preventive visits on the effect of postcards on HPV vaccination. After receiving a preventive visit, 76% (269/356) of girls remained unvaccinated. Nearly half of the effect of postcards on HPV vaccination was mediated by preventive visits (44%; 95% CI = 9.2% to 78.0%). Postcards increased HPV vaccine initiation mainly by increasing the likelihood of HPV vaccine receipt during preventive visits (pure indirect effect = 32.3%; 95% CI = 1.5% to 63.1%), and also by increasing the occurrence of preventive visits (mediated interaction = 11.3%; 95% CI = 1.5 to 21.1). Reminders likely increased vaccination rates during well visits by priming parents for HPV vaccine conversations with their child’s health care provider. Thus, reminder effectiveness may be increased if timed closely to preventive care visits and/or combined with interventions that improve provider recommendations. Trial Registration: ClinicalTrials.gov, NCT04208269, Registered 23, December 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04208269.
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Affiliation(s)
- Stephanie A S Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
| | - Susan T Vadaparampil
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center, Moffitt Cancer Center Magnolia Campus, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Department of Pediatrics, University of Florida, Dept of Pediatrics PO BOX 100296, Gainesville, FL 32610-0296, USA
| | - Courtney Scherr
- Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center, Moffitt Cancer Center Magnolia Campus, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.,Department of Communication Studies, Northwestern University, Chicago, IL 60611, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
| | - Stephanie L Filipp
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA.,Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
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21
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Menzies R, Heron L, Lampard J, McMillan M, Joseph T, Chan J, Storken A, Marshall H. A randomised controlled trial of SMS messaging and calendar reminders to improve vaccination timeliness in infants. Vaccine 2020; 38:3137-3142. [PMID: 32147296 DOI: 10.1016/j.vaccine.2020.02.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effectiveness of SMS reminders in improving vaccination coverage has been assessed previously, with effectiveness varying between settings. However, there are very few studies on their effect on the timeliness of vaccination. DESIGN Unblinded, randomised controlled trial with blocked sampling. METHODS 1594 Australian infants and young children were recruited to assess the impact of (1) SMS reminders only, (2) a personalised calendar, (3) SMS reminder and personalised calendar and (4) no intervention, on receipt of vaccine within 30 days of the due date. Outcomes were measured for receipt of vaccines due at 2, 4, 6, 12 and 18 months of age. A post-hoc assessment was also conducted of the impact of a new national "No jab No Pay" policy introduced during the trial, which removed philosophical objections as an exemption for financial penalties for non-vaccination. RESULTS There was a statistically significant improvement in on-time vaccination only at the 12 month schedule point amongst infants who received SMS reminders alone (RR 1.09, 95% CI 1.01-1.18) or in combination with a personalised calendar (1.11, CI 1.03-1.20) compared to controls. This impact was limited to participants who had received one or more previous doses late. No statistically significant impacts of calendar interventions alone were seen. There was a high rate of on-time compliance amongst control participants - 95%, 86%, 80%, 74% at the 4, 6, 12 and 18 month schedule points respectively, which increased more than 10 percentage points after implementation of the "No Jab, No Pay" policy. CONCLUSIONS SMS reminders are more effective in improving timeliness where pre-existing compliance is lower, but the 18 month schedule point appeared to be less amenable to intervention. Australia and New Zealand Clinical Trial Registration No. ACTRN12614000970640.
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Affiliation(s)
- R Menzies
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia.
| | - L Heron
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Kids Research Institute, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - J Lampard
- Kids Research Institute, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - M McMillan
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
| | - T Joseph
- Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - J Chan
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - A Storken
- Department of Health, South Australia, Adelaide, SA, Australia
| | - H Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia
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22
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Silverman-Lloyd LG, Dominguez Cortez J, Godage SK, Valenzuela Araujo D, Rivera T, Polk S, DeCamp LR. Immigrant Latino parents demonstrated high interactivity with pediatric primary care text messaging intervention. Mhealth 2020; 6:45. [PMID: 33209916 PMCID: PMC7656102 DOI: 10.21037/mhealth.2020.01.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The majority of Latino immigrants have been shown to have a mobile phone. Cellular phones offer a low-cost method of reaching larger populations and have the potential for increased tailoring and interactivity. This supports the development of mHealth interventions to address healthcare disparities in this population. In this study we sought to evaluate the feasibility and acceptability of interactive Spanish-language text messages sent throughout a child's first year of life in a low-income, limited-English proficient (LEP) Latino population to support families in accessing and using pediatric primary care more effectively. METHODS Participants (n=79) received interactive text messages over a period of 12 months as a part of a multi-modal mHealth intervention conducted at an urban academic pediatric primary care practice. Inclusion criteria were: singleton infant <2 months of age, enrollment in public health insurance, parent age >18, parent preferred healthcare language of Spanish, and at least one household cellular phone. Interactive text messages were designed to promote increased healthcare engagement and prompted participant responses through preprogramed algorithms. Text message sequences included clinic appointment reminders, support for obtaining medicine and completing referral appointments, monitoring of illness care needs and use, and parent support program reminders. Descriptive analyses were used to examine text message volume, usability, and participant response to text sequences. RESULTS Among participants, mean parent age was 30.1 years (SD: 6.1 years); mean years in the US was 7.5 years (SD: 5.1 years). 63.3% of parents had less than a high school education and 84.8% of parents had possible/high likelihood of limited health literacy. Participants completed the majority of sequences with appointment reminder sequences having the quickest response time. The top quartile of responders completed 88.3% of sequences; lower educational attainment was associated with lower text message sequence completion. Participants rated the program positively, especially the appointment reminders. CONCLUSIONS LEP Latino parents successfully engaged with interactive Spanish-language text sequences and parent acceptability was high. This study demonstrates feasibility for interventions employing this technology. Text message interventions may be a feasible approach to reduce healthcare disparities and costs for vulnerable populations.
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Affiliation(s)
- Luke G. Silverman-Lloyd
- University of California, Berkeley-University of California, San Francisco Joint Medical Program, Berkeley, CA, USA
| | - Jose Dominguez Cortez
- Johns Hopkins Center for Health/Salud and Opportunity for Latinos, Baltimore, MD, USA
| | | | | | - Tatiahna Rivera
- Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA
| | - Sarah Polk
- Johns Hopkins Center for Health/Salud and Opportunity for Latinos, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lisa Ross DeCamp
- Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
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23
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Domek GJ, Contreras-Roldan IL, Bull S, O'Leary ST, Bolaños Ventura GA, Bronsert M, Kempe A, Asturias EJ. Text message reminders to improve infant immunization in Guatemala: A randomized clinical trial. Vaccine 2019; 37:6192-6200. [PMID: 31492475 DOI: 10.1016/j.vaccine.2019.08.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Millions of infants worldwide remain under-immunized and at risk for unnecessary morbidity and mortality. Text messaging may offer a low-cost solution. We aimed to evaluate text message reminders to improve infant immunization in Guatemala. METHODS A randomized clinical trial was conducted at four public health clinics in rural and urban Guatemala. Infants ages six weeks to six months presenting for the first visit of the primary immunization series were randomly and equally allocated to an intervention or usual care group. Intervention participants were sent three text reminders before the second and third vaccine visits. The main outcome was timeliness of the second and third visits of the primary immunization series. RESULTS Of 1088 families approached for enrollment between March to November 2016, 871 were eligible and 720 (82.7%) participated; only 54 families did not own a cell phone. Due to country-wide vaccine shortages, visit completion was used as a proxy for overall immunization coverage. In intention to treat analysis, both intervention and usual care groups had high rates of visit completion, but intervention participants presented on the scheduled date more often (151 [42.2%] of 358 intervention vs. 111 [30.7%] of 362 usual care participants for visit 2, p = 0.001, and 112 [34.0%] of 329 intervention vs. 90 [27.0%] of 333 usual care participants for visit 3, p = 0.05). Intervention caregivers were significantly more likely to want to receive future text message reminders for vaccines and other appointments and were more willing to pay for these reminders. CONCLUSION Caregivers who were sent text message reminders in urban and rural Guatemala were less delayed for their child's immunization visits and reported high user satisfaction. Text message reminders may be an effective tool to increase infant vaccination coverage in low-income settings by reminding parents to vaccinate. TRIAL REGISTRATION NCT02567006 at clinicaltrials.gov.
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Affiliation(s)
- Gretchen J Domek
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, B065, 13123 E. 16th Ave., Aurora, CO 80045, USA; Center for Global Health, Colorado School of Public Health, A090, 13199 E. Montview Blvd., Suite 310, Aurora, CO 80045, USA.
| | - Ingrid L Contreras-Roldan
- Center for Health Studies, Universidad del Valle de Guatemala, 18 Av. 11-95, Zona 15, Vista Hermosa III, Guatemala City, Guatemala
| | - Sheana Bull
- Center for Global Health, Colorado School of Public Health, A090, 13199 E. Montview Blvd., Suite 310, Aurora, CO 80045, USA; Department of Community and Behavioral Health, Colorado School of Public Health, B119, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Sean T O'Leary
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, B065, 13123 E. 16th Ave., Aurora, CO 80045, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, F443, 13199 E. Montview Blvd., Suite 300, Aurora, CO 80045, USA
| | | | - Michael Bronsert
- Center for Global Health, Colorado School of Public Health, A090, 13199 E. Montview Blvd., Suite 310, Aurora, CO 80045, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, F443, 13199 E. Montview Blvd., Suite 300, Aurora, CO 80045, USA
| | - Allison Kempe
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, B065, 13123 E. 16th Ave., Aurora, CO 80045, USA; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, F443, 13199 E. Montview Blvd., Suite 300, Aurora, CO 80045, USA
| | - Edwin J Asturias
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, B065, 13123 E. 16th Ave., Aurora, CO 80045, USA; Center for Global Health, Colorado School of Public Health, A090, 13199 E. Montview Blvd., Suite 310, Aurora, CO 80045, USA; Department of Epidemiology, Colorado School of Public Health, B119, 13001 E. 17th Place, Aurora, CO 80045, USA
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24
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Esteban-Vasallo M, Domínguez-Berjón M, García-Riolobos C, Zoni A, Aréjula Torres J, Sánchez-Perruca L, Astray-Mochales J. Effect of mobile phone text messaging for improving the uptake of influenza vaccination in patients with rare diseases. Vaccine 2019; 37:5257-5264. [DOI: 10.1016/j.vaccine.2019.07.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 12/01/2022]
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25
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Stephens AB, Wynn CS, Stockwell MS. Understanding the use of digital technology to promote human papillomavirus vaccination - A RE-AIM framework approach. Hum Vaccin Immunother 2019; 15:1549-1561. [PMID: 31158064 PMCID: PMC6746491 DOI: 10.1080/21645515.2019.1611158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 04/01/2019] [Accepted: 04/21/2019] [Indexed: 12/14/2022] Open
Abstract
The human papillomavirus virus (HPV) vaccine is effective at preventing various cancers, but coverage falls short of targets that are needed for community protection. Here, we use the RE-AIM implementation framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) to understand how text, email, and electronic health record (EHR) reminders and social media campaigns can be used as part of policy and practice interventions to increase HPV vaccination. These technology-based interventions could be used together and mainstreamed into clinical and system-based practice to have the greatest impact. Of the interventions explored, text-based, email-based, and EHR reminders have the most evidence behind them to support their effectiveness. While there are several studies of promotion of the HPV vaccine on social media, more studies are needed to demonstrate their effects and better methods are needed to be able to attribute results to these interventions.
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Affiliation(s)
- Ashley B Stephens
- Department of Pediatrics, Columbia University, New York, NY, USA
- NewYork-Presbyterian Hospital, New York, NY, USA
| | - Chelsea S Wynn
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Melissa S Stockwell
- Department of Pediatrics, Columbia University, New York, NY, USA
- NewYork-Presbyterian Hospital, New York, NY, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
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26
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Atkinson KM, Wilson K, Murphy MSQ, El-Halabi S, Kahale LA, Laflamme LL, El-Khatib Z. Effectiveness of digital technologies at improving vaccine uptake and series completion - A systematic review and meta-analysis of randomized controlled trials. Vaccine 2019; 37:3050-3060. [PMID: 31036457 DOI: 10.1016/j.vaccine.2019.03.063] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/11/2019] [Accepted: 03/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Recent outbreaks and renewed concerns about immunization coverage call for new and effective interventions to improve vaccine uptake. Digital technologies have the potential to help address both suboptimal vaccine uptake and series completion. However, the effectiveness of pushing information and reminders to patients through digital technologies to address vaccination is not known. OBJECTIVE(S) The aim of this study is to determine if digital push interventions are effective in increasing vaccine uptake and series completion compared to non-digital interventions. METHODS We searched for RCTs where adults or parents of children were eligible for vaccination, the intervention was digital-push and the comparison group was non-digital. We included outcomes of vaccine uptake or series completion. We estimated summary effect sizes, heterogeneity using the χ2 test and quantified using the I2 statistic. Where heterogeneity remained significant, we conducted subgroup analyses. We assessed risk of bias, certainty of evidence and publication bias. RESULTS The search identified 159 peer-reviewed scientific publications. After review, a total of 12 manuscripts representing 13 empirical studies published between 2012 and 2016 were included. When comparing digital push interventions to non-digital ones, patients had 1.18[1.11,1.25] the odds of receiving vaccination or series completion compared to controls. In parents of children aged 18 and younger, those receiving digital push had a 1.22[1.15,1.30] increased odds compared to controls. Both analyses had high statistical heterogeneity, with I2 values of 86% and 79% respectively. The risk of bias was low with 10 of 13 studies considered low risk in five or more domains. The certainty of evidence for series completion was very low and for vaccine uptake was assessed to be moderate. CONCLUSION This study provides evidence that digital push technologies have a modest, positive impact on vaccine uptake and series completion compared to non-digital interventions.
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Affiliation(s)
- Katherine M Atkinson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada.
| | - Kumanan Wilson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada.
| | - Malia S Q Murphy
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Soha El-Halabi
- Skoun Lebanese Addiction Center, Beirut, Lebanon; Department of Learning, Informatics, Management and Ethics, Karolinska Instituet, Stockholm, Sweden
| | - Lara A Kahale
- AUB GRADE Center, American University of Beirut, Lebanon
| | - Lucie L Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Ziad El-Khatib
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Québec, Canada
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Tolou-Shams M, Yonek J, Galbraith K, Bath E. Text Messaging to Enhance Behavioral Health Treatment Engagement Among Justice-Involved Youth: Qualitative and User Testing Study. JMIR Mhealth Uhealth 2019; 7:e10904. [PMID: 30950808 PMCID: PMC6473210 DOI: 10.2196/10904] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 11/16/2018] [Accepted: 01/26/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mental health and substance use disorders are highly prevalent in justice-involved youth, yet only 8% of court-involved, nonincarcerated (CINI) youth in need of treatment receive it. Dual diagnosis (co-occurring psychiatric and substance use disorders) in justice-involved youth is highly predictive of recidivism. Identifying novel approaches, such as the use of mobile health (mHealth) technologies, to close this gap between need and receipt of behavioral health treatment for the CINI population could potentially offset rates of reoffending into adulthood. Text-messaging (short message service, SMS) interventions have demonstrated efficacy in improving treatment adherence and other associated outcomes in other vulnerable youth populations, but development and testing of mHealth interventions to improve behavioral health treatment rates and outcomes for CINI youth are lacking. OBJECTIVE This study aimed to collect qualitative data from key stakeholders to inform the development of a theoretically grounded, family-based text-messaging (SMS) intervention targeting CINI youth's behavioral health treatment engagement; additionally, the aim was to conduct end-user testing over 6 months with CINI youth and caregivers to determine intervention feasibility and acceptability. METHODS CINI youth and caregivers were referred from a California-based Juvenile Probation Department and community-based provider organizations providing services for justice-involved youth. Eligibility criteria included the following: being a justice-involved youth or a caregiver of a justice-involved youth, English speaking, youth aged 13 to 17 years old and either referred to or currently attending mental health or substance use treatment, and youth and caregiver have access to a cell phone with text-messaging capability. RESULTS Overall, 28 individuals participated in focus groups and interviews-8 youth, 5 caregivers, and 15 juvenile justice (JJ) personnel. Three major themes emerged: (1) texting among JJ personnel and CINI youth and caregivers in their caseload is common but not systematic, (2) stigma and privacy are perceived as barriers to texting youth about behavioral health treatment appointments, and (3) messages should be short, simple, relatable, positive, and personalized. In total, 9 participants (7 youth and 2 caregivers) participated in end-user testing and rated the intervention as useful, helpful, and supportive. CONCLUSIONS Text messaging (SMS) is an acceptable and feasible means of reminding CINI youth to attend behavioral health treatment appointments. Future implementation challenges include making text messaging (SMS) personalized and tailored but not resource intensive (eg, requiring one-to-one, 24/7 human contact) and identifying which systems will deliver and sustain the intervention. Text messaging (SMS) among justice personnel, youth, and their caregivers is already widespread, but lack of clear guidelines about privacy, confidentiality, and information sharing poses ethical conundrums. Future hybrid-type research designs that explore the efficacy of the intervention while also studying ethical, system, and policy-level factors associated with using digital health interventions to improve CINI youth outcomes is a key next step.
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Affiliation(s)
- Marina Tolou-Shams
- Division of Infant, Child and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Juliet Yonek
- Division of Infant, Child and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Katharine Galbraith
- Division of Infant, Child and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, Weill Institute of Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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McClure C, Cunningham M, Bull S, Berman S, Allison MA. Using Mobile Health to Promote Early Language Development: A Narrative Review. Acad Pediatr 2018; 18:850-854. [PMID: 30098442 DOI: 10.1016/j.acap.2018.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/13/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022]
Abstract
In this narrative review, we first present a brief overview of known disparities in children's language development based on socioeconomic status and efforts in the primary care setting to promote children's language development. Next, we define mobile health (m-health) and review the limited, published literature regarding the effectiveness of m-health interventions in promoting children's health, in general, and language development, in particular. Finally, we discuss the potential role of smartphone applications to increase parental behaviors that promote their children's language development, as well as challenges that should be addressed as the field of m-health continues to grow.
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Affiliation(s)
- Catherine McClure
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora
| | - Maureen Cunningham
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora; Center for Global Health , Colorado School of Public Health, Aurora
| | - Sheana Bull
- Department of Community and Behavioral Health , Colorado School of Public Health, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (M Allison), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
| | - Stephen Berman
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora; Center for Global Health , Colorado School of Public Health, Aurora
| | - Mandy A Allison
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora.
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Kolff CA, Scott VP, Stockwell MS. The use of technology to promote vaccination: A social ecological model based framework. Hum Vaccin Immunother 2018; 14:1636-1646. [PMID: 29781750 PMCID: PMC6067841 DOI: 10.1080/21645515.2018.1477458] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Vaccinations are an important and effective cornerstone of preventive medical care. Growing technologic capabilities and use by both patients and providers present critical opportunities to leverage these tools to improve vaccination rates and public health. We propose the Social Ecological Model as a useful theoretical framework to identify areas in which technology has been or may be leveraged to target undervaccination across the individual, interpersonal, organizational, community, and society levels and the ways in which these levels interact.
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Affiliation(s)
- Chelsea A Kolff
- a Department of Pediatrics , Columbia University , New York , NY , USA.,b Department of Population and Family Health , Mailman School of Public Health, Columbia University , New York , NY , USA
| | - Vanessa P Scott
- a Department of Pediatrics , Columbia University , New York , NY , USA.,c NewYork-Presbyterian Hospital , New York , NY , USA
| | - Melissa S Stockwell
- a Department of Pediatrics , Columbia University , New York , NY , USA.,b Department of Population and Family Health , Mailman School of Public Health, Columbia University , New York , NY , USA.,c NewYork-Presbyterian Hospital , New York , NY , USA
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Schwebel FJ, Larimer ME. Using text message reminders in health care services: A narrative literature review. Internet Interv 2018; 13:82-104. [PMID: 30206523 PMCID: PMC6112101 DOI: 10.1016/j.invent.2018.06.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Despite the extensive use of mHealth behavior change interventions, questions remain about the use of technology-based reminders in delivering health care services. Text messaging, or short message service (SMS), is one reminder method that has been extensively researched. Most SMS-reminder research is distributed across a range of health care outcomes. The aim of this article is to systematically review the aggregate impact of these reminders on overall health care outcomes. METHODS A systematic literature review was conducted and yielded 2316 articles. Studies were included if they used SMS reminders to support patient health care outcomes. Study methodology was aligned with the PRISMA guidelines for systematic reviews. RESULTS Following screening, 162 articles met inclusion criteria. Of these studies, 93 investigated medical compliance reminders and 56 investigated appointment reminders. The review found that nearly all the SMS-reminder studies helped improve patient medical compliance and appointment reminders. Additionally, researchers reported numerous benefits from using SMS reminders, including ease of use, relative inexpensiveness, and rapid and automated message delivery. Minimal risks were reported and most participants found the reminders to be acceptable. DISCUSSION Text messages appear to be an effective reminder mechanism to promote improved patient appointment and medical compliance. Reminders should continue to be evaluated and improved to determine the most effective timing and frequency of messages for improving outcomes.
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Affiliation(s)
- Frank J. Schwebel
- University of Washington, Department of Psychology, 119A Guthrie Hall Box 351525, Seattle, WA 98195-1525, United States of America,Corresponding author.
| | - Mary E. Larimer
- University of Washington, Department of Psychology, 119A Guthrie Hall Box 351525, Seattle, WA 98195-1525, United States of America,University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th, Suite 300, Office 312, Box 354944, Seattle, WA 98105, United States of America
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Ozawa S, Yemeke TT, Thompson KM. Systematic review of the incremental costs of interventions that increase immunization coverage. Vaccine 2018; 36:3641-3649. [PMID: 29754699 PMCID: PMC7853081 DOI: 10.1016/j.vaccine.2018.05.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 01/25/2023]
Abstract
Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function.
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Affiliation(s)
- Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
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Jaca A, Mathebula L, Iweze A, Pienaar E, Wiysonge CS. A systematic review of strategies for reducing missed opportunities for vaccination. Vaccine 2018; 36:2921-2927. [PMID: 29680199 DOI: 10.1016/j.vaccine.2018.04.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Missed opportunities for vaccination (MOVs) occur when persons eligible for vaccination visit a health facility and do not get the vaccines they need. We conducted a systematic review to assess effects of interventions for reducing MOVs. METHODS We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in April 2017. Three authors independently screened search outputs, reviewed potentially eligible papers, assessed risk of bias, and extracted data; resolving disagreements by consensus. We expressed study results as risk ratios (RR) with 95% confidence intervals (CI) and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. RESULTS Six studies (five trials and one cohort study) met our inclusion criteria, all conducted in the United States of America. All six studies had various limitations and were classified as having a high risk of bias. We found moderate certainty evidence that the following interventions probably improve vaccination coverage: patient education (RR 1.92, 95% CI 1.38-2.68), patient tracking using community health workers (RR 1.18, 95% CI 1.11-1.25), and patient tracking and provider prompts (RR 1.24, 95% CI 1.18-1.31). In addition, we found low certainty evidence that concurrent interventions targeting health-facility (education, prompts, and audit and feedback) and family settings (phone calls) may increase vaccination coverage (RR 1.25, 95% CI 1.08-1.46). CONCLUSIONS The currently available evidence suggests that patient education, patient tracking, outreach sessions, and provider prompts reduce missed opportunities for vaccination and improve vaccination coverage. Rigorous studies are required to confirm these findings and increase the certainty of the current evidence base. WHO is currently coordinating efforts to generate such evidence, especially from low-income and middle-income countries, and it is likely that the data will be available in the next few years.
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Affiliation(s)
- Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Lindi Mathebula
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Arthur Iweze
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Elizabeth Pienaar
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Lehnert JD, Shevach A, Walker S, Wang R, Fitzgerald TJ, Graitcer SB. Development and pilot testing of a text message vaccine reminder system for use during an influenza pandemic. Hum Vaccin Immunother 2018; 14:1647-1653. [PMID: 29451833 DOI: 10.1080/21645515.2018.1440162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In an influenza pandemic, two vaccine doses administered 21 days apart may be needed for individuals of all ages to achieve seroprotection. Achieving dose-series completion can be challenging even for routinely recommended vaccines. To prepare for a two-dose influenza pandemic vaccine campaign and promote dose-series completion and correct dosing intervals, CDC and its partners developed a text message-based vaccine reminder system to remind persons who receive a first dose of pandemic influenza vaccine to receive the second dose. Taking advantage of the high prevalence of cell phones in the United States, the system sent second-dose text message reminders and hyperlinks to educational information. The system was pilot tested from November 2015 to April 2016 among graduate public health students enrolled at four United States universities. Universities were selected based on convenience, and each university used a different recruitment method. Among 59 volunteers who pilot tested the system and completed a survey, 57 (92%) felt the system would be helpful during a pandemic. Forty (68%) respondents felt the information included in the messages was informative. Volunteers recommended including actionable ways to stay healthy during a pandemic, though specific suggestions varied. With further development, text reminder systems could be used to promote adherence to a two-dose regimen in a future pandemic, although audience-specific messaging and other complementary systems will likely be needed. Public and private partners can adapt and implement this tool in conjunction with their routine patient information systems to improve dose-series completion and ensure optimal protection during an influenza pandemic.
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Affiliation(s)
- Jonathan D Lehnert
- a IHRC, Inc. , Atlanta , GA , USA.,b Immunization Services Division, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Alex Shevach
- b Immunization Services Division, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA.,c Carter Consulting, Inc. , Atlanta , GA , USA
| | - Sydney Walker
- d Northrop Grumman Corporation , Atlanta , GA , USA.,e Office of Health Communications Science, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Rose Wang
- e Office of Health Communications Science, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Thomas J Fitzgerald
- a IHRC, Inc. , Atlanta , GA , USA.,b Immunization Services Division, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Samuel B Graitcer
- b Immunization Services Division, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta , GA , USA
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Jacobson Vann JC, Jacobson RM, Coyne‐Beasley T, Asafu‐Adjei JK, Szilagyi PG. Patient reminder and recall interventions to improve immunization rates. Cochrane Database Syst Rev 2018; 1:CD003941. [PMID: 29342498 PMCID: PMC6491344 DOI: 10.1002/14651858.cd003941.pub3] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Immunization rates for children and adults are rising, but coverage levels have not reached optimal goals. As a result, vaccine-preventable diseases still occur. In an era of increasing complexity of immunization schedules, rising expectations about the performance of primary care, and large demands on primary care providers, it is important to understand and promote interventions that work in primary care settings to increase immunization coverage. One common theme across immunization programs in many nations involves the challenge of implementing a population-based approach and identifying all eligible recipients, for example the children who should receive the measles vaccine. However, this issue is gradually being addressed through the availability of immunization registries and electronic health records. A second common theme is identifying the best strategies to promote high vaccination rates. Three types of strategies have been studied: (1) patient-oriented interventions, such as patient reminder or recall, (2) provider interventions, and (3) system interventions, such as school laws. One of the most prominent intervention strategies, and perhaps best studied, involves patient reminder or recall systems. This is an update of a previously published review. OBJECTIVES To evaluate and compare the effectiveness of various types of patient reminder and recall interventions to improve receipt of immunizations. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and CINAHL to January 2017. We also searched grey literature and trial registers to January 2017. SELECTION CRITERIA We included randomized trials, controlled before and after studies, and interrupted time series evaluating immunization-focused patient reminder or recall interventions in children, adolescents, and adults who receive immunizations in any setting. We included no-intervention control groups, standard practice activities that did not include immunization patient reminder or recall, media-based activities aimed at promoting immunizations, or simple practice-based awareness campaigns. We included receipt of any immunizations as eligible outcome measures, excluding special travel immunizations. We excluded patients who were hospitalized for the duration of the study period. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane and the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We present results for individual studies as relative rates using risk ratios, and risk differences for randomized trials, and as absolute changes in percentage points for controlled before-after studies. We present pooled results for randomized trials using the random-effects model. MAIN RESULTS The 75 included studies involved child, adolescent, and adult participants in outpatient, community-based, primary care, and other settings in 10 countries.Patient reminder or recall interventions, including telephone and autodialer calls, letters, postcards, text messages, combination of mail or telephone, or a combination of patient reminder or recall with outreach, probably improve the proportion of participants who receive immunization (risk ratio (RR) of 1.28, 95% confidence interval (CI) 1.23 to 1.35; risk difference of 8%) based on moderate certainty evidence from 55 studies with 138,625 participants.Three types of single-method reminders improve receipt of immunizations based on high certainty evidence: the use of postcards (RR 1.18, 95% CI 1.08 to 1.30; eight studies; 27,734 participants), text messages (RR 1.29, 95% CI 1.15 to 1.44; six studies; 7772 participants), and autodialer (RR 1.17, 95% CI 1.03 to 1.32; five studies; 11,947 participants). Two types of single-method reminders probably improve receipt of immunizations based on moderate certainty evidence: the use of telephone calls (RR 1.75, 95% CI 1.20 to 2.54; seven studies; 9120 participants) and letters to patients (RR 1.29, 95% CI 1.21 to 1.38; 27 studies; 81,100 participants).Based on high certainty evidence, reminders improve receipt of immunizations for childhood (RR 1.22, 95% CI 1.15 to 1.29; risk difference of 8%; 23 studies; 31,099 participants) and adolescent vaccinations (RR 1.29, 95% CI 1.17 to 1.42; risk difference of 7%; 10 studies; 30,868 participants). Reminders probably improve receipt of vaccinations for childhood influenza (RR 1.51, 95% CI 1.14 to 1.99; risk difference of 22%; five studies; 9265 participants) and adult influenza (RR 1.29, 95% CI 1.17 to 1.43; risk difference of 9%; 15 studies; 59,328 participants) based on moderate certainty evidence. They may improve receipt of vaccinations for adult pneumococcus, tetanus, hepatitis B, and other non-influenza vaccinations based on low certainty evidence although the confidence interval includes no effect of these interventions (RR 2.08, 95% CI 0.91 to 4.78; four studies; 8065 participants). AUTHORS' CONCLUSIONS Patient reminder and recall systems, in primary care settings, are likely to be effective at improving the proportion of the target population who receive immunizations.
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Affiliation(s)
- Julie C Jacobson Vann
- The University of North Carolina at Chapel HillSchool of NursingCarrington HallChapel HillNorth CarolinaUSA27599‐7460
| | - Robert M Jacobson
- Mayo ClinicPediatric and Adolescent Medicine200 First Street, SWRochesterMinnesotaUSA55905‐0001
| | - Tamera Coyne‐Beasley
- University of North CarolinaGeneral Pediatrics and Adolescent MedicineChapel HillNorth CarolinaUSA
| | - Josephine K Asafu‐Adjei
- University of North Carolina at Chapel HillDepartment of Biostatistics, School of Nursing120 North Medical Drive, 2005 Carrington HallChapel HillNorth CarolinaUSA27599
| | - Peter G Szilagyi
- University of California Los AngelesDepartment of Pediatrics90024Los AngelesCaliforniaUSA90024
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Haas K, Martin A, Park KT. Text Message Intervention (TEACH) Improves Quality of Life and Patient Activation in Celiac Disease: A Randomized Clinical Trial. J Pediatr 2017; 185:62-67.e2. [PMID: 28343658 PMCID: PMC5637528 DOI: 10.1016/j.jpeds.2017.02.062] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/20/2017] [Accepted: 02/23/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine the impact of the Text Message Educational Automated Compliance Help (TEACH) text message intervention as a pragmatic approach for patient engagement among adolescents with celiac disease (CD) as measured by gluten-free diet (GFD) adherence, patient activation, and quality of life (QOL). STUDY DESIGN Randomized controlled trial with patient recruitment at a pediatric, university-based hospital and through social media; 61 participants ages 12-24 years with CD diagnosed at least 1 year were enrolled. The TEACH intervention cohort received 45 unique text messages over a 3-month study period while the control group received standard of care treatment. Primary outcome measures included objective markers of GFD adherence included serum tissue transglutaminase IgA and deamidated gliadin peptide IgA levels. Secondary patient-reported outcomes collected via online survey included the Celiac Dietary Adherence Test, National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Global Short Form measure of QOL, Celiac Symptom Index, and Patient Activation Measure. All measures were assessed at enrollment and after the 3-month study period. Statistical analysis performed using the 2-tailed paired Student t test. RESULTS Among the TEACH intervention group, there was significant improvement comparing enrollment scores with 3-month follow-up scores in patient activation (Patient Activation Measure score 63.1 vs 72.5, P?=?.01) and QOL (NIH PROMIS Global Mental Health 50.8 vs 53.3, P?=?.01 and NIH PROMIS Global Physical Health 50.8 vs 57.7, P?=?.03). There was no statistically significant difference in patient-reported or objectively measured GFD adherence. CONCLUSIONS TEACH is an effective intervention among patients with CD to improve patient activation and QOL, even among a cohort with GFD adherence at baseline. TRIAL REGISTRATION ClinicalTrials.gov: NCT02458898.
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Affiliation(s)
- Kelly Haas
- Department of Pediatrics, Division of Gastroenterology, Stanford University School of Medicine, Stanford University, Palo Alto, CA.
| | - Andrew Martin
- Center for Clinical Informatics, Stanford University School of Medicine, Stanford University, Palo Alto, CA
| | - KT Park
- Department of Pediatrics, Division of Gastroenterology, Stanford University School of Medicine, Stanford University, Palo Alto, CA
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The impacts of email reminder/recall on adolescent influenza vaccination. Vaccine 2017; 35:3089-3095. [PMID: 28455173 DOI: 10.1016/j.vaccine.2017.04.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/27/2017] [Accepted: 04/12/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND We sought to: (1) explore the feasibility of using email for seasonal influenza vaccination reminders to parents of adolescents and (2) assess influenza vaccination rates among adolescents whose parents were randomized to either receive or not receive email reminders. METHODS Email addresses were obtained for parents of patients 10-18years from 4 practices in Michigan. Addresses were randomized to either receive email reminders, or not. Reminder messages were sent during October 2012-March 2013 (Season 1) and October 2013-March 2014 (Season 2). Vaccination status was determined 60days following the last email reminder for each season using the statewide Michigan Care Improvement Registry (MCIR); per protocol bivariate and multivariate logistic regression analyses were conducted to evaluate reminder notification. RESULTS After email cleaning, testing, and matching with MCIR, approximately half of email addresses (2348 of 5312 in Season 1; 3457 of 6549 in Season 2) were randomized. Bivariate analyses found that influenza vaccination within 60days after notification date was similar among those notified (34%) versus not notified (29%) in both Season 1 (p=0.06) and Season 2 (39% vs. 37%, p=0.20). However, multivariate models adjusted for season, site, and receipt of notification in two seasons found a higher likelihood of influenza vaccination among children that received notification (aOR=1.28, 95% CI=1.09, 1.51); in addition, differences in influenza vaccination were also observed between practice sites (range: p=0.15 to p<0.001). CONCLUSIONS We found that practice-based email influenza vaccine reminders to parents of adolescents are feasible, but not without complications. Our study demonstrates that email reminders from practices can yield increases in influenza vaccination rates among adolescents. Practices should consider email as an option for influenza reminders and establish business practices for collecting and maintaining patient email addresses. This study is registered at www.ClinicalTrials.gov id #NCT01732315.
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What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions. PLoS One 2017; 12:e0170581. [PMID: 28152012 PMCID: PMC5289471 DOI: 10.1371/journal.pone.0170581] [Citation(s) in RCA: 286] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 01/08/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. METHODS Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. RESULTS Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. CONCLUSIONS Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health-related outcome and reported economic data, many did not report all recommended economic outcome items and were lacking in comprehensive analysis. The identified economic evaluations varied by disease or condition focus, economic outcome measurements, perspectives, and were distributed unevenly geographically, limiting formal meta-analysis. Further research is needed in low and low-middle income countries and to understand the impact of different mHealth types. Following established economic reporting guidelines will improve this body of research.
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Rand CM, Vincelli P, Goldstein NPN, Blumkin A, Szilagyi PG. Effects of Phone and Text Message Reminders on Completion of the Human Papillomavirus Vaccine Series. J Adolesc Health 2017; 60:113-119. [PMID: 27836533 DOI: 10.1016/j.jadohealth.2016.09.011] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the effect of phone or text message reminders to parents of adolescents on human papillomavirus (HPV) vaccine series completion in Rochester, NY. METHODS We performed parallel randomized controlled trials of phone and text reminders for HPV vaccine for parents of 11- to 17-year olds in three urban primary care clinics. The main outcome measures were time to receipt of the third dose of HPV vaccine and HPV vaccination rates. RESULTS We enrolled 178 phone intervention (180 control) and 191 text intervention (200 control) participants. In multivariate survival analysis controlling for gender, age, practice, insurance, race, and ethnicity, the time from enrollment to receipt of the third HPV dose for those receiving a phone reminder compared with controls was not significant overall (hazard ratio [HR] = 1.30, p = .12) but was for those enrolling at dose 1 (HR = 1.91, p = .007). There was a significant difference in those receiving a text reminder compared with controls (HR = 2.34, p < .0001; an average of 71 days earlier). At the end of the study, 48% of phone intervention versus 40% of phone control (p = .34), and 49% of text intervention versus 30% of text control (p = .001) adolescents had received 3 HPV vaccine doses. CONCLUSIONS In this urban population of parents of adolescents, text message reminders for HPV vaccine completion for those who had already started the series were effective, whereas phone message reminders were only effective for those enrolled at dose 1.
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Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
| | - Phyllis Vincelli
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Nicolas P N Goldstein
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Aaron Blumkin
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles (UCLA), Los Angeles, California
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Keeshin SW, Feinberg J. Text Message Reminder-Recall to Increase HPV Immunization in Young HIV-1-Infected Patients. J Int Assoc Provid AIDS Care 2016; 16:110-113. [PMID: 28325131 PMCID: PMC5513148 DOI: 10.1177/2325957416682302] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
HIV infected patients have higher rates of HPV infection, worse disease progression, increase severity of disease, and are at higher risk for intraepithelial neoplasia and cancer than their HIV negative counterparts. We conducted a yearlong pilot project to evaluate the impact of text message HPV immunization reminder-recall in young HIV-1 positive patients in a large urban academic HIV clinic. We found that text message reminder-recall improved HPV immunization uptake in a young, primarily black and un- or under-insured HIV-1 infected patients. As communication by texting is characteristic of teens and young adults in the general population, text message reminder-recalls should be considered a viable option to improve vaccination rates among young HIV patients.
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Affiliation(s)
- Susana Williams Keeshin
- 1 Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah College of Medicine, Salt Lake City, UT, USA
| | - Judith Feinberg
- 2 Department of Behavioral Medicine and Psychiatry, West Virginia University, School of Medicine, Morgantown, WV, USA
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