OBJECTIVE: To pilot test the Text Reminders for Immunization Compliance in Kids (TRICKs) program to evaluate its feasibility and potential to increase immunization coverage. DESIGN: Randomized controlled trial (RCT). SETTING: Pediatric clinic. PARTICIPANTS: Parents of newborns being discharged from a local hospital who intended to seek child health care at the University-sponsored pediatric resident and faculty clinic. INTERVENTION: Text message immunization reminders prior to immunization due dates. MAIN OUTCOME MEASURES: Receipt and timeliness of immunizations at 2, 4 and 6 months of age. RESULTS:Participants (N=90) were English (83%) or Spanish (17%) speaking. The majority were female (83%), on public insurance (59%), and had adequate health literacy (96%). Parents were married or a member of an unmarried couple (62%). Over 66% had a high school diploma or less. Greater numbers of intervention children received immunizations and were "on time" using per protocol analysis; though not statistically significance. Limitations include sample size, problematic text messaging software, and loss of phone service at 7 months for 40% of intervention parents. However, post-intervention interviews (N=18) indicated strong support for TRICKs; 83% found the text message reminders very helpful and 17% somewhat helpful. DISCUSSION: Pilot testing allowed us to assess processes, including recruitment, retention, and software, which will increase the success of an RCT. Software with built-in backup systems is needed for follow-up when mobile service is interrupted. However, in spite of limitations, immunization rates were higher in the text message reminder group, though not statistically significant. Parent support and interest was high. A fully powered RCT is needed with follow-up over the full 4-3-1-3-3-1 series. Based on our results, for 80% power where we expected 90% compliance in the intervention group and 80% in the control group we need 219 per group, plus increases to address drop out and loss of follow-up.
RCT Entities:
OBJECTIVE: To pilot test the Text Reminders for Immunization Compliance in Kids (TRICKs) program to evaluate its feasibility and potential to increase immunization coverage. DESIGN: Randomized controlled trial (RCT). SETTING: Pediatric clinic. PARTICIPANTS: Parents of newborns being discharged from a local hospital who intended to seek child health care at the University-sponsored pediatric resident and faculty clinic. INTERVENTION: Text message immunization reminders prior to immunization due dates. MAIN OUTCOME MEASURES: Receipt and timeliness of immunizations at 2, 4 and 6 months of age. RESULTS:Participants (N=90) were English (83%) or Spanish (17%) speaking. The majority were female (83%), on public insurance (59%), and had adequate health literacy (96%). Parents were married or a member of an unmarried couple (62%). Over 66% had a high school diploma or less. Greater numbers of intervention children received immunizations and were "on time" using per protocol analysis; though not statistically significance. Limitations include sample size, problematic text messaging software, and loss of phone service at 7 months for 40% of intervention parents. However, post-intervention interviews (N=18) indicated strong support for TRICKs; 83% found the text message reminders very helpful and 17% somewhat helpful. DISCUSSION: Pilot testing allowed us to assess processes, including recruitment, retention, and software, which will increase the success of an RCT. Software with built-in backup systems is needed for follow-up when mobile service is interrupted. However, in spite of limitations, immunization rates were higher in the text message reminder group, though not statistically significant. Parent support and interest was high. A fully powered RCT is needed with follow-up over the full 4-3-1-3-3-1 series. Based on our results, for 80% power where we expected 90% compliance in the intervention group and 80% in the control group we need 219 per group, plus increases to address drop out and loss of follow-up.
Authors: Wendy C Shields; Elise Omaki; Eileen M McDonald; Ruth Rosenberg; Mary Aitken; Martha Wood Stevens; Andrea C Gielen Journal: Pediatr Emerg Care Date: 2018-12 Impact factor: 1.454
Authors: David A Fedele; Christopher C Cushing; Alyssa Fritz; Christina M Amaro; Adrian Ortega Journal: JAMA Pediatr Date: 2017-05-01 Impact factor: 16.193
Authors: Melissa S Stockwell; Carolyn Westhoff; Elyse Olshen Kharbanda; Celibell Y Vargas; Stewin Camargo; David K Vawdrey; Paula M Castaño Journal: Am J Public Health Date: 2013-12-19 Impact factor: 9.308
Authors: Gretchen J Domek; Ingrid L Contreras-Roldan; Edwin J Asturias; Michael Bronsert; Guillermo Antonio Bolaños Ventura; Sean T O'Leary; Allison Kempe; Sheana Bull Journal: Mhealth Date: 2018-04-17