Annika M Hofstetter1, Angela Barrett2, Stewin Camargo3, Susan L Rosenthal4, Melissa S Stockwell5. 1. Department of Pediatrics, University of Washington, Seattle, WA, United States; Seattle Children's Research Institute, Seattle, WA, United States; Department of Pediatrics, Columbia University, New York, NY, United States. Electronic address: annika.hofstetter@seattlechildrens.org. 2. Department of Pediatrics, Columbia University, New York, NY, United States. Electronic address: ab2839@cumc.columbia.edu. 3. Department of Pediatrics, Columbia University, New York, NY, United States. Electronic address: stewinc@gmail.com. 4. Department of Pediatrics, Columbia University, New York, NY, United States; NewYork-Presbyterian Hospital, New York, NY, United States; Department of Psychiatry, Columbia University, New York, NY, United States. Electronic address: slr2154@cumc.columbia.edu. 5. Department of Pediatrics, Columbia University, New York, NY, United States; NewYork-Presbyterian Hospital, New York, NY, United States; Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States. Electronic address: mss2112@cumc.columbia.edu.
Abstract
BACKGROUND:Many adolescents with chronic medical conditions (CMCs) are at risk of vaccine-preventable infection, yet are frequently under-vaccinated. Text message reminders, particularly those with embedded educational information, have been shown to increase general pediatric vaccination. Their use has not been studied specifically among adolescents with CMCs. METHODS:Eligible parents of adolescents with CMCs receiving care at one of 4 academically-affiliated pediatric clinics and requiring human papillomavirus (first dose), influenza, and/or pneumococcal polysaccharide vaccines were randomized in 4 consecutive cohorts to receive text message vaccine reminders with or without embedded educational information ("educational" vs. "plain" arm, respectively). Educational reminders, including one interactive message, addressed infection risk, vaccine safety/efficacy, and physician recommendations. Up to 5 weekly and 2 booster reminders were sent (October 2014-January 2015). Receipt of any needed vaccine and missed vaccination opportunities by 4, 12, and 24weeks after the initial reminder were compared between arms. RESULTS:Of randomized parents (n=295), 175 (59.3%) were Spanish-speaking; most had adolescents with CMCs who were 13-17years (n=229; 77.6%) and publically insured (n=272; 92.5%). Baseline demographics and parental vaccine beliefs were similar between arms. More adolescents in the plain vs. educational reminder arm received any needed vaccine by 4weeks (31.9% vs. 22.7%, adjusted relative risk [aRR] 1.47, 95% CI 1.01-2.14), but not by 12 or 24weeks. Plain reminders were noted in post hoc analyses to have a greater effect than educational reminders in certain sub-populations, including 11-12year-olds and those sent the initial reminder in early fall. Fewer adolescents in the plain vs. educational reminder arm had a missed vaccination opportunity by 4weeks (10.9% vs. 41.3%; aRR 0.21, 95% CI 0.07-0.60), but not by 12 or 24weeks. CONCLUSION: Plain text message vaccine reminders appear to have a positive effect compared to educational ones in the short-term and for certain families. TRIAL REGISTRATION: NCT02231957 (www.clinicaltrials.gov).
RCT Entities:
BACKGROUND: Many adolescents with chronic medical conditions (CMCs) are at risk of vaccine-preventable infection, yet are frequently under-vaccinated. Text message reminders, particularly those with embedded educational information, have been shown to increase general pediatric vaccination. Their use has not been studied specifically among adolescents with CMCs. METHODS: Eligible parents of adolescents with CMCs receiving care at one of 4 academically-affiliated pediatric clinics and requiring human papillomavirus (first dose), influenza, and/or pneumococcalpolysaccharide vaccines were randomized in 4 consecutive cohorts to receive text message vaccine reminders with or without embedded educational information ("educational" vs. "plain" arm, respectively). Educational reminders, including one interactive message, addressed infection risk, vaccine safety/efficacy, and physician recommendations. Up to 5 weekly and 2 booster reminders were sent (October 2014-January 2015). Receipt of any needed vaccine and missed vaccination opportunities by 4, 12, and 24weeks after the initial reminder were compared between arms. RESULTS: Of randomized parents (n=295), 175 (59.3%) were Spanish-speaking; most had adolescents with CMCs who were 13-17years (n=229; 77.6%) and publically insured (n=272; 92.5%). Baseline demographics and parental vaccine beliefs were similar between arms. More adolescents in the plain vs. educational reminder arm received any needed vaccine by 4weeks (31.9% vs. 22.7%, adjusted relative risk [aRR] 1.47, 95% CI 1.01-2.14), but not by 12 or 24weeks. Plain reminders were noted in post hoc analyses to have a greater effect than educational reminders in certain sub-populations, including 11-12year-olds and those sent the initial reminder in early fall. Fewer adolescents in the plain vs. educational reminder arm had a missed vaccination opportunity by 4weeks (10.9% vs. 41.3%; aRR 0.21, 95% CI 0.07-0.60), but not by 12 or 24weeks. CONCLUSION: Plain text message vaccine reminders appear to have a positive effect compared to educational ones in the short-term and for certain families. TRIAL REGISTRATION: NCT02231957 (www.clinicaltrials.gov).
Authors: Kelly Ann Schmidtke; Peter G Nightingale; Katharine Reeves; Suzy Gallier; Ivo Vlaev; Samuel I Watson; Richard J Lilford Journal: BMJ Qual Saf Date: 2019-08-05 Impact factor: 7.035