Effect of a Text Messaging Intervention on Influenza Vaccination in an Urban, Low-Income Pediatric and Adolescent Population A Randomized Controlled Trial
Effect of a Text Messaging Intervention on Influenza Vaccination in an Urban, Low-Income Pediatric and Adolescent Population A Randomized Controlled Trial
复制标题
DOI：
10.1001/jama.2012.502
复制
发表时间：
2012-04-25
影响因子：
120.7
通讯作者：
Camargo, Stewin
中科院分区：
文献类型：
--
作者：
Stockwell, Melissa S.;Kharbanda, Elyse Olshen;Camargo, Stewin
背景流感感染会导致巨大的费用、发病率和死亡率。流感疫苗接种对于儿童和青少年尤为重要，他们是其他高危人群的重要传播源，但儿科和青少年疫苗覆盖率仍然很低。传统疫苗提醒对低收入人群效果有限；然而，短信是一种新颖的、可扩展的方法来促进流感疫苗接种。 目的 评估针对低收入城市父母的有针对性的短信提醒，以促进儿童和青少年接受流感疫苗接种。 设计、设置和参与者 对 2010-2011 年流感季节期间在美国 4 个社区诊所接受护理的 9213 名 6 个月至 18 岁儿童和青少年进行随机对照试验。在 9213 名儿童和青少年中，7574 名在干预开始日期之前未接种流感疫苗，因此被纳入主要分析。 干预 分配接受干预的儿童的家长每周最多收到 5 条与免疫登记相关的短信，其中提供有关周六诊所的教育信息和说明。干预组和常规护理组均接受常规护理、自动电话提醒以及在研究地点张贴的信息传单。主要结果措施截至 2011 年 3 月 31 日，通过电子健康记录在免疫登记处记录了流感疫苗剂量的收到情况。在典型的广泛流感活动之前的较早秋季审查日期对收到情况进行了二次评估。结果 研究儿童和青少年主要是少数群体，88% 的人有公共保险，并且58% 来自讲西班牙语的家庭。截至2011年3月31日，与常规护理组（39.9%；n=1509）相比，干预组中儿童和青少年接种流感疫苗的比例较高（43.6%；n=1653）（差异，3.7% [95% CI, 1.5%-5.9%]；相对比率[RRR]，1.09 [95% CI， 1.04-1.15]；P=.001)。在秋季审查日期，干预组中有 27.1% (n=1026) 接受过流感疫苗，而常规护理组中有 22.8% (n=864) 接受过流感疫苗（差异为 4.3% [95% CI, 2.3%-6.3%]；RRR，1.19 [95% CI，1.10-1.28]；P
Context Influenza infection results in substantial costs, morbidity, and mortality. Vaccination against influenza is particularly important in children and adolescents who are a significant source of transmission to other high-risk populations, yet pediatric and adolescent vaccine coverage remains low. Traditional vaccine reminders have had a limited effect on low-income populations; however, text messaging is a novel, scalable approach to promote influenza vaccination.Objective To evaluate targeted text message reminders for low-income, urban parents to promote reciept of influenza vaccination among children and adolescents.Design, Setting, and Participants Randomized controlled trial of 9213 children and adolescents aged 6 months to 18 years receiving care at 4 community-based clinics in the United States during the 2010-2011 influenza season. Of the 9213 children and adolescents, 7574 had not received influenza vaccine prior to the intervention start date and were included in the primary analysis.Intervention Parents of children assigned to the intervention received up to 5 weekly immunization registry-linked text messages providing educational information and instructions regarding Saturday clinics. Both the intervention and usual care groups received the usual care, an automated telephone reminder, and access to informational flyers posted at the study sites.Main Outcome Measures Receipt of an influenza vaccine dose recorded in the immunization registry via an electronic health record by March 31, 2011. Receipt was secondarily assessed at an earlier fall review date prior to typical widespread influenza activity.Results Study children and adolescents were primarily minority, 88% were publicly insured, and 58% were from Spanish-speaking families. As of March 31, 2011, a higher proportion of children and adolescents in the intervention group (43.6%; n=1653) compared with the usual care group (39.9%; n=1509) had received influenza vaccine (difference, 3.7% [95% CI, 1.5%-5.9%]; relative rate ratio [RRR], 1.09 [95% CI, 1.04-1.15]; P=.001). At the fall review date, 27.1% (n=1026) of the intervention group compared with 22.8% (n=864) of the usual care group had received influenza vaccine (difference, 4.3% [95% CI, 2.3%-6.3%]; RRR, 1.19 [95% CI, 1.10-1.28]; P