Direct Messaging to Parents/Guardians to Improve Adolescent Immunizations
Direct Messaging to Parents/Guardians to Improve Adolescent Immunizations
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DOI：
10.1016/j.jadohealth.2014.11.023
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发表时间：
2015-05-01
影响因子：
7.6
通讯作者：
Kaelber, David C.
中科院分区：
文献类型：
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作者：
Bar-Shain, David S.;Stager, Margaret M.;Kaelber, David C.
目的：研究向父母/监护人发送直接消息对青少年免疫接种率的影响。方法：电子健康记录规则确定需要免疫接种的青少年。通过单一供应商使用自动文本、预先录制的语音和/或明信片向青少年的家长/监护人发送消息。 结果：3,393 名年龄在 11-18 岁、在过去 2 年内接受过一次或多次初级保健就诊、被确定需要（平均 2.04 年）疫苗接种（脑膜炎球菌结合疫苗、人乳头瘤病毒或破伤风、白喉和百日咳疫苗）的患者的家长/监护人信息（平均年龄 14 岁；50% 为男性；38% 为非洲裔美国人；23% 为白人；19% 为西班牙裔；79% 有公共医疗保险）。总共发送了 7,094 条消息：3,334 条自动语音 (47%)、2,631 条短信 (37%) 和 1,129 封明信片 (16%)。第一条消息发出后，865 名青少年 (25.5%) 至少接种了一种疫苗。在信息发布的 24 周内，959 次就诊（83.8% 是医生就诊，16.2% 是护士就诊）中接种了 1,324 种疫苗（745 种人乳头瘤病毒；403 种脑膜炎球菌结合疫苗；以及 176 种破伤风、白喉和百日咳疫苗）。每次接种疫苗的平均就诊费用为 1.77 美元，总报销额为 204 美元。免疫完成率没有因年龄、性别、种族/民族或保险类型而出现差异。第 24 周时，一条消息比两条或三条消息更有效（分别为 35.6%、19.4% 和 24.1%；p
Purpose: To study the impact on adolescent immunization rates of direct messages to parents/guardians.Methods: Electronic health record rules identified adolescents needing an immunization. Parents/guardians of adolescents were messaged via a single vendor using automated text, prerecorded voice, and/or postcard.Results: Parents/guardians of 3,393 patients, ages 11-18 years, with one or more primary care visits in the prior 2 years, identified as needing (average of 2.04 years) a vaccination (meningococcal conjugate, human papillomavirus, or tetanus, diphtheria, and pertussis vaccines) were messaged (mean age, 14 years; 50% male; 38% African-American; 23% white; 19% Hispanic; and 79% public health insurance). A total of 7,094 messages were sent: 3,334 automated voice (47%), 2,631 texts (37%), and 1,129 postcards (16%). After the first message, 865 adolescents (25.5%) received at least one vaccine. Within 24 weeks of messaging 1,324 vaccines (745 human papillomavirus; 403 meningococcal conjugate; and 176 tetanus, diphtheria, and pertussis vaccines) occurred in 959 visits (83.8% physician visits and 16.2% nurse visits). Average visits generated $204 gross reimbursement for $1.77 in messaging expenses per vaccine given. No differences in immunization completion rates occurred by age, gender, race/ethnicity, or insurance type. At 24 weeks, one message was more effective than two or three messages (35.6%, 19.4%, and 24.1% effectiveness, respectively; p