SMS mobile technology to improve early childhood vaccine coverage in Guatemala

描述（由申请人提供）：移动技术，如短消息服务（SMS）文本，在低收入和中等收入国家（LMICs）的疾病管理方面具有巨大且未开发的潜力。这方面的一个重要例子涉及改进儿童疫苗接种系列。免疫接种是最成功和最具成本效益的公共卫生干预措施之一，然而，数以百万计的一岁以下儿童仍然免疫接种不足，并且由于疫苗可预防的原因，过早死亡、长期后遗症和残疾的风险增加。特别是在发展中国家，提供婴儿初级系列疫苗的一个主要障碍是，提供者难以与父母就这些疫苗的需求和及时性进行沟通。许多低收入和中等收入国家没有有效的预防保健服务和良好的儿童保健，使得提供免疫接种和其他儿童保健方案更加困难。迫切需要采取干预措施，改善提供全面儿童保育服务（如免疫接种）的卫生保健机构与幼儿父母之间的沟通，以改善健康结果（如疫苗接种的及时性、接受度和覆盖率）。短消息服务（SMS）文本消息是一种可访问的低成本通信手段，在全球广泛使用。在过去两年中，研究小组在危地马拉开发并证明了短信免疫提醒系统的可行性和消费者可接受性，该系统允许卫生保健工作者收集儿童免疫接种数据并向父母/监护人发送短信提醒，以参加疫苗接种预约。在这项探索性和发展性研究中，我们将优化、实施和评估一种以证据为基础的集中方法，使用研究小组开发的修改版本的短信提醒/召回系统来增加免疫递送。该项目将评估我们改进后的集中方法在危地马拉两个不同的社会经济和地理区域的潜在效力，包括在开发该系统的危地马拉城进行试点测试，以及在贫困的特里菲尼奥西南地区进行新的引入，研究小组在那里建立了长期的公私合作伙伴关系，提供产前、孕产妇和儿科护理。这项研究提供了美国和危地马拉公共、私营和政府机构之间的创新伙伴关系，可以作为支持国际研究网络和建设中低收入国家研究能力的重要范例。这项研究有可能显著改善疫苗的交付和覆盖范围，并有机会扩大项目的可扩展性。重要的是，这一独特合作创造的技术和行政基础设施将成为未来提供其他临床预防服务的平台

DESCRIPTION (provided by applicant): Mobile technologies, such as Short Message Service (SMS) texts, have tremendous and untapped potential for disease management in low- and middle-income countries (LMICs). One important example of this involves improving the childhood vaccination series. Immunization is one of the most successful and cost-effective public health interventions, and yet millions of children under the age of one remain under-immunized and at increased risk for premature death, long-term sequelae, and disability due to vaccine-preventable causes. A major barrier to delivering the infant primary series, especially in developing countries, is the difficulty providers have in communicating with parents about the need for and timeliness of these vaccines. Many LMICs do not have functioning preventive health services and well child care, making the delivery of immunizations and other child health programs more difficult. There is an urgent need for interventions that improve communication between health care facilities providing comprehensive child care services (e.g. immunizations) and parents of young children to improve health outcomes (e.g. the timeliness, acceptance, and coverage of vaccinations). Short Message Service (SMS) text messages are an accessible and low-cost means of communication that are widely used globally. Over the past two years, the study team developed and demonstrated the feasibility and consumer acceptability of an SMS immunization reminder system in Guatemala which allowed healthcare workers to collect data on child immunizations and send text message reminders to parents/guardians to attend vaccination appointments. In this proposed exploratory and developmental study, we will optimize, implement, and evaluate an evidence-based centralized method of increasing immunization delivery using a modified version of the SMS reminder/recall system developed by the study team. The project will evaluate the potential for efficacy of our modified centralized approach in two different socio-economic and geographic regions of Guatemala, including a pilot test in Guatemala City where the system was developed and a new introduction in the impoverished southwest Trifinio region where the study team has a well-established and long-term public-private partnership to provide prenatal, maternal, and pediatric care. This study provides an innovative partnership between public, private, and governmental institutions both in the United States and Guatemala that can serve as an important example of supporting international research networks and building research capacity in LMICs. This study has the potential to significantly improve vaccine delivery and coverage with the opportunity for program scalability. Importantly, the technical and administrative infrastructure created by this unique collaboration will be a platform on which the future delivery of other clinical preventive services can be built.