Text 4Health-Kids: Text Message Reminder-Recalls for Early childhood Vaccination

描述(申请人提供)：虽然我们已经达到了2010年健康人目标，在19-35个月大的美国儿童中，初级免疫接种系列的覆盖率为80%，但仍有20%的儿童仍未接种。此外，免疫覆盖率低和疫苗可预防疾病暴发的地区依然存在。免疫提醒-召回已被证明是成功的，但受到以具有成本效益的方式快速确定和接触到大量目标人口的能力的限制。提醒-通过短信召回可能提供一个创新的机会，以提高疫苗接种覆盖率。目前，89%的美国人拥有手机。目前还没有关于如何优化设计这些系统的证据，因此短信免疫提醒-召回尚未广泛实施。我们团队之前的形成性研究表明，短信提醒召回可能既有效，又被父母很好地接受。我们正在进行的青少年短信项目Text4Health的初步结果显示，到目前为止，收到短信的110名父母中有15.5%(95%可信区间：8.722.0)会回来进行后续免疫接种，而对照组的这一比例为0%(p=0.000)，并表明与免疫登记关联的短信提醒可以显著提高接种率。受到这些初步结果的鼓舞，在目前的提案中，我们计划通过针对儿童早期免疫接种、纳入免疫预约提醒、并包括六个家庭实践和儿科护理环境来扩大这一干预措施，扩展到我们的青少年干预措施之外。在这项研究中，我们寻求(1)评估父母和提供者对与免疫相关的短信的兴趣、偏好和满意度，(2)衡量定制短信免疫预约/免疫召回警报的有效性和成本，这些短信与完善的免疫登记相关联，以提高MMR1和DTaP3哨兵疫苗的覆盖率和及时性。我们将针对以拉丁裔为主、医疗服务不足的人群中年幼儿童的父母。我们的方法旨在解决采用和可伸缩性的关键障碍，并增加对低收入人口的接触。这项研究旨在为开发“最佳实践”铺平道路，允许任何免疫登记机构、卫生部门或大型团体实践使用这项技术来提高免疫覆盖率。 公共卫生相关性：这项拟议的研究使用短信免疫预约提醒/免疫召回，为医疗服务不足背景的儿童的父母提供信息，以提高免疫覆盖率。短信干预措施的成功实施可能会改变目前的提醒-回忆方法。

DESCRIPTION (provided by applicant): Although we have reached the Healthy People 2010 goal of 80% coverage among U.S. children 19-35 months of age for the primary immunization series, 20% of children still remain under-immunized. In addition, pockets of low immunization coverage and outbreaks of vaccine preventable disease persist. Immunization reminder-recalls have been shown to be successful, but have been limited by the ability to rapidly identify and reach large target populations in a cost-effective manner. Reminder-recalls via text message may offer an innovative opportunity to improve vaccination coverage. Currently, 89% of Americans own a cell phone. Evidence on how to optimally design these systems is not yet available and thus text message immunization reminder-recalls have not been widely implemented. Prior formative research by our team suggests that text messages reminder-recalls may be both effective and well accepted by parents. Preliminary results from our on-going adolescent text messaging project, Text4Health, show great promise with 15.5% (95% CI: 8.7, 22.0) of the 110 parents texted so far returning for a subsequent immunization compared to 0% in the control group (p =0.000) and suggest that text messaging reminders linked to a immunization registry can significantly increase immunization rates. Encouraged by these preliminary results, in the current proposal we plan to extend this intervention by targeting early childhood immunizations, incorporating immunization appointment reminders, and including six family practice and pediatric care settings, expanding beyond those in our adolescent intervention. In this study, we seek to (1) assess parental and provider interest in, preferences for and satisfaction with immunization related text messaging, (2) measure the effectiveness and costs of tailored text message immunization appointment/immunization recall alerts linked to a well-established immunization registry to increase coverage rates and timeliness of the sentinel vaccines of MMR1 and DTaP3. We will target parents of young children from a primarily Latino, medically underserved population. Our methodologies are designed to address key barriers to adoption and scalability and to increase access to low-income populations. This research aims to pave the way to develop a "best practice," allowing any immunization registry, department of health, or large group practice employ this technology to improve immunization coverage. PUBLIC HEALTH RELEVANCE: This proposed research uses text message immunization appointment reminders / immunization recalls for parents of children from medically underserved backgrounds to improve immunization coverage. Successful implementation of text message interventions could transform the current approach to reminder-recalls.