SMS mobile technology to improve early childhood vaccine coverage in Guatemala

描述（由申请人提供）：移动的技术，如短信服务（SMS）文本，在低收入和中等收入国家（LMIC）的疾病管理方面具有巨大的未开发潜力。这方面的一个重要例子是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，但仍有数百万1岁以下儿童免疫接种不足，过早死亡、长期后遗症和因疫苗可预防的原因而致残的风险增加。提供婴儿初级系列疫苗的一个主要障碍，特别是在发展中国家，是提供者难以与父母沟通这些疫苗的必要性和及时性。许多中低收入国家没有有效的预防性卫生服务和良好的儿童保健，使免疫接种和其他儿童保健方案的提供更加困难。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、接受度和覆盖面）。短消息服务（SMS）文本消息是全球广泛使用的可访问且低成本的通信手段。在过去的两年里，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的可接受性，该系统允许医疗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。在这项拟议的探索性和发展性研究中，我们将优化、实施和评估一种基于证据的集中方法，该方法使用研究小组开发的修改版短信提醒/召回系统来增加免疫接种。该项目将评估我们修改后的集中式方法在危地马拉两个不同的社会经济和地理区域的有效性，包括在危地马拉城进行的试点测试，该系统是在那里开发的，并在贫困的西南部特里菲尼奥地区进行了新的介绍，研究小组在那里建立了良好的长期公私合作伙伴关系，以提供产前，孕产妇和儿科护理。这项研究为美国和危地马拉的公共、私营和政府机构提供了一种创新的伙伴关系，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一个重要例子。这项研究有可能显着提高疫苗的交付和覆盖率，并有机会实现计划的可扩展性。重要的是，这种独特的合作所创造的技术和行政基础设施将成为一个平台，未来提供其他临床预防服务 可以建造。

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.