Flu2Text: A Multi-Site Study assessing an Intervention for 2nd Dose of Influenza Vaccine

问题：流感感染导致高发病率和死亡率。幼儿特别容易患上 流感疫苗接种不完整，因为根据他们以前的疫苗接种情况，许多人需要2剂 在一个季节，因为一剂并不能提供足够的保护。但只有一半的人， 第一个剂量接受第二个剂量。除了忘记记得返回后续剂量，收到2 父母对流感疫苗接种的知识有限， 了解第二剂的必要性，以及及时接受该剂量的重要性。 即使在弱势群体中，美国90%的成年人也拥有手机。在一个可扩展的， 短信可以提供疫苗提醒，既可以提醒家庭返回， 第二剂，并提供教育信息，可以促进流感疫苗的健康知识， 解决导致漏服或延迟第二剂的常见障碍。我们的研究在一个低收入， 城市主要是多米尼加社区已经证明了使用短信提醒的有效性， 与仅书面提醒相比，接受第二剂流感疫苗的人数增加（72.2% vs. 57.7%; p<0.01）。虽然以前的短信疫苗提醒研究已经证明是成功的，但它们已经被 在当地进行，主要针对低收入人群。因此，一项全国范围的研究对以下方面至关重要： 了解短信提醒的有效性和最佳使用方法， 其子女在不同的实践环境中得到照顾。为实现这一目标，建议 研究有3个具体目的：目的1：比较改善第二剂的有效性， 与普通流感疫苗相比， 在特定季节需要两剂的不同儿科人群中进行护理。目的2：比较 个性化文本在提高第二剂流感疫苗及时性方面的有效性 在不同儿科人群中嵌入教育信息与常规护理的消息提醒， 在特定季节需要两次剂量。目的3：评估修改文本的父母和儿童特征 信息有效性。方法：在两个季节，2000名6个月至8岁儿童的父母 在全国50个诊所中，接受过第一次流感的人需要两剂疫苗（共4000人） 该季节的疫苗剂量将随机接受1）嵌入有 流感疫苗健康知识推广信息或2）常规护理。家长将通过招募 美国儿科学会国家儿科研究办公室设置（PROS）网络。成果： 主要结果是在赛季结束前（4月30日）接受两次剂量。次要结局将是 第二次剂量接收的及时性。如果成功的话，这个项目可以支持和告知一个新的范例， 以低成本、可扩展的方式进行互动式健康传播，并易于传播。

Problem: Influenza infection results in high morbidity and mortality. Young children are at particular risk for incomplete influenza vaccination because, depending on their previous vaccination status, many need 2 doses in a single season, as one dose does not confer adequate protection. Yet, only half of those who receive the first dose receive the second. Besides forgetting to remember to return for subsequent doses, receipt of 2 doses in a season can be affected by limited parental knowledge regarding influenza vaccination such as lack of understanding of the need for a second dose, as well as the importance of prompt receipt of that dose. Even among disadvantaged populations, 90% of adults in the U.S. have a cellphone. In a scalable, efficient manner, text messaging can provide vaccine reminders that can both remind families to return for a second dose as well as offer educational information that can promote influenza vaccine health-literacy by addressing common barriers that result in missing or delaying a second dose. Our research in one low-income, urban primarily Dominican community has demonstrated the efficacy of using text message reminders to increase receipt of 2nd dose of influenza vaccine compared to solely a written reminder (72.2% vs. 57.7%; p<0.01). While previous text message vaccine reminder studies have demonstrated success, they have been conducted locally and primarily with a low-income population. A study with national scope is therefore vital to understanding the effectiveness and optimal use of text message reminders to parents with varied backgrounds and whose children are cared for in diverse practice settings. To achieve this goal, the proposed study has 3 specific aims: AIM 1: To compare the effectiveness i n improving receipt of the second dose of influenza vaccine of personalized text message reminders embedded with educational information vs. usual care in a diverse pediatric population in need of two doses in a given season. AIM 2: To compare the effectiveness i n improving t h e timeliness of the second dose of influenza vaccine of personalized text message reminders embedded with educational information vs. usual care in a diverse pediatric population in need of two doses in a given season. AIM 3: To assess parental and child characteristics that modify text message effectiveness. Methods: In each of 2 seasons, 2000 parents of 6 months through 8 year-old children in need of two doses that season (4000 total) in 50 practices nationally who have received the 1st influenza vaccine dose that season will be randomized to receive either 1) text message reminders embedded with influenza vaccine health-literacy promoting information or 2) usual care. Parents will be recruited through the American Academy of Pediatrics national Pediatric Research in Office Settings (PROS) network. Outcomes: The primary outcome is receipt of two doses by the end of the season (April 30). A secondary outcome will be timeliness of second dose receipt. If successful, this project could support and inform a new paradigm in interactive health communication in a low cost, scalable manner that may be readily disseminated.