Dini E F, Linkins R W, Sigafoos J
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Prev Med. 2000 Feb;18(2):132-9. doi: 10.1016/s0749-3797(99)00086-0.
Recent evaluations of computer-generated reminder/recall messages have suggested that they are an inexpensive, labor-saving method of improving office visitation rates of childhood immunization providers. This study assesses the sustained impact of computer-generated messages on immunization coverage during the first two years of life.
Randomized, controlled trial.
County health department in the Denver metropolitan area.
Children (n = 1227) 60 to 90 days of age who had received the first dose of diphtheria-tetanus-pertussis (DTP) and/or poliovirus vaccines.
Households of children were randomized into four groups to receive: telephone messages followed by letters (Group A); telephone messages alone (Group B); letters only (Group C); or no notification (Group D). Households in the intervention groups (A, B, and C) received up to five computer-generated telephone messages and/or up to four letters each time their children became due for immunization(s).
Immunization series completion at 24 months of age.
Children whose families were randomized to receive any of the interventions were 21% more likely to have completed the immunization series by 24 months of age than were children randomized into the control group (49.2% vs 40.9%; RR [rate ratio] = .21; CI [confidence interval] = 1.01, 1.44). While not statistically significant, children in Group A were 23% more likely to complete their immunization series by 24 months of age than those in the control group (50.2% vs 40.9%; RR = 1.23; CI = 1.00, 1.52). No differences were detected among the intervention groups. The costs per additional child completing the series by 24 months of age in Group A was $226 ($79 after start-up costs were discounted).
Computer-generated contacts, either by phone or by mail (or both combined), used each time vaccines become due, are efficacious in increasing immunization coverage of children under 2 years of age.
最近对计算机生成的提醒/召回信息的评估表明，它们是提高儿童免疫接种机构门诊就诊率的一种低成本、节省劳动力的方法。本研究评估了计算机生成的信息在儿童出生后头两年对免疫接种覆盖率的持续影响。
随机对照试验。
丹佛大都会区的县卫生部门。
60至90日龄已接种第一剂白喉-破伤风-百日咳（DTP）和/或脊髓灰质炎疫苗的儿童（n = 1227）。
将儿童家庭随机分为四组，分别接受：电话信息后接信件（A组）；仅电话信息（B组）；仅信件（C组）；或无通知（D组）。干预组（A、B和C组）的家庭在每次孩子应接种疫苗时，最多接收五条计算机生成的电话信息和/或最多四封信。
24月龄时免疫接种系列完成情况。
随机分配接受任何一种干预措施的儿童家庭中的儿童，到24月龄时完成免疫接种系列的可能性比随机分配到对照组的儿童高21%（49.2%对40.9%；率比[RR]=1.21；置信区间[CI]=1.01，1.44）。虽然无统计学意义，但A组儿童到24月龄时完成免疫接种系列的可能性比对照组儿童高23%（50.2%对40.9%；RR = 1.23；CI = 1.00，1.52）。各干预组之间未检测到差异。A组中每增加一名在24月龄时完成系列接种的儿童的成本为226美元（扣除启动成本后为79美元）。
每次疫苗到期时使用计算机生成的电话或邮件（或两者结合）进行联系，可有效提高2岁以下儿童的免疫接种覆盖率。
