O'Leary Sean T, Lee Michelle, Lockhart Steven, Eisert Sheri, Furniss Anna, Barnard Juliana, Eblovi Darren, Shmueli Doron, Stokley Shannon, Dickinson L Miriam, Kempe Allison
Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Denver, Colorado;
Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Denver, Colorado;
Pediatrics. 2015 Nov;136(5):e1220-7. doi: 10.1542/peds.2015-1089. Epub 2015 Oct 5.
To evaluate the effectiveness and cost of bidirectional short messaging service in increasing rates of vaccination and well child care (WCC) among adolescents.
We included all adolescents needing a recommended adolescent vaccine (n = 4587) whose parents had a cell-phone number in 5 private and 2 safety-net pediatric practices. Adolescents were randomized to intervention (n = 2228) or control (n = 2359). Parents in the intervention group received up to 3 personalized short messaging services with response options 1 (clinic will call to schedule), 2 (parent will call clinic), or STOP (no further short messaging service). Primary outcomes included completion of all needed services, WCC only, all needed vaccinations, any vaccination, and missed opportunity for vaccination.
Intervention patients were more likely to complete all needed services (risk ratio [RR] 1.31, 95% confidence interval [CI] 1.12-1.53), all needed vaccinations (RR 1.29, 95% CI 1.12-1.50), and any vaccination (RR 1.36, 95% CI 1.20-1.54). Seventy-five percent of control patients had a missed opportunity versus 69% of intervention (P = .002). There was not a significant difference for WCC visits. Responding that the clinic should call to schedule ("1") was associated with the highest effect size for completion of all needed services (RR 1.89, 95% CI 1.41-2.54). Net cost ranged from $855 to $3394 per practice.
Bidirectional short messaging service to parents was effective at improving rates for all adolescent vaccinations and for all needed services, especially among parents who responded they desired a call from the practice.
评估双向短信服务在提高青少年疫苗接种率和儿童健康保健（WCC）率方面的有效性和成本。
我们纳入了所有需要接种推荐的青少年疫苗的青少年（n = 4587），其父母在5家私立和2家安全网儿科诊所留有手机号码。青少年被随机分为干预组（n = 2228）或对照组（n = 2359）。干预组的父母收到多达3条个性化短信，回复选项包括1（诊所将致电安排）、2（家长将致电诊所）或停止（不再接收短信服务）。主要结局包括完成所有所需服务、仅完成儿童健康保健、完成所有所需疫苗接种、进行任何疫苗接种以及错过疫苗接种机会。
干预组患者更有可能完成所有所需服务（风险比[RR] 1.31，95%置信区间[CI] 1.12 - 1.53）、所有所需疫苗接种（RR 1.29，95% CI 1.12 - 1.50）以及任何疫苗接种（RR 1.36，95% CI 1.20 - 1.54）。75%的对照组患者错过机会，而干预组为69%（P = 0.002）。儿童健康保健就诊方面无显著差异。回复诊所应致电安排（“1”）与完成所有所需服务的效应量最高相关（RR 1.89，95% CI 1.41 - 2.54）。每家诊所的净成本在855美元至3394美元之间。
向家长提供双向短信服务可有效提高所有青少年疫苗接种率和所有所需服务的完成率，尤其是在那些回复希望诊所致电的家长中。
