Dombkowski Kevin J, Cowan Anne E, Reeves Sarah L, Foley Matthew R, Dempsey Amanda F
The Child Health Evaluation and Research (CHEAR) Center, Division of General Pediatrics, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48109, United States.
The Child Health Evaluation and Research (CHEAR) Center, Division of General Pediatrics, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48109, United States.
Vaccine. 2017 May 25;35(23):3089-3095. doi: 10.1016/j.vaccine.2017.04.033. Epub 2017 Apr 25.
We sought to: (1) explore the feasibility of using email for seasonal influenza vaccination reminders to parents of adolescents and (2) assess influenza vaccination rates among adolescents whose parents were randomized to either receive or not receive email reminders.
Email addresses were obtained for parents of patients 10-18years from 4 practices in Michigan. Addresses were randomized to either receive email reminders, or not. Reminder messages were sent during October 2012-March 2013 (Season 1) and October 2013-March 2014 (Season 2). Vaccination status was determined 60days following the last email reminder for each season using the statewide Michigan Care Improvement Registry (MCIR); per protocol bivariate and multivariate logistic regression analyses were conducted to evaluate reminder notification.
After email cleaning, testing, and matching with MCIR, approximately half of email addresses (2348 of 5312 in Season 1; 3457 of 6549 in Season 2) were randomized. Bivariate analyses found that influenza vaccination within 60days after notification date was similar among those notified (34%) versus not notified (29%) in both Season 1 (p=0.06) and Season 2 (39% vs. 37%, p=0.20). However, multivariate models adjusted for season, site, and receipt of notification in two seasons found a higher likelihood of influenza vaccination among children that received notification (aOR=1.28, 95% CI=1.09, 1.51); in addition, differences in influenza vaccination were also observed between practice sites (range: p=0.15 to p<0.001).
We found that practice-based email influenza vaccine reminders to parents of adolescents are feasible, but not without complications. Our study demonstrates that email reminders from practices can yield increases in influenza vaccination rates among adolescents. Practices should consider email as an option for influenza reminders and establish business practices for collecting and maintaining patient email addresses. This study is registered at www.ClinicalTrials.gov id #NCT01732315.
我们试图：（1）探讨使用电子邮件向青少年家长发送季节性流感疫苗接种提醒的可行性，以及（2）评估其家长被随机分配接受或不接受电子邮件提醒的青少年的流感疫苗接种率。
从密歇根州的4家医疗机构获取了10至18岁患者家长的电子邮件地址。这些地址被随机分配为接受或不接受电子邮件提醒。提醒信息在2012年10月至2013年3月（第一季）和2013年10月至2014年3月（第二季）期间发送。使用全州范围的密歇根医疗改善登记系统（MCIR）在每个季节最后一封电子邮件提醒发出60天后确定疫苗接种状态；按照方案进行双变量和多变量逻辑回归分析以评估提醒通知的效果。
在对电子邮件进行清理、测试并与MCIR匹配后，大约一半的电子邮件地址（第一季5312个中的2348个；第二季6549个中的3457个）被随机分配。双变量分析发现，在第一季（p = 0.06）和第二季（39%对37%，p = 0.20）中，在通知日期后60天内，收到通知者（34%）和未收到通知者（29%）的流感疫苗接种情况相似。然而，在对季节、地点以及两个季节中是否收到通知进行调整的多变量模型中，发现收到通知的儿童接种流感疫苗的可能性更高（校正比值比=1.28，95%置信区间=1.09，1.51）；此外，在不同医疗机构之间也观察到了流感疫苗接种情况的差异（范围：p = 0.15至p<0.001）。
我们发现，基于医疗机构向青少年家长发送电子邮件流感疫苗提醒是可行的，但并非没有问题。我们的研究表明，医疗机构发送的电子邮件提醒可以提高青少年的流感疫苗接种率。医疗机构应考虑将电子邮件作为流感提醒的一种选择，并建立收集和维护患者电子邮件地址的业务流程。本研究已在www.ClinicalTrials.gov注册，编号为#NCT01732315。
