一项随机对照试验，研究通过短信消息和日历提醒来提高婴儿疫苗接种及时性。

A randomised controlled trial of SMS messaging and calendar reminders to improve vaccination timeliness in infants.

机构信息

Kirby Institute, University of New South Wales, Kensington, NSW, Australia.

National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; Kids Research Institute, The Children's Hospital Westmead, Westmead, NSW, Australia.

出版信息

Vaccine. 2020 Mar 30;38(15):3137-3142. doi: 10.1016/j.vaccine.2020.02.045. Epub 2020 Mar 5.

DOI:10.1016/j.vaccine.2020.02.045

PMID:32147296

Abstract

BACKGROUND

The effectiveness of SMS reminders in improving vaccination coverage has been assessed previously, with effectiveness varying between settings. However, there are very few studies on their effect on the timeliness of vaccination.

DESIGN

Unblinded, randomised controlled trial with blocked sampling.

METHODS

1594 Australian infants and young children were recruited to assess the impact of (1) SMS reminders only, (2) a personalised calendar, (3) SMS reminder and personalised calendar and (4) no intervention, on receipt of vaccine within 30 days of the due date. Outcomes were measured for receipt of vaccines due at 2, 4, 6, 12 and 18 months of age. A post-hoc assessment was also conducted of the impact of a new national "No jab No Pay" policy introduced during the trial, which removed philosophical objections as an exemption for financial penalties for non-vaccination.

RESULTS

There was a statistically significant improvement in on-time vaccination only at the 12 month schedule point amongst infants who received SMS reminders alone (RR 1.09, 95% CI 1.01-1.18) or in combination with a personalised calendar (1.11, CI 1.03-1.20) compared to controls. This impact was limited to participants who had received one or more previous doses late. No statistically significant impacts of calendar interventions alone were seen. There was a high rate of on-time compliance amongst control participants - 95%, 86%, 80%, 74% at the 4, 6, 12 and 18 month schedule points respectively, which increased more than 10 percentage points after implementation of the "No Jab, No Pay" policy.

CONCLUSIONS

SMS reminders are more effective in improving timeliness where pre-existing compliance is lower, but the 18 month schedule point appeared to be less amenable to intervention. Australia and New Zealand Clinical Trial Registration No. ACTRN12614000970640.

摘要

背景

短信提醒在提高疫苗接种率方面的有效性已被评估过，其在不同环境下的效果存在差异。然而，关于其对疫苗接种及时性影响的研究却非常少。

设计

采用盲法、随机对照试验，采用分组抽样。

方法

共招募了 1594 名澳大利亚婴幼儿，以评估以下四种干预措施对疫苗接种及时性的影响：（1）仅发送短信提醒，（2）个性化日历，（3）短信提醒和个性化日历，（4）无干预。结果衡量的是在疫苗应在 2、4、6、12 和 18 个月龄时的 30 天内接种疫苗的情况。试验期间还进行了一项事后评估，评估了新的全国性“无针无薪”政策的影响，该政策取消了因未接种疫苗而处以经济处罚的哲学豁免。

结果

仅在接受短信提醒的婴儿中，12 个月的接种时间点有统计学意义的显著改善（RR 1.09，95%CI 1.01-1.18）或与个性化日历结合（1.11，CI 1.03-1.20）与对照组相比。这种影响仅限于那些已经接种过一次或多次疫苗且接种时间较晚的参与者。单独使用日历干预措施并没有产生统计学上显著的影响。对照组的按时接种率非常高——分别为 4、6、12 和 18 个月的接种时间点的 95%、86%、80%和 74%，在“无针无薪”政策实施后，这一比例增加了 10 多个百分点。