Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, United States; Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, United States.
Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, United States; Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO, United States.
Vaccine. 2021 Jun 29;39(29):3983-3990. doi: 10.1016/j.vaccine.2021.05.053. Epub 2021 May 28.
As the rates of vaccination decline in children with logistical barriers to vaccination, new strategies to increase vaccination are needed. The goal of this study was to develop and evaluate the effectiveness of the Vaccines For Babies (VFB) intervention, an automated reminder system with online resources to address logistical barriers to vaccination in caregivers of children enrolled in an integrated healthcare system. Effectiveness was evaluated in a randomized controlled trial.
Qualitative interviews were conducted with parents of children less than two years old to identify logistical barriers to vaccination that were used to develop the VFB intervention. VFB included automated reminders to schedule the 6- and 12-month vaccine visit linking caregivers to resources to address logistic barriers, sent to the preferred mode of outreach (text, email, and/or phone). Parents of children between 3 and 10 months of age with indicators of logistical barriers to vaccination were randomized to receive VFB or usual well child care (UC). The primary outcome was percentage of days undervaccinated at 2 years of life. A difference in differences analysis was conducted.
Qualitative interviews with 6 parents of children less than 2 years of age identified transportation, scheduling challenges, and knowledge of vaccine timing as logistical barriers to vaccination. We enrolled 250 participants in the trial, 45% were loss to follow-up. There were no significant differences in vaccination uptake between those enrolled in UC or the VFB intervention (0.51%, p = 0.86). In Medicaid enrolled participants, there was a modest decrease in percentage of days undervaccinated in the VFB intervention compared to UC (6.3%, p = 0.07).
Automated Reminders and with links to heath system resources was not shown to increase infant vaccination uptake demonstrating additional resources are needed to address the needs of caregivers experiencing logistical barriers to vaccination.
由于疫苗接种率在有接种后勤障碍的儿童中下降，因此需要新的策略来增加疫苗接种率。本研究的目的是开发和评估 Vaccines For Babies（VFB）干预措施的有效性，这是一种自动化提醒系统，配有在线资源，旨在解决在综合医疗保健系统中登记的儿童的看护人在疫苗接种方面的后勤障碍。该有效性在一项随机对照试验中进行了评估。
对 2 岁以下儿童的父母进行了定性访谈，以确定疫苗接种的后勤障碍，这些障碍用于开发 VFB 干预措施。VFB 包括安排 6 个月和 12 个月疫苗接种预约的自动化提醒，将看护人联系到解决后勤障碍的资源，这些提醒通过首选的外联方式（短信、电子邮件和/或电话）发送。有接种后勤障碍迹象的 3 至 10 个月大儿童的父母被随机分配接受 VFB 或常规儿童保健（UC）。主要结果是 2 岁以下未接种疫苗的天数百分比。进行了差异中的差异分析。
对 6 名 2 岁以下儿童的父母进行的定性访谈确定了交通、安排挑战和疫苗接种时间知识是疫苗接种的后勤障碍。我们在试验中招募了 250 名参与者，其中 45%的人失访。接受 UC 或 VFB 干预的参与者在疫苗接种率方面没有显著差异（0.51%，p=0.86）。在参加医疗补助计划的参与者中，VFB 干预组与 UC 相比，未接种疫苗的天数百分比略有下降（6.3%，p=0.07）。
自动化提醒加上与卫生系统资源的链接并没有显示出可以增加婴儿疫苗接种率，这表明需要额外的资源来满足面临疫苗接种后勤障碍的看护人的需求。
