Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
J Pediatr. 2023 Feb;253:158-164.e1. doi: 10.1016/j.jpeds.2022.09.035. Epub 2022 Oct 4.
To determine effectiveness of text/telephone outreach messages, with and without coronavirus disease 2019 (COVID-19) vaccine information.
We conducted an intent-to-treat, multiarm, randomized clinical trial with adolescents aged 12-17 years. Eligible patients did not have an adolescent well-care visit in the past year or scheduled in the next 45 days or an active electronic health record portal account. We randomized participants to the standard message, COVID-19 vaccine message, or no message (control) group and delivered 2 text messages or telephone calls (per family preference) to the message groups. The primary outcome was adolescent well-care visit completion within 8 weeks, and secondary outcomes were adolescent well-care visit scheduled within 2 weeks and receiving COVID-19 vaccine within 8 weeks.
We randomized 1235 adolescents (mean age, 14 ± 1.5 years; 51.6% male; 76.7% Black; 4.1% Hispanic/Latinx; 88.3% publicly insured). The standard message group had higher odds of scheduling an adolescent well-care visit compared with the control group (OR, 2.07; 95% CI, 1.21-3.52) and COVID-19 vaccine message group (OR, 1.66; 95% CI, 1.00-2.74). The odds of completing an adolescent well-care visit did not differ significantly (standard message group vs control group; OR, 1.35; 95% CI, 0.88-2.06; COVID-19 vaccine message group vs control group, OR, 1.33; 95% CI, 0.87-2.03). In per-protocol analyses, adolescents in the standard message group were twice as likely as the control group to receive the COVID-19 vaccine (OR, 2.48; 95% CI, 1.05-5.86).
Outreach messages were minimally effective. Efforts are needed to address widening disparities.
ClinicalTrials.gov: NCT04904744.
确定带有和不带有 2019 年冠状病毒病（COVID-19）疫苗信息的文本/电话外展信息的效果。
我们对 12-17 岁的青少年进行了一项意向治疗、多臂、随机临床试验。符合条件的患者在过去一年中没有进行青少年常规护理就诊，也没有在接下来的 45 天内安排就诊，或没有活动的电子健康记录门户账户。我们将参与者随机分配到标准信息组、COVID-19 疫苗信息组或无信息组（对照组），并根据家庭偏好向信息组发送 2 条短信或电话。主要结果是在 8 周内完成青少年常规护理就诊，次要结果是在 2 周内安排青少年常规护理就诊和在 8 周内接种 COVID-19 疫苗。
我们随机分配了 1235 名青少年（平均年龄 14±1.5 岁；51.6%为男性；76.7%为黑人；4.1%为西班牙裔/拉丁裔；88.3%为公共保险）。与对照组相比，标准信息组安排青少年常规护理就诊的可能性更高（比值比，2.07；95%置信区间，1.21-3.52）和 COVID-19 疫苗信息组（比值比，1.66；95%置信区间，1.00-2.74）。完成青少年常规护理就诊的可能性差异无统计学意义（标准信息组与对照组相比；比值比，1.35；95%置信区间，0.88-2.06；COVID-19 疫苗信息组与对照组相比，比值比，1.33；95%置信区间，0.87-2.03）。在符合方案分析中，标准信息组的青少年接种 COVID-19 疫苗的可能性是对照组的两倍（比值比，2.48；95%置信区间，1.05-5.86）。
外展信息效果有限。需要努力解决日益扩大的差距。
ClinicalTrials.gov：NCT04904744。
