Rosen Kyra, Krelle Holly, King William C, Klapheke Nathan, Pina Paulo, Anderman Judd, Chung Alicia, Mendoza Felicia, Bagheri Ashley, Stadelman Jay, Tsuruo Sarah, Horwitz Leora Idit
NYU Grossman School of Medicine, New York, New York, USA.
NYU Grossman School of Medicine, New York, New York, USA
BMJ Qual Saf. 2025 Apr 17;34(5):339-348. doi: 10.1136/bmjqs-2024-017893.
Previous studies have demonstrated that text message reminders can improve pediatric vaccination rates, including low income & diverse settings such as those served by federally qualified health centers. In this study, we aimed to improve compliance with routine childhood immunizations via a text message intervention in a network of urban, federally qualified health centers at a large academic medical center. We targeted parents or guardians of children aged 0-2 years who were overdue or due within 14 days for at least one routine childhood immunization without a scheduled appointment. In Round 1, two versions of a text were compared to a control (no text). In subsequent Rounds, a new text was compared to a control (no text). In each round the content, wording, and frequency of texts changed. Subjects were randomized to receive a text (treatment group(s)) or to not receive a text (control group) in each round between 2020 and 2022. The primary outcome was whether overdue vaccines had been given by 12 week follow up. The secondary outcome was appointment scheduling within the 72 hours after text messages were sent. In Round 1 (n=1203) no significant differences were found between groups in overdue vaccine administration per group or per patient at follow up, or in appointment scheduling. In Round 2 (n=251) there was no significant difference in vaccine administration per group or per patient. However, significantly more patients in the intervention group scheduled an appointment (9.1% vs. 1.7%, p=0.01). In Round 3 (n=1034), vaccine administration was significantly higher in the intervention group compared to the control overall (7.0% vs. 5.5%, 0.016) and per subject (p=0.02). Significantly more patients in the intervention group scheduled an appointment compared to the control (3.3% vs. 1.2%, p=0.02). We found that text messaging can be an effective intervention to promote health service utilization such as pediatric vaccination rates, which although improved in this study, remain low.
先前的研究表明，短信提醒可以提高儿童疫苗接种率，包括在低收入及多样化环境中，如由联邦合格健康中心服务的场所。在本研究中，我们旨在通过短信干预，提高一家大型学术医疗中心城市联邦合格健康中心网络中儿童常规免疫接种的依从性。我们的目标是0至2岁儿童的父母或监护人，这些儿童至少有一项常规儿童免疫接种逾期或在14天内到期且未预约。在第一轮中，将两种版本的短信与对照组（无短信）进行比较。在随后的轮次中，将一条新短信与对照组（无短信）进行比较。每一轮中短信的内容、措辞和频率都有所变化。在2020年至2022年期间，受试者在每一轮中被随机分配接受短信（治疗组）或不接受短信（对照组）。主要结局是在12周随访时是否已接种逾期疫苗。次要结局是在发送短信后72小时内预约安排情况。在第一轮（n = 1203）中，各治疗组之间在随访时每组或每位患者的逾期疫苗接种情况以及预约安排方面均未发现显著差异。在第二轮（n = 251）中，每组或每位患者的疫苗接种情况没有显著差异。然而，干预组中安排预约的患者明显更多（9.1% 对1.7%，p = 0.01）。在第三轮（n = 1034）中，与对照组相比，干预组的总体疫苗接种率（7.0% 对5.5%，p = 0.016）和每位受试者的疫苗接种率（p = 0.02）显著更高。与对照组相比，干预组中安排预约的患者明显更多（3.3% 对1.2%，p = 0.02）。我们发现，短信提醒可以作为一种有效的干预措施来促进医疗服务的利用，如儿童疫苗接种率，尽管在本研究中有所提高，但仍然较低。
