Linkins R W, Dini E F, Watson G, Patriarca P A
National Immunization Program, Centers for Disease Control and Prevention, Georgia Division of Public Health, Atlanta.
Arch Pediatr Adolesc Med. 1994 Sep;148(9):908-14. doi: 10.1001/archpedi.1994.02170090022002.
To assess the effectiveness of computer-generated telephone reminder and recall messages in increasing preschool immunization visits.
Randomized, controlled trial.
Fourteen counties in urban and rural Georgia.
Children (N = 8002) who were younger than 2 years; had telephone numbers listed in preexisting computerized immunization databases; and were due or late for immunization(s) during the 4-month enrollment period.
Households of children were randomized to receive or not receive a general or vaccine-specific computer-generated telephone reminder or recall message the day before the child was due, or immediately after randomization if the child was late.
The rates of immunization visits during the 30-day follow-up period.
Of the 4636 children whose households were randomized to receive a message, 1684 (36.3%) visited the health department within 30 days compared with 955 (28.4%) of the 3366 children whose households were not contacted (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.20 to 1.37; P < .01). Immunization visits were more frequent (41.1%) among the 3257 children whose households actually received the message (RR = 1.45; 95% CI = 1.36 to 1.56; P < .01). Improvement in immunization visits was similar for general and specific messages, greater for recall than reminder messages, and greatest for children who were late for the third dose of the diphtheria-tetanus-pertussis vaccine and the measles-mumps-rubella vaccine.
These data suggest a simple and effective way to increase preschool immunization visits, particularly for vaccines associated with the lowest immunization rates.
评估计算机生成的电话提醒和召回信息在增加学龄前儿童免疫接种就诊率方面的有效性。
随机对照试验。
佐治亚州城乡的14个县。
年龄小于2岁；在现有的计算机免疫数据库中登记有电话号码；且在4个月的入组期内该免疫接种应接种或已逾期的儿童（N = 8002）。
将儿童家庭随机分为两组，一组在儿童应接种疫苗的前一天收到或未收到计算机生成的通用或特定疫苗的电话提醒或召回信息，若儿童已逾期，则在随机分组后立即发送。
30天随访期内的免疫接种就诊率。
在随机分组后应接收信息的4636名儿童中，1684名（36.3%）在30天内前往了卫生部门就诊，相比之下，未收到信息的3366名儿童中有955名（28.4%）就诊（风险比[RR]=1.28；95%置信区间[CI]=1.20至1.37；P<.01）。在实际收到信息的3257名儿童中，免疫接种就诊更为频繁（41.1%）（RR = 1.45；95%CI = 1.36至1.56；P<.01）。通用信息和特定信息在免疫接种就诊方面的改善相似，召回信息比提醒信息效果更好，对于白喉-破伤风-百日咳疫苗第三剂和麻疹-腮腺炎-风疹疫苗逾期的儿童效果最佳。
这些数据表明了一种简单有效的方法来增加学龄前儿童的免疫接种就诊率，特别是对于免疫接种率最低的疫苗。
