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PRISM: Personalized Reminders for Immunizations Using Short Messaging Systems

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Human papillomavirus vaccine series completion rates in a low-income, Latino adolescent population were high for patients receiving text messages reminders.

Project Details -
Completed

Childhood vaccines are often administered to patients during well-child visits. For vaccines administered as a series, encouraging families to come back into the office for subsequent doses can be challenging. Methods to remind patients they are due for a vaccine, such as telephone calls or post cards, are well established; however, they have mixed results in low-income populations.

To examine the effect of educational information in vaccine reminder text messages to patients’ families, the research team compared the human papillomavirus (HPV) vaccine series completion rates in two groups of primarily Latino patients receiving primary care services at one of four urban community clinics in New York City. One group received conventional text message vaccine reminders, while another group received educational text message reminders customized to the family’s stage of decision making about the vaccine.

The specific aim of the research was as follows:

  • Compare the effectiveness in improving HPV vaccine series completion for minority adolescents of personalized text message reminders with tailored vaccine health literacy-promoting information versus conventional text message vaccination reminders. 

To determine the family’s stage of decision making, the investigators designed a short cascade of text messages asking if the family was aware the patient needed another HPV dose and if the patient was planning to come in for the vaccine. Subsequent texts included educational information targeted to the stage of decision making.

While the initial results indicated no difference in HPV series completion rates for the two study groups, a secondary analysis found that patients in both study groups had a significantly higher rate of HPV series completion rate (74.1 percent) than patients that had not enrolled in the study (45.2 percent). These results indicate that any text message reminders may lead to timely HPV series completion in a low-income minority population. Compared to other methods of recalling patients for vaccination, these messages are a simple, scalable, and low-cost way to meet Healthcare Effectiveness Data and Information Set (HEDIS) quality measures and improve adherence.

Texting Reminders to Low-Income, Minority Patients Improves Vaccination Rates

Texting Reminders to Low-Income, Minority Patients Improves Vaccination Rates

Human papillomavirus vaccine series completion rates in a low-income, Latino adolescent population were high for patients receiving text messages reminders.

Getting patients due for vaccines back into the office

Childhood vaccines are often administered to patients during well-child visits. For vaccines administered as a series, encouraging families to come back into the office for subsequent doses can be challenging. Methods to remind patients they are due for a vaccine, such as telephone calls or post cards, are well established, however have mixed results in low-income populations. One physician and researcher wondered if the effectiveness of text messaging for these populations could be increased if educational information was added to the messages.

We all have very busy schedules, so when there is something doctor’s offices can do as a reminder that is simple, families find that very helpful.”
– Dr. Stockwell

Customized text messages providing educational information

To examine the effect of educational information in vaccine reminder text messages to patients’ families, Dr. Melissa Stockwell and her Columbia University-based research team compared the human papillomavirus (HPV) vaccine series completion rates in two groups of primarily Latino patients receiving primary care services at one of four urban, community clinics in New York City. One group received conventional text message vaccine reminders, while another group received educational text message reminders customized to the family’s stage of decision making about the vaccine. To determine the family’s stage of decision making, Dr. Stockwell designed a short cascade of text messages asking if the family was aware the patient needed another HPV dose and if the patient was planning to come in for the vaccine. Subsequent texts included educational information targeted to the stage of decision making.

Unexpected, yet exciting results

While the initial results indicated no difference in HPV series completion rates for the two study groups, a secondary analysis found that those patients in both study groups had a significantly higher rate of HPV series completion rate (74.1 percent) than patients that had not enrolled in the study (45.2 percent). These results indicate that any text message reminders may lead to timely HPV series completion in a low-income, minority population. Dr. Stockwell wants stakeholders to recognize the value of text messaging vaccine reminders to patients. Compared to other methods of recalling patients for vaccination, these messages are a simple, scalable, and low-cost way to meet Healthcare Effectivness Data and Information Set (HEDIS) quallity measures and improve performance.