Well-Child Visit Trial

Text Message Follow-up for Patients Who Have Missed Well-Child Visits: Randomized Controlled Trial

This project will use Twilio as a platform for a text messaging campaign to implement timely follow up with parents/guardians of children ages 0 to 17 years who have missed Well Child Visits (WCVs). The first phase of this project was an open trial. This second phase of the study will be a randomized controlled trial (RCT) to randomly assign parents/guardians of children who missed a WCV to an intervention condition or no intervention, and assess reasons for missed visits and experiences at last visit. Parents/guardians will receive text messages notifying them of missed visits and prompting them to reschedule, as well as inviting them to complete an online survey. Each reminder message will at minimum direct parents/guardians to reschedule by phone or by the patient portal. Outcomes of the follow-up campaign will be evaluated, including rescheduled visits within 6 weeks of missed visit and attendance at rescheduled visit. This aim will incorporate patient Electronic Health Record (EHR) data into mixed effects logistic regressions for the primary study outcomes.

Study Overview

• Status: Completed
• Conditions: Child Health; Text Messaging
• Intervention / Treatment: Other: Text message reminders

Detailed Description

Well-Child visits (WCV) are an opportunity to maximize the health and future well-being and development of children. Missed visits, however, can result in negative outcomes for patients and families and for the healthcare system. For patients, missed primary care visits can result in greater Emergency Department (ED) visits and hospitalizations, and in delays in diagnosing a variety of medical conditions, including identification of child abuse and neglect. For healthcare systems, missed visits result in decreased efficiency, lower quality measures, decreased provider productivity, and loss in revenue. Although smart phones are nearly ubiquitous, even among more economically disadvantaged populations, literature to date has reported only on using text messages for pre-visit reminders. There is a tremendous opportunity to study use of text messaging to engage families in follow-up for missed WCV. Even more so, testing the use of text messages with different content is missing, as well as using text messages to invite patients to share reasons for missing the last WCV.

• Study Type: Interventional
• Enrollment (Actual): 739
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Winston-Salem, North Carolina, United States, 27157
      • Wake Forest University Health Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Patients included in text messaging campaign (caregivers receive text messages):

• Are 0-17 years
• No-showed for a well-child visit scheduled at one of five locations: Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, or Pediatrics-Clemmons
• Have a phone number on record for a primary caregiver
• With primary language for contact that is English or Spanish

Caregivers must be 18 years or older

Exclusion Criteria:

Patients who:

• Are 18+ years old
• No-showed for a different type of visit, or no-showed for a WCV at a different practice location
• Already rescheduled their appointment by the time the sample list was generated
• Have primary language specified that is not English or Spanish.

Caregivers who are under 18 years old

Study Plan

How is the study designed?

Design Details

• Primary Purpose: HEALTH_SERVICES_RESEARCH
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Reminder; Participants will be sent a text message reminder of their missed well-child visit.	Other: Text message reminders; Text messages will be sent to parents/guardians of children ages 0 to 17 years who missed their well child visits.
NO_INTERVENTION: Treatment as usual; This group will receive treatment as usual, which involves no text messaging follow-up.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of rescheduled well child visits	If parent/guardian rescheduled well child visit	6 weeks after missed well child visit
Number of completed (rescheduled) well child visits	If parent/guardian completed (rescheduled) well child visit	6 weeks after missed well child visit

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of child patient emergency department visits	If child patient had an emergency department visit	6 weeks after missed well child visit
Number of child patient hospitalizations	If child patient required hospitalization	6 weeks after missed well child visit

Collaborators and Investigators

• Sponsor: Wake Forest University Health Sciences

Study record dates

Study Major Dates

• Study Start (ACTUAL): May 13, 2022
• Primary Completion (ACTUAL): August 9, 2022
• Study Completion (ACTUAL): August 9, 2022

Study Registration Dates

• First Submitted: September 15, 2021
• First Submitted That Met QC Criteria: October 6, 2021
• First Posted (ACTUAL): October 20, 2021

Study Record Updates

• Last Update Posted (ACTUAL): September 30, 2022
• Last Update Submitted That Met QC Criteria: September 27, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: text messaging; child health; well child visits
• Other Study ID Numbers: IRB00074978-RCT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No