Twilio Well-Child Visit Pilot Open Trial

Text Message Follow-up for Patients Who Have Missed Well-Child Visits: Open 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 no-showed for WCVs. The first phase of the study will be an open trial to assess feasibility and acceptability of three different reminder messages, analyze preliminary data, and collect feedback from participants using interviews to identify the top one or two performing messages. Each reminder message will at minimum direct parents/guardians to reschedule by phone or by the patient portal. These findings will be used to conduct the second phase of the study, a randomized controlled trial.

Study Overview

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

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): 500
• 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: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Open Trial; Patients within the Wake Forest Baptist Health system who no-showed for scheduled well child visits at Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, and Pediatrics-Clemmons.

Other: Text message reminders; Text messages will be sent to parents/guardians of children ages 0 to 17 years who no-showed for their well child visits.; Other: Interviews; Interviews will be conducted with a subset of participants to identify the top one or two performing text messages.; Other: Survey; Alongside notification text messages regarding no-showed visits, participants will be invited to participate in a survey about their experience with the health system. This survey will assess reasons for missing the WCV and primary caregiver's perspective on the experience at the prior visit.

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 no-showed well child visit
Number of completed (rescheduled) well child visits	If parent/guardian completed (rescheduled) well child visit	6 weeks after no-showed 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 no-showed well child visit
Number of child patient hospitalizations	If child patient required hospitalization	6 weeks after no-showed well child visit

Collaborators and Investigators

• Sponsor: Wake Forest University Health Sciences

Study record dates

Study Major Dates

• Study Start (Actual): December 17, 2021
• Primary Completion (Actual): April 8, 2022
• Study Completion (Actual): April 8, 2022

Study Registration Dates

• First Submitted: December 29, 2021
• First Submitted That Met QC Criteria: December 29, 2021
• First Posted (Actual): January 12, 2022

Study Record Updates

• Last Update Posted (Actual): July 6, 2022
• Last Update Submitted That Met QC Criteria: June 30, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

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

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