Personalized Reminders for Immunization Using Short Messaging Systems to Improve Human Papillomavirus Vaccination Series Completion: Parallel-Group Randomized Trial

Chelsea S Wynn, Marina Catallozzi, Chelsea A Kolff, Stephen Holleran, Dodi Meyer, Rajasekhar Ramakrishnan, Melissa S Stockwell, Chelsea S Wynn, Marina Catallozzi, Chelsea A Kolff, Stephen Holleran, Dodi Meyer, Rajasekhar Ramakrishnan, Melissa S Stockwell

Abstract

Background: Completion rates among adolescents who initiate the human papillomavirus (HPV) vaccine 3-dose series are low. SMS text message vaccine reminders are effective, but less is known about the best types for HPV series completion or the ability to assess and target vaccine decision-making stage.

Objective: The aim of this study is to compare the effectiveness of HPV vaccine series completion in minority adolescents who received precision and educational versus conventional SMS text message reminders.

Methods: Enrolled parents of adolescents aged 9-17 years who received the first HPV vaccine dose at 1 of the 4 academic-affiliated community health clinics in New York City were randomized 1:1 to 1 of the 2 parallel, unblinded arms: precision SMS text messages (which included stage-targeted educational information, next dose due date, and site-specific walk-in hours) or conventional SMS text messages without educational information. Randomization was stratified according to gender, age, and language. The primary outcome was series completion within 12 months. In post hoc analysis, enrollees were compared with concurrent nonenrollees and historical controls.

Results: Overall, 956 parents were enrolled in the study. The precision (475 families) and conventional (481 families) SMS text message arms had similarly high series completion rates (344/475, 72.4% vs 364/481, 75.7%). A total of 42 days after the first dose, two-thirds of families, not initially in the preparation stage, moved to preparation or vaccinated stage. Those in either SMS text message arm had significantly higher completion rates than nonenrollees (708/1503, 47.1% vs 679/1503, 45.17%; P<.001). Even after removing those needing only 2 HPV doses, adolescents receiving any SMS text messages had higher completion rates than historical controls (337/2823, 11.93% vs 981/2823, 34.75%; P<.001). A population-wide effect was seen from 2014 to 2016, above historical trends.

Conclusions: SMS text message reminders led to timely HPV vaccine series completion in a low-income, urban, minority study population and also led to population-wide effects. Educational information did not provide an added benefit to this population.

Trial registration: ClinicalTrials.gov NCT02236273; https://ichgcp.net/clinical-trials-registry/NCT02236273.

Keywords: adolescent; human papillomavirus; mHealth; minority health; mobile health; mobile phone; mobile reminders; smartphone; text messaging; text reminders; transtheoretical model; vaccine completion; vaccine decision-making; vaccine education.

Conflict of interest statement

Conflicts of Interest: All authors declare no competing financial interests. MSS was a coinvestigator on a grant from the Pfizer Medical Education Group for a different investigator-initiated study but received no financial support.

©Chelsea S Wynn, Marina Catallozzi, Chelsea A Kolff, Stephen Holleran, Dodi Meyer, Rajasekhar Ramakrishnan, Melissa S Stockwell. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 27.12.2021.

Figures

Figure 1
Figure 1
Transtheoretical model stage allocation in the day 21 message. HPV: human papillomavirus.
Figure 2
Figure 2
Precision and conventional arm SMS text message examples. HPV: human papillomavirus.
Figure 3
Figure 3
Study enrollment.
Figure 4
Figure 4
Human papillomavirus vaccine series completion within 12 months of initiation by year of initiation.

References

    1. Elam-Evans LD, Yankey D, Singleton JA, Sterrett N, Markowitz LE, Williams CL, Fredua B, McNamara L, Stokley S. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Aug 21;69(33):1109–16. doi: 10.15585/mmwr.mm6933a1. doi: 10.15585/mmwr.mm6933a1.
    1. Widdice LE, Bernstein DI, Leonard AC, Marsolo KA, Kahn JA. Adherence to the HPV vaccine dosing intervals and factors associated with completion of 3 doses. Pediatrics. 2011 Jan;127(1):77–84. doi: 10.1542/peds.2010-0812. peds.2010-0812
    1. Damnjanović K, Graeber J, Ilić S, Lam WY, Lep Z, Morales S, Pulkkinen T, Vingerhoets L. Parental decision-making on childhood vaccination. Front Psychol. 2018 Jun 13;9:735. doi: 10.3389/fpsyg.2018.00735. doi: 10.3389/fpsyg.2018.00735.
    1. Iribarren SJ, Brown W, Giguere R, Stone P, Schnall R, Staggers N, Carballo-Diéguez A. Scoping review and evaluation of SMS/text messaging platforms for mHealth projects or clinical interventions. Int J Med Inform. 2017 Dec;101:28–40. doi: 10.1016/j.ijmedinf.2017.01.017.S1386-5056(17)30028-X
    1. Payne HE, Lister C, West JH, Bernhardt JM. Behavioral functionality of mobile apps in health interventions: a systematic review of the literature. JMIR Mhealth Uhealth. 2015 Feb 26;3(1):e20. doi: 10.2196/mhealth.3335. v3i1e20
    1. Zhao J, Freeman B, Li M. Can mobile phone apps influence people's health behavior change? An evidence review. J Med Internet Res. 2016 Oct 31;18(11):e287. doi: 10.2196/jmir.5692. v18i11e287
    1. Badawy SM, Cronin RM, Hankins J, Crosby L, DeBaun M, Thompson AA, Shah N. Patient-centered ehealth interventions for children, adolescents, and adults with sickle cell disease: systematic review. J Med Internet Res. 2018 Jul 19;20(7):e10940. doi: 10.2196/10940.v20i7e10940
    1. Ramsey WA, Heidelberg RE, Gilbert AM, Heneghan MB, Badawy SM, Alberts NM. eHealth and mHealth interventions in pediatric cancer: a systematic review of interventions across the cancer continuum. Psychooncology. 2020 Jan;29(1):17–37. doi: 10.1002/pon.5280.
    1. Ahlers-Schmidt CR, Chesser A, Hart T, Paschal A, Nguyen T, Wittler RR. Text messaging immunization reminders: feasibility of implementation with low-income parents. Prev Med. 2010;50(5-6):306–7. doi: 10.1016/j.ypmed.2010.02.008. doi: 10.1016/j.ypmed.2010.02.008.S0091-7435(10)00063-0
    1. Stockwell MS, Kharbanda EO, Martinez RA, Vargas CY, Vawdrey DK, Camargo S. Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: a randomized controlled trial. JAMA. 2012 Apr 25;307(16):1702–8. doi: 10.1001/jama.2012.502.307/16/1702
    1. O'Leary ST, Lee M, Lockhart S, Eisert S, Furniss A, Barnard J, Eblovi D, Shmueli D, Stokley S, Dickinson LM, Kempe A. Effectiveness and cost of bidirectional text messaging for adolescent vaccines and well care. Pediatrics. 2015 Dec;136(5):e1220–7. doi: 10.1542/peds.2015-1089.peds.2015-1089
    1. Jacobson VJ, Jacobson RM, Coyne-Beasley T, Asafu-Adjei JK, Szilagyi PG. Patient reminder and recall interventions to improve immunization rates. Cochrane Database Syst Rev. 2018 Dec 18;1:CD003941. doi: 10.1002/14651858.CD003941.pub3.
    1. Kharbanda EO, Stockwell MS, Fox HW, Andres R, Lara M, Rickert VI. Text message reminders to promote human papillomavirus vaccination. Vaccine. 2011 Mar 21;29(14):2537–41. doi: 10.1016/j.vaccine.2011.01.065.S0264-410X(11)00125-3
    1. Stephens AB, Wynn CS, Stockwell MS. Understanding the use of digital technology to promote human papillomavirus vaccination - A RE-AIM framework approach. Hum Vaccin Immunother. 2019;15(7-8):1549–61. doi: 10.1080/21645515.2019.1611158.
    1. Rand CM, Brill H, Albertin C, Humiston SG, Schaffer S, Shone LP, Blumkin AK, Szilagyi PG. Effectiveness of centralized text message reminders on human papillomavirus immunization coverage for publicly insured adolescents. J Adolesc Health. 2015 May;56(5 Suppl):S17–20. doi: 10.1016/j.jadohealth.2014.10.273.S1054-139X(14)00707-1
    1. Kempe A, O'Leary S, Shoup J, Stokley S, Lockhart S, Furniss A, Dickinson LM, Barnard J, Daley MF. Parental choice of recall method for HPV vaccination: a pragmatic trial. Pediatrics. 2016 Mar;137(3):e20152857. doi: 10.1542/peds.2015-2857. peds.2015-2857
    1. Aragones A, Bruno D, Ehrenberg M, Tonda-Salcedo J, Gany F. Parental education and text messaging reminders as effective community based tools to increase HPV vaccination rates among Mexican American children. Preventive Medicine Reports. 2015 Aug;2(2):554–8. doi: 10.1016/j.pmedr.2015.06.015.S0091-7435(13)00116-3
    1. Morris J, Wang W, Wang L, Peddecord KM, Sawyer MH. Comparison of reminder methods in selected adolescents with records in an immunization registry. J Adolesc Health. 2015 May;56(5 Suppl):S27–32. doi: 10.1016/j.jadohealth.2015.01.010.S1054-139X(15)00029-4
    1. Rand CM, Vincelli P, Goldstein NP, Blumkin A, Szilagyi PG. Effects of phone and text message reminders on completion of the human papillomavirus vaccine series. J Adolesc Health. 2017 Jan;60(1):113–9. doi: 10.1016/j.jadohealth.2016.09.011.S1054-139X(16)30355-X
    1. Bar-Shain DS, Stager MM, Runkle AP, Leon JB, Kaelber DC. Direct messaging to parents/guardians to improve adolescent immunizations. J Adolesc Health. 2015 May;56(5 Suppl):S21–6. doi: 10.1016/j.jadohealth.2014.11.023.S1054-139X(14)00764-2
    1. Tull F, Borg K, Knott C, Beasley M, Halliday J, Faulkner N, Sutton K, Bragge P. Short message service reminders to parents for increasing adolescent human papillomavirus vaccination rates in a secondary school vaccine program: a randomized control trial. J Adolesc Health. 2019 Jul;65(1):116–23. doi: 10.1016/j.jadohealth.2018.12.026. S1054-139X(19)30019-9
    1. Immunization Laws and Regulations. New York State Department of Health. [2021-11-18]. .
    1. CDC recommends only two HPV shots for younger adolescents: CDC Newsroom Releases. Centers For Disease Control and Prevention. [2020-08-10]. .
    1. Hofstetter AM, Vargas CY, Kennedy A, Kitayama K, Stockwell MS. Parental and provider preferences and concerns regarding text message reminder/recall for early childhood vaccinations. Prev Med. 2013 Aug;57(2):75–80. doi: 10.1016/j.ypmed.2013.04.007.S0091-7435(13)00116-3
    1. Kim S, So J. How message fatigue toward health messages leads to ineffective persuasive outcomes: examining the mediating roles of reactance and inattention. J Health Commun. 2018;23(1):109–16. doi: 10.1080/10810730.2017.1414900.
    1. So J, Kim S, Cohen H. Message fatigue: conceptual definition, operationalization, and correlates. Commun Monographs. 2016 Nov 02;84(1):5–29. doi: 10.1080/03637751.2016.1250429.
    1. Nyhan B, Reifler J, Richey S, Freed GL. Effective messages in vaccine promotion: a randomized trial. Pediatrics. 2014 Apr;133(4):e835–42. doi: 10.1542/peds.2013-2365.peds.2013-2365
    1. Badawy SM, Thompson AA, Kuhns LM. Medication adherence and technology-based interventions for adolescents with chronic health conditions: a few key considerations. JMIR Mhealth Uhealth. 2017 Dec 22;5(12):e202. doi: 10.2196/mhealth.8310. v5i12e202
    1. Badawy SM, Thompson AA, Liem RI. Technology access and smartphone app preferences for medication adherence in adolescents and young adults with sickle cell disease. Pediatr Blood Cancer. 2016 May;63(5):848–52. doi: 10.1002/pbc.25905.
    1. Perski O, Blandford A, West R, Michie S. Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis. Transl Behav Med. 2017 Jun;7(2):254–67. doi: 10.1007/s13142-016-0453-1. 10.1007/s13142-016-0453-1
    1. Perski O, Blandford A, Ubhi HK, West R, Michie S. Smokers' and drinkers' choice of smartphone applications and expectations of engagement: a think aloud and interview study. BMC Med Inform Decis Mak. 2017 Dec 28;17(1):25. doi: 10.1186/s12911-017-0422-8. 10.1186/s12911-017-0422-8
    1. Bianco A, Mascaro V, Zucco R, Pavia M. Parent perspectives on childhood vaccination: how to deal with vaccine hesitancy and refusal? Vaccine. 2019 Feb 08;37(7):984–90. doi: 10.1016/j.vaccine.2018.12.062.S0264-410X(19)30033-7
    1. Radovic A, Badawy SM. Technology use for adolescent health and wellness. Pediatrics. 2020 May;145(Suppl 2):S186–94. doi: 10.1542/peds.2019-2056G.peds.2019-2056G
    1. Lau P, Pitkethly A, Leung B, Lau E, Wang J. The intervention effect of SMS delivery on Chinese adolescent's physical activity. Int J Environ Res Public Health. 2019 Mar 04;16(5):787. doi: 10.3390/ijerph16050787. ijerph16050787
    1. Horner GN, Agboola S, Jethwani K, Tan-McGrory A, Lopez L. Designing patient-centered text messaging interventions for increasing physical activity among participants with type 2 diabetes: qualitative results from the text to move intervention. JMIR Mhealth Uhealth. 2017 Apr 24;5(4):e54. doi: 10.2196/mhealth.6666. v5i4e54
    1. Agboola S, Jethwani K, Lopez L, Searl M, O'Keefe S, Kvedar J. Text to move: a randomized controlled trial of a text-messaging program to improve physical activity behaviors in patients with type 2 diabetes mellitus. J Med Internet Res. 2016 Nov 18;18(11):e307. doi: 10.2196/jmir.6439. v18i11e307
    1. Chahar P, Mohanty VR, Aswini YB. Designing and validation of text messages for m-Health intervention for tobacco cessation and management. Indian J Cancer. 2018;55(4):390–3. doi: 10.4103/ijc.IJC_569_17. IndianJournalofCancer_2018_55_4_390_253298
    1. Kong J, Ha Y. Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction. J Korean Acad Nurs. 2013 Aug;43(4):557–67. doi: 10.4040/jkan.2013.43.4.557.201308557
    1. A text messaging approach to behavioural change, tailored using the transtheoretical model, in the primary prevention of type 2 diabetes mellitus in Asian Indians. Imperial College London, United Kingdom, [2021-11-14]. .
    1. Badawy SM, Radovic A. Digital approaches to remote pediatric health care delivery during the covid-19 pandemic: existing evidence and a call for further research. JMIR Pediatr Parent. 2020 Jun 25;3(1):e20049. doi: 10.2196/20049. v3i1e20049
    1. Serlachius A, Badawy SM, Thabrew H. Psychosocial challenges and opportunities for youth with chronic health conditions during the covid-19 pandemic. JMIR Pediatr Parent. 2020 Oct 12;3(2):e23057. doi: 10.2196/23057. doi: 10.2196/23057.v3i2e23057

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