Novel immunization reminder/recall approaches: rural and urban differences in parent perceptions.
OBJECTIVE
To assess the following among parents of young children: (1) preferences about the source of immunization reminder/recall (R/R) messages, (2) the degree of acceptability of different R/R modalities, and (3) factors that influence preferences, including rural and urban characteristics.


METHODS
We conducted a survey among parents of children 19 to 35 months old who needed ≥1 immunization according to the Colorado Immunization Information System (CIIS). Equal numbers of urban and rural respondents were randomly selected. Up to 4 surveys were mailed to each parent who had a valid address.


RESULTS
After removing invalid addresses, the response rate was 55% (334 of 607). Half of parents (49.7%) had no preference about whether the public health department or their child's doctor sent reminders. Urban parents were more likely to prefer R/R come from their child's doctor (46.7%) compared to rural parents (33.7%), P = .003. Mail was the preferred R/R method (57.7%), then telephone (17.0%), e-mail (12.7%), and text message (10.7%). Although not preferred, 60.1% reported it would be acceptable to receive R/R by e-mail and 46.2% by text message. Factors associated with preferring to receive R/R from their child's doctor were urban residence and educational level of college graduate or greater.


CONCLUSIONS
A large portion of parents are willing to be reminded about vaccinations by their health department rather than their child's provider and via novel modalities, such as e-mail or text messaging. Urbanicity and higher educational level were associated with preferring that R/R come from a provider.
Children's Outcomes Research Program, The Children's Hospital, Denver, Colo. Electronic address: Alison.Saville@ucdenver.edu.
Alison W
AW
Saville
Children's Outcomes Research Program, The Children's Hospital, Denver, Colo; Colorado Health Outcomes Program, University of Colorado Denver, Denver, Colo.
Brenda
B
Beaty
Children's Outcomes Research Program, The Children's Hospital, Denver, Colo; Colorado Health Outcomes Program, University of Colorado Denver, Denver, Colo; Department of Family Medicine, University of Colorado Denver, Denver, Colo.
L Miriam
LM
Dickinson
Children's Outcomes Research Program, The Children's Hospital, Denver, Colo.
Steven
S
Lockhart
Children's Outcomes Research Program, The Children's Hospital, Denver, Colo; Department of Pediatrics, University of Colorado Denver, Denver, Colo.
Allison
A
Kempe
D000328:Adult; D001294:Attitude to Health; D002675:Child, Preschool; D003258:Consumer Behavior; D034742:Electronic Mail; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008297:Male; D010290:Parents; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011634:Public Health; D017010:Reminder Systems; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D060145:Text Messaging; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
centralized reminder/recall; immunizations; parent perception; parent preferences; population-based reminder/recall; recall and reminder message