title: Impacting delayed pediatric influenza vaccination: a randomized controlled trial of text message reminders.
abstract: BACKGROUND
  Influenza vaccination coverage is low, especially among low-income populations. Most doses are generally administered early in the influenza season, yet sustained vaccination efforts are crucial for achieving optimal coverage. The impact of text message influenza vaccination reminders was recently demonstrated in a low-income population. Little is known about their effect on children with delayed influenza vaccination or the most effective message type.
  
  
  OBJECTIVE
  To determine the impact of educational plus interactive text message reminders on influenza vaccination of urban low-income children unvaccinated by late fall.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Parents of 5,462 children aged 6 months-17 years from four academically affiliated pediatric clinics who were unvaccinated by mid-November 2011.
  
  
  METHODS
  Eligible parents were stratified by their child's age and pediatric clinic site and randomized using a 1:1:1 allocation to educational plus interactive text message reminders, educational-only text message reminders, or usual care. Using an immunization registry-linked text messaging system, parents of intervention children received up to seven weekly text message reminders. One of the messages sent to parents in the educational plus interactive text message arm allowed selection of more information about influenza and influenza vaccination.
  
  
  METHODS
  Influenza vaccination by March 31, 2012. Data were collected and analyzed between 2012 and 2014.
  
  
  RESULTS
  Most children were publicly insured and Spanish speaking. Baseline demographics were similar between groups. More children of parents in the educational plus interactive text message arm were vaccinated (38.5%) versus those in the educational-only text message (35.3%; difference=3.3%, 95% CI=0.02%, 6.5%; relative risk ratio (RRR)=1.09, 95% CI=1.002, 1.19) and usual care (34.8%; difference=3.8%, 95% CI=0.6%, 7.0%; RRR=1.11, 95% CI=1.02-1.21) arms.
  
  
  CONCLUSIONS
  Text message reminders with embedded educational information and options for interactivity have a small positive effect on influenza vaccination of urban, low-income, minority children who remain unvaccinated by late fall.
authors: Department of Pediatrics, Columbia University; NewYork-Presbyterian Hospital, New York, New York.
authors: Annika M
authors: AM
authors: Hofstetter
authors: Department of Pediatrics, Columbia University.
authors: Celibell Y
authors: CY
authors: Vargas
authors: Department of Pediatrics, Columbia University.
authors: Stewin
authors: S
authors: Camargo
authors: Department of Pediatrics, Columbia University.
authors: Stephen
authors: S
authors: Holleran
authors: Department of Biomedical Informatics, Mailman School of Public Health, Columbia University.
authors: David K
authors: DK
authors: Vawdrey
authors: HealthPartners Institute for Education and Research, Minneapolis, Minnesota.
authors: Elyse Olshen
authors: EO
authors: Kharbanda
authors: Department of Pediatrics, Columbia University; Department of Population and Family Health, Mailman School of Public Health, Columbia University; NewYork-Presbyterian Hospital, New York, New York. Electronic address: mss2112@columbia.edu.
authors: Melissa S
authors: MS
authors: Stockwell
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011203:Poverty; D017010:Reminder Systems; D060145:Text Messaging
chemical_list: D007252:Influenza Vaccines