title: Effectiveness of centralized text message reminders on human papillomavirus immunization coverage for publicly insured adolescents.
abstract: OBJECTIVE
  We evaluated a managed care organization (MCO)-generated text message reminder-recall system designed to improve human papillomavirus (HPV) vaccination coverage.
  
  
  METHODS
  We conducted a randomized controlled trial of text reminder-recall for parents of 3,812 publicly insured adolescents aged 11-16 years with no prior HPV vaccinations who were enrolled in a single MCO and were patients at one of 39 primary care practices. We determined the rate of HPV receipt for intervention versus control with the Kaplan-Meier failure function and determined hazard ratios using a clustered stratified Cox model, clustering on primary care provider and stratified on practice. We examined results for all subjects, and for those with a valid phone number, stratified by age group (11-13 years and 14-16 years) and gender. A post hoc analysis included all subjects and controlled for age and gender.
  
  
  RESULTS
  HPV dose 1 vaccination rates were not significantly different when all participants were included, but for the subset of parents (54%) able to receive messages, HPV dose 1 rates were 13% for the control group and 16% for the intervention group; hazard ratio, 1.3 (95% confidence interval, 1.0-1.6; p = .04), when controlling for age and gender. There were no significant findings in the analysis stratified by age and gender.
  
  
  CONCLUSIONS
  MCO-based text reminders are feasible and have a modest effect on HPV dose 1 vaccination rates for those parents able to receive text messages with valid phone numbers in the MCO database. Future studies should examine a similar intervention for those parents who already accepted the first HPV vaccine dose.
authors: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York. Electronic address: Cynthia_Rand@urmc.rochester.edu.
authors: Cynthia M
authors: CM
authors: Rand
authors: Monroe Plan for Medical Care, Rochester, New York.
authors: Howard
authors: H
authors: Brill
authors: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors: Christina
authors: C
authors: Albertin
authors: Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
authors: Sharon G
authors: SG
authors: Humiston
authors: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors: Stanley
authors: S
authors: Schaffer
authors: Department of Research, Division of Primary Care Research, American Academy of Pediatrics, Elk Grove Village, Illinois.
authors: Laura P
authors: LP
authors: Shone
authors: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors: Aaron K
authors: AK
authors: Blumkin
authors: Mattel Children's Hospital UCLA, Los Angeles, California.
authors: Peter G
authors: PG
authors: Szilagyi
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D008297:Male; D008329:Managed Care Programs; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D011203:Poverty; D011634:Public Health / Q000379:methods; D017010:Reminder Systems / Q000295:instrumentation*; D060145:Text Messaging; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescent health services; Human papillomavirus vaccines; Reminder systems; Text messaging