title: Parental reminder, recall and educational interventions to improve early childhood immunisation uptake: A systematic review and meta-analysis.
abstract: Vaccination is one of the most effective ways of reducing childhood mortality. Despite global uptake of childhood vaccinations increasing, rates remain sub-optimal, meaning that vaccine-preventable diseases still pose a public health risk. A range of interventions to promote vaccine uptake have been developed, although this range has not specifically been reviewed in early childhood. We conducted a systematic review and meta-analysis of parental interventions to improve early childhood (0-5 years) vaccine uptake. Twenty-eight controlled studies contributed to six separate meta-analyses evaluating aspects of parental reminders and education. All interventions were to some extent effective, although findings were generally heterogeneous and random effects models were estimated. Receiving both postal and telephone reminders was the most effective reminder-based intervention (RD=0.1132; 95% CI=0.033-0.193). Sub-group analyses suggested that educational interventions were more effective in low- and middle-income countries (RD=0.13; 95% CI=0.05-0.22) and when conducted through discussion (RD=0.12; 95% CI=0.02-0.21). Current evidence most supports the use of postal reminders as part of the standard management of childhood immunisations. Parents at high risk of non-compliance may benefit from recall strategies and/or discussion-based forums, however further research is needed to assess the appropriateness of these strategies.
authors.affiliation: Department of Psychology, Durham University, Durham DH1 3LE, UK. Electronic address: hannah.harvey@durham.ac.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Harvey
authors.affiliation: Department of Psychology, Durham University, Durham DH1 3LE, UK. Electronic address: n.n.reissland@durham.ac.uk.
authors.forename: Nadja
authors.initials: N
authors.lastname: Reissland
authors.affiliation: Durham University School of Medicine, Pharmacy and Health, Wolfson Research Institute, Stockton-On-Tees TS17 6BH, UK. Electronic address: j.m.mason@durham.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Mason
mesh_terms: D002675:Child, Preschool; D005260:Female; D006266:Health Education; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000193:education* / Q000523:psychology; D017010:Reminder Systems; D014611:Vaccination
keywords: Early childhood; Education; Intervention; Recall and reminder; Uptake; Vaccination