Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Abstract

ABSTRACT. Objective. Strong scientific evidence and national recommendations support the use of reminder and recall messages to improve immunization coverage rates, yet reports have suggested that only a minority of pediatric practices use such messages. Our aims were to 1) determine the proportions of pediatric practices and public clinics that currently use practicebased reminder or recall messages and routinely undergo immunization assessment efforts, 2) evaluate barriers and supports to implementing these practices, and 3) identify predictors of either current use or plans for future adoption of these practices.Methods. This study combined qualitative and quantitative methods in sequential phases. In the qualitative phase, we conducted semistructured, open-ended interviews with a convenience sample of 18 clinician-administrators representing adopters and nonadopters of these messages in both private practices and public health clinics. In the subsequent quantitative phase, we mailed a structured, closed-ended survey to national samples of randomly selected pediatricians (n ‫؍‬ 600) and public clinics (n ‫؍‬ 600).Results. Response rates were 75% for pediatricians and 77% for public clinics. Among pediatricians, 38% were conducting regular assessments of immunization coverage but only 16% were currently using routine reminder or recall messages. Among public clinics, 85% were conducting regular assessments and 51% were using reminder or recall messages. Among pediatricians' practices, the most commonly reported barriers to the adoption of reminder or recall messages were lack of time and funding and the inability to identify children at specified ages. For pediatricians' practices, the strongest predictors of current use of reminder or recall messages were having a champion who led efforts to improve immunization delivery (odds ratio: 1.85; 95% confidence interval: 1.08 -3.18) and current use of regular immunization assessments (odds ratio: 2.30; 95% confidence interval: 1.33-3.84). Likewise, for public health clinics, having a champion to lead immunization improvement efforts and believing that their current system needed improvement was associated with current use of reminder or recall messages.Conclusions. Reminder and recall messages remain underused by both pediatricians and public health clinics. Promising strategies to promote adoption of these approaches in both the private and the public sectors include identifying and training champions to promote immunization delivery improvement efforts and helping practices develop methods to identify children at specific ages. Pediatrics 2003;112:1076 -1082; immunizations, interventions, quality of care, recall, reminder, assessment.ABBREVIATIONS. OR, odds ratio; CI, confidence interval.

SMS text messaging improves outpatient attendance

“…Further, the ease with which the SMS software can be accessed and applied in real-world settings significantly diminishes the required technical skill compared with other software-driven reminder systems, a factor which has been identified as a significant barrier to uptake of more technologically advanced reminder techniques. 14 In summary, this study indicates that SMS text messaging is a very efficacious technique to improve clinic attendance, access to services and revenue generation in the ambulatory care setting.…”

Effect of a novel birth intervention and reminder-recall on on-time immunization compliance in high-risk children

“…Although previous studies have shown that reminder-recall based interventions can improve immunization rates, few providers actually use these methods, especially in a population seeking care in the public sector. 10 Several investigators have examined the impact of various strategies of telephone and mail reminder-recall on childhood Figure 1. Up-to-date immunization rates by age for BIRTH PIP and CPS data.…”

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

“…13,14 Nevertheless, little evidence exists for the effectiveness of practice-based reminder/recall for adolescent immunizations, 15,16 although in one recent study in 4 practices researchers demonstrated increased immunization rates. 17 Moreover, few practices actually use reminder/recall for patients of any age [18][19][20] ; barriers include the added workload, costs, and complexities of conducting such a program. 21,22 Furthermore, some recent studies targeting low-income populations found little or no benefit to practice-based reminder/recall for young children because of difficulties in reaching families that often change addresses or telephone numbers.…”