Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study
BackgroundVaccine coverage for 18-month-old children in Canada is often below the recommended level, which may be partially because of parental forgetfulness. SMS text message reminders have been shown to potentially improve childhood immunization uptake but have not been wid...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2022-11-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2022/11/e37579 |
| _version_ | 1797734689075625984 |
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| author | Shannon E MacDonald Emmanuel Marfo Hannah Sell Ali Assi Andrew Frank-Wilson Katherine Atkinson James D Kellner Deborah McNeil Kristin Klein Lawrence W Svenson |
| author_facet | Shannon E MacDonald Emmanuel Marfo Hannah Sell Ali Assi Andrew Frank-Wilson Katherine Atkinson James D Kellner Deborah McNeil Kristin Klein Lawrence W Svenson |
| author_sort | Shannon E MacDonald |
| collection | DOAJ |
| description |
BackgroundVaccine coverage for 18-month-old children in Canada is often below the recommended level, which may be partially because of parental forgetfulness. SMS text message reminders have been shown to potentially improve childhood immunization uptake but have not been widely used in Alberta, Canada. In addition, it has been noted that language barriers may impede immunization service delivery but continue to remain unaddressed in many existing reminder and recall systems.
ObjectiveThis study aimed to assess the effectiveness and acceptability of using SMS text messages containing a link to web-based immunization information in different languages to remind parents of their child’s 18-month immunization appointment.
MethodsThe Childhood Immunization Reminder Project was a pilot intervention at 2 public health centers, one each in Lethbridge and Edmonton, Alberta, Canada. Two SMS text message reminders were sent to parents: a booking reminder 3 months before their child turned 18 months old and an appointment reminder 3 days before their scheduled appointment. Booking reminders included a link to the study website hosting immunization information in 9 languages. To evaluate intervention effectiveness, we compared the absolute attendance no-show rates before the intervention and after the intervention. The acceptability of the intervention was evaluated through web-based surveys completed by parents and public health center staff. Google Analytics was used to determine how often web-based immunization information was accessed, from where, and in which languages.
ResultsFollowing the intervention, the health center in Edmonton had a reduction of 6.4% (95% CI 3%-9.8%) in appointment no-shows, with no change at the Lethbridge Health Center (0.8%, 95% CI −1.4% to 3%). The acceptability surveys were completed by 222 parents (response rate: 23.9%) and 22 staff members. Almost all (>95%) respondents indicated that the reminders were helpful and provided useful suggestions for improvement. All surveyed parents (222/222, 100%) found it helpful to read web-based immunization information in their language of choice. Google Analytics data showed that immunization information was most often read in English (118/207, 57%), Punjabi (52/207, 25.1%), Arabic (13/207, 6.3%), Spanish (12/207, 5.8%), Italian (4/207, 1.9%), Chinese (4/207, 1.9%), French (2/207, 0.9%), Tagalog (1/207, 0.5%), and Vietnamese (1/207, 0.5%).
ConclusionsThe study’s findings support the use of SMS text message reminders as a convenient and acceptable method to minimize parental forgetfulness and potentially reduce appointment no-shows. The diverse languages accessed in web-based immunization information suggest the need to provide appropriate translated immunization information. Further research is needed to evaluate the impact of SMS text message reminders on childhood immunization coverage in different settings. |
| first_indexed | 2024-03-12T12:48:01Z |
| format | Article |
| id | doaj.art-fc46984f84e14b4691e88adac46f2861 |
| institution | Directory Open Access Journal |
| issn | 2291-5222 |
| language | English |
| last_indexed | 2024-03-12T12:48:01Z |
| publishDate | 2022-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj.art-fc46984f84e14b4691e88adac46f28612023-08-28T23:15:08ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222022-11-011011e3757910.2196/37579Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot StudyShannon E MacDonaldhttps://orcid.org/0000-0003-4675-4433Emmanuel Marfohttps://orcid.org/0000-0002-9654-404XHannah Sellhttps://orcid.org/0000-0001-8468-1410Ali Assihttps://orcid.org/0000-0003-2988-8376Andrew Frank-Wilsonhttps://orcid.org/0000-0002-5486-239XKatherine Atkinsonhttps://orcid.org/0000-0001-9220-8316James D Kellnerhttps://orcid.org/0000-0002-9083-2980Deborah McNeilhttps://orcid.org/0000-0003-0944-5615Kristin Kleinhttps://orcid.org/0000-0002-4347-5626Lawrence W Svensonhttps://orcid.org/0000-0002-3391-578X BackgroundVaccine coverage for 18-month-old children in Canada is often below the recommended level, which may be partially because of parental forgetfulness. SMS text message reminders have been shown to potentially improve childhood immunization uptake but have not been widely used in Alberta, Canada. In addition, it has been noted that language barriers may impede immunization service delivery but continue to remain unaddressed in many existing reminder and recall systems. ObjectiveThis study aimed to assess the effectiveness and acceptability of using SMS text messages containing a link to web-based immunization information in different languages to remind parents of their child’s 18-month immunization appointment. MethodsThe Childhood Immunization Reminder Project was a pilot intervention at 2 public health centers, one each in Lethbridge and Edmonton, Alberta, Canada. Two SMS text message reminders were sent to parents: a booking reminder 3 months before their child turned 18 months old and an appointment reminder 3 days before their scheduled appointment. Booking reminders included a link to the study website hosting immunization information in 9 languages. To evaluate intervention effectiveness, we compared the absolute attendance no-show rates before the intervention and after the intervention. The acceptability of the intervention was evaluated through web-based surveys completed by parents and public health center staff. Google Analytics was used to determine how often web-based immunization information was accessed, from where, and in which languages. ResultsFollowing the intervention, the health center in Edmonton had a reduction of 6.4% (95% CI 3%-9.8%) in appointment no-shows, with no change at the Lethbridge Health Center (0.8%, 95% CI −1.4% to 3%). The acceptability surveys were completed by 222 parents (response rate: 23.9%) and 22 staff members. Almost all (>95%) respondents indicated that the reminders were helpful and provided useful suggestions for improvement. All surveyed parents (222/222, 100%) found it helpful to read web-based immunization information in their language of choice. Google Analytics data showed that immunization information was most often read in English (118/207, 57%), Punjabi (52/207, 25.1%), Arabic (13/207, 6.3%), Spanish (12/207, 5.8%), Italian (4/207, 1.9%), Chinese (4/207, 1.9%), French (2/207, 0.9%), Tagalog (1/207, 0.5%), and Vietnamese (1/207, 0.5%). ConclusionsThe study’s findings support the use of SMS text message reminders as a convenient and acceptable method to minimize parental forgetfulness and potentially reduce appointment no-shows. The diverse languages accessed in web-based immunization information suggest the need to provide appropriate translated immunization information. Further research is needed to evaluate the impact of SMS text message reminders on childhood immunization coverage in different settings.https://mhealth.jmir.org/2022/11/e37579 |
| spellingShingle | Shannon E MacDonald Emmanuel Marfo Hannah Sell Ali Assi Andrew Frank-Wilson Katherine Atkinson James D Kellner Deborah McNeil Kristin Klein Lawrence W Svenson Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study JMIR mHealth and uHealth |
| title | Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study |
| title_full | Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study |
| title_fullStr | Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study |
| title_full_unstemmed | Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study |
| title_short | Text Message Reminders to Improve Immunization Appointment Attendance in Alberta, Canada: The Childhood Immunization Reminder Project Pilot Study |
| title_sort | text message reminders to improve immunization appointment attendance in alberta canada the childhood immunization reminder project pilot study |
| url | https://mhealth.jmir.org/2022/11/e37579 |
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