Abstract
BackgroundAdherence to childhood immunization schedules is a function of various factors. Given the increased use of technology as a strategy to increase immunization coverage, it is important to investigate how parents perceive different forms of communication, including traditional means and text-message reminders.ObjectiveTo examine current forms of communication about immunization information, parents’ satisfaction levels with these communication modes, perceived barriers and benefits to using text messaging, and the ideal content of text messages for immunization reminders.MethodsStructured interviews were developed and approved by two Institutional Review Boards. A convenience sample of 50 parents was recruited from two local pediatric clinics. The study included a demographics questionnaire, the shortened form of the Test of Functional Health Literacy for Adults (S-TOFHLA), questions regarding benefits and barriers of text communication from immunization providers, and preferred content for immunization reminders. Content analyses were performed on responses to barriers, benefits, and preferred content (all Cohen’s kappas > 0.70).ResultsRespondents were mostly female (45/50, 90%), white non-Hispanic (31/50, 62%), between 20–41 years (mean = 29, SD 5), with one or two children (range 1–9). Nearly all (48/50, 96%) had an S-TOFHLA score in the “adequate” range. All parents (50/50, 100%) engaged in face-to-face contact with their child’s physician at appointments, 74% (37/50) had contact via telephone, and none of the parents (0/50, 0%) used email or text messages. Most parents were satisfied with the face-to-face (48/50, 96%) and telephone (28/50, 75%) communication. Forty-nine of the 50 participants (98%) were interested in receiving immunization reminders by text message, and all parents (50/50, 100%) were willing to receive general appointment reminders by text message. Parents made 200 comments regarding text-message reminders. Benefits accounted for 63.5% of comments (127/200). The remaining 37.5% (73/200) regarded barriers; however, no barriers could be identified by 26% of participants (13/50). Parents made 172 comments regarding preferred content of text-message immunization reminders. The most frequently discussed topics were date due (50/172, 29%), general reminder (26/172, 26%), and child’s name (21/172, 12%).ConclusionsMost parents were satisfied with traditional communication; however, few had experienced any alternative forms of communication regarding immunizations. Benefits of receiving text messages for immunization reminders far outweighed the barriers identified by parents. Few barriers identified were text specific. Those that were, centered on cost if parents did not have unlimited texting plans.
Highlights
Adherence to childhood immunization schedules is likely a function of various factors, including parents’ health literacy skills [1,2,3,4,5,6], immunization knowledge [7,8], and perceived quality of patient–provider communication [9]
Most parents were satisfied with traditional communication; few had experienced any alternative forms of communication regarding immunizations
Benefits of receiving text messages for immunization reminders far outweighed the barriers identified by parents
Summary
Adherence to childhood immunization schedules is likely a function of various factors, including parents’ health literacy skills [1,2,3,4,5,6], immunization knowledge [7,8], and perceived quality of patient–provider communication [9]. There is some indication of knowledge gaps among low-income mothers regarding vaccinations, the intended purposes of these immunizations, and appropriate vaccination schedules [7,8] Determining what these and other parents’ preferences are for receiving vaccination information, as well as identifying perceived communication barriers and needs, might help researchers and practitioners design more effective interventions. Vaccination status did not show a significant association; the findings indicated a significant difference in vaccination status at 3 months and 7 months of age These results highlight the importance of health literacy skills for subsequent vaccinations. Given the increased use of technology as a strategy to increase immunization coverage, it is important to investigate how parents perceive different forms of communication, including traditional means and text-message reminders
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