Abstract
BackgroundCompletion rates among adolescents who initiate the human papillomavirus (HPV) vaccine 3-dose series are low. SMS text message vaccine reminders are effective, but less is known about the best types for HPV series completion or the ability to assess and target vaccine decision-making stage.ObjectiveThe aim of this study is to compare the effectiveness of HPV vaccine series completion in minority adolescents who received precision and educational versus conventional SMS text message reminders.MethodsEnrolled parents of adolescents aged 9-17 years who received the first HPV vaccine dose at 1 of the 4 academic-affiliated community health clinics in New York City were randomized 1:1 to 1 of the 2 parallel, unblinded arms: precision SMS text messages (which included stage-targeted educational information, next dose due date, and site-specific walk-in hours) or conventional SMS text messages without educational information. Randomization was stratified according to gender, age, and language. The primary outcome was series completion within 12 months. In post hoc analysis, enrollees were compared with concurrent nonenrollees and historical controls.ResultsOverall, 956 parents were enrolled in the study. The precision (475 families) and conventional (481 families) SMS text message arms had similarly high series completion rates (344/475, 72.4% vs 364/481, 75.7%). A total of 42 days after the first dose, two-thirds of families, not initially in the preparation stage, moved to preparation or vaccinated stage. Those in either SMS text message arm had significantly higher completion rates than nonenrollees (708/1503, 47.1% vs 679/1503, 45.17%; P<.001). Even after removing those needing only 2 HPV doses, adolescents receiving any SMS text messages had higher completion rates than historical controls (337/2823, 11.93% vs 981/2823, 34.75%; P<.001). A population-wide effect was seen from 2014 to 2016, above historical trends.ConclusionsSMS text message reminders led to timely HPV vaccine series completion in a low-income, urban, minority study population and also led to population-wide effects. Educational information did not provide an added benefit to this population.Trial RegistrationClinicalTrials.gov NCT02236273; https://clinicaltrials.gov/ct2/show/NCT02236273
Highlights
SMS text message reminders led to timely human papillomavirus (HPV) vaccine series completion in a low-income, urban, minority study population and led to population-wide effects
Underreporting of vaccinations is likely low; underreporting would have affected the intervention and usual care groups. Despite these aspects of the study, our findings lend strength to the growing body of evidence showing that mobile health (mHealth) or eHealth interventions such as SMS text message reminders can be used to tangibly promote child and adolescent health [40], in the realm of HPV vaccination, in which outcomes are consistently substandard to national goals
We demonstrate the efficacy of SMS text message reminders in a low-income, tight knit, and connected minority community, which helps answer the call to improve upon digital approaches that “address disparities in access to care related to race and ethnicity, socioeconomic status” [40]
Summary
Completion rates among adolescents who initiate the human papillomavirus (HPV) vaccine 3-dose series are low. Despite the highly efficacious vaccine being recommended for all adolescents, completion rates among those who initiate the series are low [1]. Adherence to the recommended HPV vaccine dosing schedule is exceedingly low; one study found that of 9- to-16-year-olds who had initiated HPV vaccination, only 28% completed the -recommended 3-dose series within 1 year [2]. Caregiver-decided vaccination delays can significantly contribute to the spread of infectious diseases in adolescents [3]. This is a salient factor to counter for HPV vaccination, as HPV infection carries short-term infection risk and long-term chronic disease risk
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
