Short Message Service Reminders Research Articles

Dermatology clinic attendance rates: Does the content of an SMS reminder make a difference?

This is a study assessing the impact of SMS reminders on ‘did not attend’ rates, including the effect of an attempt to ‘nudge’ patients by highlighting the financial burden to the NHS of a missed appointment in an effort to motivate them to attend their outpatient clinic appointment.

Acceptability of short message service reminders as the support tool for PrEP adherence among young women in Mukono district, Uganda.

Adolescent girls and young women (AGYW) have a disproportionately high incidence of HIV compared to males of the same age in Uganda. AGYW are a priority sub-group for daily oral Pre-Exposure Prophylaxis (PrEP), but their adherence has consistently remained low. Short Message Service (SMS) reminders could improve adherence to PrEP in AGYW. However, there is paucity of literature about acceptability of SMS reminders among AGYW using PrEP. We assessed the level of acceptability of SMS reminders as a PrEP adherence support tool and the associated factors, among AGYW in Mukono district, Central Uganda. We consecutively enrolled AGYW using PrEP in Mukono district in a cross sectional study. A structured pre-tested questionnaire was administered to participants by three trained research assistants. Data were analyzed in STATA 17.0; continuous variables were summarized using median and interquartile range (IQR) while categorical variables were summarized using frequencies and percentages. Acceptability of SMS was defined as willingness to accept SMS reminders to support PrEP adherence and was assessed using the seven constructs of the theoretical framework of acceptability. The relationship between the outcome and independent variables was assessed using a modified Poisson regression with robust standard errors. During the month of August 2022, 142 AGYW with median age 22 years (IQR; 18, 24) of whom 80.3% owned a personal mobile phone were assessed. SMS reminders were highly acceptable [90.9%, 95% Confidence Interval (CI) [84.9, 95.0]]. Rural residence was negatively associated with acceptability of SMS reminders (aPR: 0.92, 95% CI (0.84, 0.99)) and having belief that SMS cannot breach individual's privacy (aPR: 1.40, 95% CI (1.07, 1.84)) was positively associated with acceptability of SMS reminders. The acceptability of SMS reminders was high in this sub-population. SMS reminder can be leveraged to support AGYW to adhere to PrEP but should be designed in a way that maintains confidentiality, and supports AGYW living in rural settings.

Implementation bottlenecks of real time medication monitoring (evriMED) for improving adherence to anti-TB drugs among people with tuberculosis in Kilimanjaro, Tanzania

IntroductionDigital Adherence Tools (DATs), which include real-time medication monitoring and Short Message Service (SMS) reminders, have been reported to improve medication adherence among people with Tuberculosis (TB). Recently, in limited resource settings, DATs have been described as a promising tool to monitor patients’ medication behaviour. We aimed to determine implementation bottlenecks of real-time medication monitoring using the evriMED device. MethodWe conducted a research study using a mixed-methods approach, involving both people with TB s and directly observed treatment (DOT) providers who participated in the REMIND-TB trial and utilized the evriMED devices. EvriMED is a medication dispenser with internet connectivity that can send real-time SMS reminders. To gather data, we extracted reports from the Wisepill dashboard, specifically the client status report. This report documented the activity status of all devices, including communication and battery status. Additionally, we conducted in-depth interviews with people with TB and TB care providers who were involved in implementing the Remind TB trial in the Kilimanjaro region. These interviews were guided by the MIDI (Measurement Instrument for Determinants of Innovation), which helps identify the factors influencing the implementation of innovations such as evriMED. ResultsOut of the initial 281 participants who were given devices, 245 completed the 6-month follow-up period. The findings indicate that at month 6, most of the devices (49%) reported battery-related challenges. Additionally, forty devices (14%) had reported more than one incidence of losing communication. Through interviews with participants, we observed that evriMED was perceived as user-friendly, and the people with TB reported high satisfaction as the device facilitated improved medication intake. TB care providers also said that evriMED was a relevant tool to be used by the people with TB. However, during the in-depth interview certain implementation bottlenecks were identified, including network issues, limited training, and low technology knowledge among TB care providers, who found the procedure of using the evriMED to be time-consuming. ConclusionImplementation of evriMED was perceived as user-friendly and highly satisfactory by people with TB. Certain implementation bottlenecks were identified as potential barriers to the use of devices. These bottlenecks include network issues, limited training, battery-related challenges and low technological knowledge among TB care providers, which may have contributed to communication loss. Further research may be needed to address these limitations and develop effective strategies to facilitate the successful implementation of evriMED as a tool for improving medication intake among people with TB.

Acceptability of using the medication monitor and experience of a differentiated care approach for TB treatment adherence among people living with TB in South Africa.

The introduction of digital adherence technologies (DATs) such as medication monitors in tuberculosis (TB) programmes supports treatment adherence among people with tuberculosis (PWTB). We evaluated the acceptability of using medication monitors (Wisepill evriMED) prompting a stepwise differentiated care approach (DCA), involving short message service (SMS), phone calls, home visits and motivational counselling, among PWTB in South Africa. We conducted 62 in-depth interviews with participants in local languages across three provinces (January-October 2020), purposively selected by treatment month, adherence history and gender. Interviews were audio recorded, transcribed verbatim and translated. Using a deductive approach and the Theoretical Framework for Acceptability (TFA), we explored acceptability across the sample attributes. PWTB across adherence histories showed a positive attitude to using the evriMED device and receiving the DCA support. PWTB described the SMS reminders and phone calls as effective reminders, though home visits were less acceptable, due to perceived stigma. Despite willingness to participate in the intervention, the large size of the monitor and sound of the alarm drew attention, potentially causing embarrassment and stigma. Due to perceived stigma, some PWTB adapted the intervention by leaving the monitor at home after removing the pills to ensure that someone else tracked usage, while the PWTB used alternative reminders such as cell phones to take their medication. Although PWTB showed a positive attitude towards the intervention, perceived stigma contributed to participants adapting their lifestyle to meet treatment adherence requirements without using the monitor. However, the medication monitor was a tool that seemed to prompt this personal change in behaviour. Achieving people-centered TB care, including the introduction of DATs, will require that TB programmes incorporate PWTB insights to maximize their use and effectiveness.

Compliance to Viral Load Monitoring Schedules Among Women Attending Prevention of Vertical HIV Transmission Services Before and During the COVID-19 Pandemic in Ehlanzeni District, Mpumalanga, South Africa

Human immunodeficiency virus (HIV) viral load (VL) monitoring was likely interrupted during the Coronavirus disease 2019 (COVID-19) pandemic. We used routine data on repeat VL testing among 667 prevention of vertical HIV transmission (PVT) clients in Ehlanzeni district, to determine compliance to VL testing recommendations and associated factors during different time periods: pre-COVID-19, transition, and COVID-19. Descriptive and multivariable Poisson regression analyses were conducted, with and without including revised PVT-guidelines rolled out in January-2020. Among 405 women with ≥ 2 VL tests, the overall median age was 30 years (interquartile range: 26–35 years). Compliance to recommended VL testing guidelines ranged between 81.5% (172/211) and 92.3% (191/207) at different time periods. Across all three periods and when revised PVT-guidelines were used, being compliant was significantly reduced among those with earliest VL = 50–999 copies/ml (incidence rate ratio (IRR) = 0.71 [95% confidence interval (CI) 0.61–0.82], p value < 0.001) and VL ≥ 1000 copies/ml (IRR = 0.18 [95% CI 0.09–0.36], p value < 0.001). When guideline revisions were excluded, compliance was only significantly reduced among those with VL ≥ 1000 copies/ml (IRR = 0.14 [95% CI 0.06–0.32], p value < 0.001) and increased during the COVID-19 period versus pre-COVID-19 (IRR = 1.10 [95% CI 1.05–1.15], p value < 0.001). Similar significant associations between compliance and VL level were observed when the COVID-19 period was analyzed separately. Significantly increased compliance to VL testing among the 25–34 years age-group versus younger women was also observed across all periods. These results highlight the importance of strengthening strategies such as short message service reminders and educational messaging, reaching all age-groups, to fast-track implementation targets for VL monitoring.

Electronic Antiretroviral Therapy Adherence Monitors and Associated Interventions Improve Adolescent-Caregiver Relationships and Self-Efficacy Among Adolescents and Young Adults with HIV in Uganda.

Many adolescents and young adults with HIV (AYWH) struggle with antiretroviral therapy (ART) adherence and experience poorer outcomes than adults. Relevant factors include forgetfulness and poor self-efficacy related to their evolving neurobiology. We qualitatively explored experiences of AYWH-caregivers dyads using real-time ART adherence monitors and associated reminder functions in the home setting. As part of an implementation science-oriented study, AYWH used the Wisepill adherence monitor for 3 months. AYWH could also opt for short message service (SMS) self-reminders, a self-selected social supporter for delayed or missed doses, or an alarm reminder. We conducted in-depth interviews with randomly selected AYWH-caregiver dyads regarding their experience using the monitor. Qualitative data were analyzed using inductive content analysis. We completed 15 AYWH-caregiver dyad interviews. Of the AYWH, 67% were female, mean age was 16 years, 56% lived with their biological mother, and 86% were virologically suppressed. AYWH and their caregivers generally found the adherence monitors acceptable, though some had privacy concerns. AYWH felt the monitors helped them take charge of their medication, largely through the real-time alarm and SMS reminders; this took the burden of adherence reminders away from the caregivers, improving strained AYWH-caregiver relationships. Two adolescents reported rebound poor adherence after monitor withdrawal. ART adherence monitors and associated tools were largely acceptable to AYWH and their caregivers in home settings. The intervention helped improve AYWH self-efficacy and alleviated burden from some AYWH-caregiver relationships. Rebound poor adherence suggests the need for on-going support and/or other means to achieve intrinsic mechanisms for sustained adherence. Clinical Trial Registration number: NCT03825952.

Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trial

Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5-12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42-0.94, p=0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23-92], SOC: 58 days [IQR: 22-94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9-100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3-88.9%, p=0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Thrasher Research Foundation and Pamela and Evan Fowler.

The Effect Of Short Message Service Reminders On Self-Management Of Type 2 Diabetes Mellitus Patients

Background: Short Message Service (SMS) can be used to increase knowledge of diabetes patients and improve adherence to recommended therapy. Methodology: The study used a Quasi-Experimental method with a Pretest-Posttest Nonequivalent Control Group design involving 40 Prolanis Diabetes Mellitus Type 2 patients, which were divided into a control group and an intervention group. Data collection used a questionnaire which was analyzed by the Mann Whitney test. Results: The results showed that there were differences in self-management in dietary adherence (p=0.008 &lt;0.05) and medication adherence (p=0.031&lt;0.05) before and after being given a short message reminder to patients with type 2 diabetes mellitus at the Kabila Health Center. Conclusion: There is an effect of short message service reminders on the self-management of type 2 diabetes mellitus patients at Kabila Health Center.

Needs and contents of a customized digital tool for retention in care and medication adherence among pregnant and breastfeeding women living with HIV in Kilimanjaro

BackgroundRetention in care and adherence to medication among pregnant and breastfeeding women living with HIV (PBWLH) are crucial for preventing mother-to-child transmission (PMTCT) of HIV. Wide coverage of mobile phones, digital tools, including internet-enabled medication dispensers and short message service (SMS), have been recommended as potential interventions to improve adherence to medication by PBWLH. The main objective of the study was to understand the needs and contents for a customized digital tool for retention in care and medication adherence among PBWLH.MethodA mixed-methods study was conducted from September 2021 to March 2022 at five health facilities in the Kilimanjaro region. We interviewed 142 pregnant and breastfeeding women, receiving PMTCT services, using a semi-structured questionnaire. Among the interviewed, twenty breastfeeding women were purposively selected and enrolled to use an internet-enabled Wisepill medication dispenser for one month. They received different types of SMS reminders for one month, and feedback on their adherence patterns was received after one month using an adherence graph from the Wisepill digital tool. Later, exit and in-depth interviews were conducted to explore the needs and contents of a future customized digital adherence tool. Descriptive analyses for quantitative data and thematic content analyses for qualitative data were also done.ResultsAmong 142 women interviewed, 42(30%) were pregnant and 100 (70%) were breastfeeding. Most 136 (95%) had access to mobile phones and used SMS daily, while 90% were interested in receiving reminder messages. Qualitative findings revealed more insights into reminders’ content and educational SMS. Most people preferred neutral SMS, which does not contain the word “medication”. Health educational SMS content was preferred to be on breastfeeding, opportunistic diseases, nutrition and entrepreneurship education. Overall, SMSs were regarded as helpful to remind clients of medication time and the medication dispenser provided them with privacy and safe storage for their medication.ConclusionsThis study's findings will help construct useful content for future digital adherence tools to support the health of pregnant and breastfeeding women living with HIV.

High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study.

Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR]=3.42 per 100 person-years [PY]; 95% CI=1.64-6.30), while zero cases occurred with PrEP use (IR=0.0 per 100PY; 95% CI=0.0-0.62), with IRR=0.0 (95% CI=0.0-0.22; p<0.001). Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention.

Two-way SMS Reminders for Medication Adherence and Quality of Life in Adults with Type 2 Diabetes: A Randomized Controlled Tria

Non-adherence to a medication regime often has a negative impact on patient outcomes. With a relatively low cost, many countries are using short messaging services to reduce non-adherence rates. In Thailand, research using a short messaging service reminder for people to take their medications is understudied. This multi-center randomized controlled trial, 2-arm, parallel-group research aimed to determine the effects of 2-way SMS reminders on the medication adherence and quality of life of adults with type 2 diabetes mellitus. Data were collected from 63 participants with diabetes in a treatment group (33) and a control group (30). The sample consisted of adults aged 18 and older who were diagnosed with diabetes living in a northeast province of Thailand. All participants received standard care, but those in the treatment group also received a tailored 2-way short message service as a mobile health (mHealth) treatment for four months. Medication adherence was measured by the level of hemoglobin A1c. Quality of life was measured using the Thai version of a Quality-of-Life Questionnaire developed by the World Health Organization and the Diabetes-39 Questionnaire. Data were analyzed using descriptive statistics. One-way repeated measures ANOVA was used to compare hemoglobin A1c levels and quality of life mean scores across three-time points (0, 2, and 4 months). The results revealed that at the completion of the study, the participants in the treatment group had significantly lower hemoglobin A1c than those in the control group and significantly better health-related quality of life, demonstrating that the 2-way SMS reminder service improved their health outcomes. Thus, it is recommended that nurses should employ mHealth, such as 2-way SMS reminder solutions tailored to patients’ daily routines. A future investigation comparing the cost-effectiveness and patient outcomes of different mHealth technologies is suggested.

What incentives encourage local communities to collect and upload mosquito sound data by using smartphones? A mixed methods study in Tanzania

BackgroundTo detect and identify mosquitoes using their characteristic high-pitched sound, we have developed a smartphone application, known as the ‘HumBug sensor’, that records the acoustic signature of this sound, along with the time and location. This data is then sent remotely to a server where algorithms identify the species according to their distinctive acoustic signature. Whilst this system works well, a key question that remains is what mechanisms will lead to effective uptake and use of this mosquito survey tool? We addressed this question by working with local communities in rural Tanzania and providing three alternative incentives: money only, short message service (SMS) reminders and money, and SMS reminders only. We also had a control group with no incentive.MethodsA multi-site, quantitative empirical study was conducted in four villages in Tanzania from April to August 2021. Consenting participants (n = 148) were recruited and placed into one of the three intervention arms: monetary incentives only; SMS reminders with monetary incentives; and SMS reminders only. There was also a control group (no intervention). To test effectiveness of the mechanisms, the number of audio uploads to the server of the four trial groups on their specific dates were compared. Qualitative focus group discussions and feedback surveys were also conducted to explore participants’ perspectives on their participation in the study and to capture their experiences of using the HumBug sensor.ResultsQualitative data analysis revealed that for many participants (37 out of 81), the main motivation expressed was to learn more about the types of mosquitoes present in their houses. Results from the quantitative empirical study indicate that the participants in the ‘control’ group switched on their HumBug sensors more over the 14-week period (8 out of 14 weeks) when compared to those belonging to the ‘SMS reminders and monetary incentives’ trial group. These findings are statistically significant (p < 0.05 or p > 0.95 under a two-sided z-test), revealing that the provision of monetary incentives and sending SMS reminders did not appear to encourage greater number of audio uploads when compared to the control.ConclusionsKnowledge on the presence of harmful mosquitoes was the strongest motive for local communities to collect and upload mosquito sound data via the HumBug sensor in rural Tanzania. This finding suggests that most efforts should be made to improve flow of real-time information back to the communities on types and risks associated with mosquitoes present in their houses.

SMS reminders increase on-time vaccination in Aboriginal and Torres Strait Islander infants.

Timely immunisation is important to protect children from communicable diseases. However, immunisation uptake in Aboriginal and Torres Strait Islander children under the age of two years is often lower than in non-Indigenous children. This contributes to the gap in health outcomes between Aboriginal and Torres Strait Islander children and non-Indigenous children. We have tested the effectiveness of short message service (SMS) reminders in improving timeliness of childhood immunisation in Aboriginal and Torres Strait Islander infants in regional Queensland, Australia. Reminders were sent to parents of Aboriginal and Torres Strait Islander children, at five immunisation age milestones: six weeks, four months, six months, 12 months, and 18 months. There was a significant improvement in the proportion of children vaccinated on-time (within 30 days of the due date), compared to an earlier age cohort, at all milestones except 12 months. The absolute risk difference (ARD) of on-time vaccination between the two cohorts ranged between 4.7% (95% confidence interval [95% CI]: 1.1-8.2%, at six weeks) and 12.9% (95% CI: 7.4-18.5%, at six months). The likelihood of on-time vaccination (rate ratio, RR) in the intervention group compared to the control group ranged from 1.05 (95% CI: 1.01-1.10, at six weeks) to 1.31 (95% CI: 1.14-1.50, at 18 months). SMS reminders were associated with an improvement in immunisation timeliness in Aboriginal and Torres Strait Islander infants at all age milestones measured except 12 months.

SMS reminders increase on-time vaccination in Aboriginal and Torres Strait Islander infants.

Timely immunisation is important to protect children from communicable diseases. However, immunisation uptake in Aboriginal and Torres Strait Islander children under the age of two years is often lower than in non-Indigenous children. This contributes to the gap in health outcomes between Aboriginal and Torres Strait Islander children and non-Indigenous children. We have tested the effectiveness of short message service (SMS) reminders in improving timeliness of childhood immunisation in Aboriginal and Torres Strait Islander infants in regional Queensland, Australia. Reminders were sent to parents of Aboriginal and Torres Strait Islander children, at five immunisation age milestones: six weeks, four months, six months, 12 months, and 18 months. There was a significant improvement in the proportion of children vaccinated on-time (within 30 days of the due date), compared to an earlier age cohort, at all milestones except 12 months. The absolute risk difference (ARD) of on-time vaccination between the two cohorts ranged between 4.7% (95% confidence interval [95% CI]: 1.1-8.2%, at six weeks) and 12.9% (95% CI: 7.4-18.5%, at six months). The likelihood of on-time vaccination (rate ratio, RR) in the intervention group compared to the control group ranged from 1.05 (95% CI: 1.01-1.10, at six weeks) to 1.31 (95% CI: 1.14-1.50, at 18 months). SMS reminders were associated with an improvement in immunisation timeliness in Aboriginal and Torres Strait Islander infants at all age milestones measured except 12 months.

Cost of improved test and treat strategies in Indonesia.

To estimate and compare the cost of improved test and treat strategies in Indonesia under HIV Awal (Early) Testing and Treatment Indonesia (HATI) implementation trial in community-based and hospital-based clinics. The cost and outcome [i.e. CD4 + cell count] and viral load (VL) at the beginning of interventions and their change overtime) analysis of Simplifying ART Initiation (SAI), Community-based Organization and community-based ART Service (CBO), Motivational Interviewing (MI), Oral Fluid-based Testing (OFT), and Short Message Service (SMS) reminder in community-based and hospital-based clinics in 2018-2019. We estimated the total and unit costs per patient (under HATI implementation trial interventions) per year from societal perspective in various settings, including costs from patients' perspective for SAI and MI. We also analyzed the outcome variables (i.e. CD4 + cell count and VL at the beginning of each intervention, the change in CD4 + cell count and VL over time, and adherence rate). The unit cost per patient per year of SAI and SMS were lower at the community-based clinics, and more patients visited community-based clinics. The cost per patient visit from patient perspective for SAI and MI was mostly lower than 10% of the patients' household monthly expenditure. Average CD4 + cell count was higher and average VL was lower at the start of interventions at the community-based clinics, while average CD4 + cell count and VL changes and adherence rate were similar between the two types of clinics. Community-based clinics hold the potential for scaling up the interventions as it costs less from societal perspective and showed better outcome improvement during the HATI implementation trial.

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above-mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above-mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

Studying Vaccination Coverage and Design of Short Message Service Based Reminder to Improve Children Vaccination Coverage in Hawassa; Sidama Region; Ethiopia

A vaccine is a kind of remedy that trains the body’s protection system so that it can combat an infection. The national routine immunization coverage in Ethiopia is low. Among the main reason for defaulting children vaccinations are disremembering the appointment date, communication gap between service providers and the community, knowhow about vaccination and etc. This work is to investigate vaccination coverage in Hawassa city and main reasons of vaccination drop out, and then provide a solution for that main reason. Data was collected from 360 children whose age is between 1 to 2 years who live in Hawassa city. The data analysis result showed that only 51% of the children are fully vaccinated; and the main reason for vaccination dropout which weighs 57% was found to be disremembering the appointment date. Providing a solution to not only one of the main reasons but also for the one which weighs the most in the city of this study will improve the vaccination coverage. As the main reason is found to be disremembering the vaccination appointment date, this work provides a Short Message Service (SMS) based automatic reminding system. The design part uses database, OzekiNG network gateway and global system for mobile communication modem with active subscriber identity module. In this system the health extension workers will register the clients’ detailed information including appointment dates during the birth of baby that will be accessed periodically by the OzekiNG to send the reminder SMS to the mothers one day a head to the day of vaccination. After automatic reminding mechanism was developed and implemented, coverage of fully vaccinated children increases from 51% to 71% and the problem of forgetting appointment date decreases from 57% to 14%. The efficiency of the developed system is found to be 85%. From the above mentioned results and the current available communication mechanisms, it can be concluded that the reminding system can be simply implemented to improve the child vaccination coverage by bridging the gap due to disremembering the vaccination appointment date.

HIV self-test reporting using mHealth platforms: A pilot study in Johannesburg, South Africa.

The main impediment to operational scale-up of HIV self-testing (HIVST) and counselling, is a dearth of information on utilisation, reporting, and linkage to care for HIV-positive individuals. To inform solutions to this issue, this study investigated the utility of self-testers reporting their results using a mobile-health (mHealth) platform, and whether seropositive users linked into care. Candidates who met the recruitment criteria across multiple sites within inner-city Johannesburg each received an HIVST kit. Using short message service (SMS) reminders (50% standard and 50% behavioural science), participants were prompted to self-report results on provided platforms. On the seventh day, users who did not make contact, were called, and surveyed via an interactive voice response system (IVRS). Multivariable regression was used in reporting by age and sex. Of the 9,505 participants, 2,467 (25.9%) participants answered any survey question, and of those, 1,933 (78.4%) were willing to self-report their HIV status. Men were more likely than women to make an inbound call (10.2% vs. 9.1%, p = 0.06) however, women were significantly more likely to self-report their test result (AOR = 1.12, 95%CI = 1.01-1.24, p = 0.025). Overall, self-reporting a test result was predicted by being younger and female. In addition, reporting HIV results was associated with age, 25-35 (AOR = 1.58, 95% CI = 1.24-2.02) and above 35 years (AOR = 2.12, 95% CI = 1.61-2.80). Out of 1,933 participants willing to report their HIV status, 314 reported a positive test, indicating a HIV prevalence of 16.2% (95% CI: 14.6%-18.0%) and of those 204 (65.0%) reported inclination to link to care. While self-reporting HIVST results via an IVRS system yielded a higher response rate, behavioural SMSs were ineffective in increasing self-reporting.

Short Message Service Reminder Nudge for Parents and Influenza Vaccination Uptake in Children and Adolescents With Special Risk Medical Conditions

Children with chronic medical conditions are at increased risk of severe influenza. Uptake of influenza vaccination in children and adolescents with these identified special risk medical conditions (SRMCs) is suboptimal. To assess the effectiveness of Flutext-4U, a parent short message service (SMS) reminder nudge intervention, in increasing influenza immunization in children and adolescents with SRMCs. This randomized clinical trial was conducted at a tertiary pediatric hospital in Adelaide, South Australia, from April 15 to September 30, 2021. Children and adolescents aged 6 months to younger than 18 years with SRMCs and a subspecialist outpatient appointment over a 5-month period during the Australian seasonal influenza vaccination season (April-August 2021) were eligible to participate. Follow-up was until September 30, 2021. Participants were randomly assigned (1:1 ratio) to control: clinician nudges (hospital vaccine availability, ease of access, and recommendation from hospital subspecialists) or SMS intervention (control conditions plus an additional SMS reminder nudge to parents), with randomization stratified by age group (<5 years, 5-14 years, or >14 to <18 years). The primary outcome was influenza vaccination, as confirmed by the Australian Immunisation Register. A total of 600 participants (intervention group: 298 [49.7%]; mean [SD] age, 11.5 [4.6] years; 162 female participants [54.4%]; control group: 302 [50.3%]; mean [SD] age, 11.4 [4.7] years; 155 female participants [51.3%]) were included. Influenza vaccination was 38.6% (113 of 293) in the SMS intervention group compared with 26.2% (79 of 302) in the control group (adjusted odds ratio [aOR], 1.79; 95% CI, 1.27-2.55; P = .001). Time to vaccine receipt was significantly lower among SMS participants (adjusted hazard ratio, 1.67; 95% CI, 1.25-2.22; P < .001). For participants randomly assigned by June 15, a significantly greater proportion receiving the SMS intervention were vaccinated during the optimal delivery period April to June 30 (SMS group: 40.0% [76 of 190] vs 25.4% [50 of 197]; aOR, 1.97; 95% CI, 1.28-3.06; P = .002). Results of this randomized clinical trial suggest that an additional SMS reminder nudge for parents delivered in the tertiary care hospital setting to children and adolescents with SMRCs resulted in higher influenza vaccine uptake compared with clinician nudges alone. ANZCTR Identifier: ACTRN12621000463875.