Text Reminders to Immunize in a Managed Care Organization
Condition: Human Papilloma Virus
MeSH terms: Papilloma
Study type: Interventional

Summary: 
      The purpose of the study is to evaluate the effectiveness of a managed care-based HPV
      vaccination reminder/recall system using a randomized controlled trial (RCT) across diverse
      practices and patient populations. The trial will measure the effectiveness of text messaging
      reminder/recall on (a) improving initiation and (b) completion rate of the HPV vaccine
      series; (c) decreasing the time between vaccine doses; and (d) improving rates of preventive
      visits for adolescents

      The hypotheses are that text-messaged reminders to parents of adolescents will result in
      improved rates of HPV vaccine series initiation, HPV vaccine series completion, will decrease
      the intervals between vaccine doses and will improve rates of preventive care among
      adolescents. Parents receiving specific text-messaged reminders about services (i.e. HPV
      vaccination, well child care visits) for which their adolescent is due will be compared to a
      control group of parents receiving general health tips through text messages.
    

Detailed description: 
      The study setting is western New York State and the Southern Tier of New York State (15
      counties total). Investigators will work with the Monroe Plan for Medical Care, an IPA-model
      managed care organization (MCO) that serves Medicaid managed care and SCHIP enrollees. The
      MCO will conduct regular reviews of insurance claims data and the New York State Immunization
      Information System of adolescents ages 11-<16 years. Parents (all over 18 years of age) of
      adolescents will receive the texted messages on their phones.

      There are no enrollment restrictions based upon race or ethnic origin. The inclusion criteria
      are that the adolescents are a) enrolled in Medicaid or SCHIP through the Monroe Plan, b)
      have been enrolled greater than 6 months with the Monroe Plan (in order to have sufficient
      claims data to determine whether they are due for a well child care visit or recommended
      immunizations), c) the Monroe Plan has received their consent to send preventive care text
      messages, d) their child attend a primary care practice that has agreed to participate and d)
      they are between the ages of 11-<16 years at the start of the study.

      The key independent measure is group allocation (intervention vs. control); an
      intention-to-treat strategy will be used to assess the effectiveness of text messaging
      reminders. Key outcome measures will be: 1) receipt of 0, 1, 2 or 3 doses of HPV vaccine 2)
      interval (in days) between doses and 3) having a preventive visit in the 6 month period.
    

Intervention name(s): Text-based reminder for recommended HPV vaccine or WCC; Non-specific text-based reminder (general health tip)
Intervention type(s): Other; Other
Intervention description(s): Patients due for a well visit or HPV vaccine received a text reminder; Parents of adolescents receive preventive health tips via text messages (not specific to services for which child is due)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Health Services Research
Keywords: HPV vaccination; Adolescent well care; Adolescent HPV immunization; HPV