Comparative Effectiveness Trial of Two Reminder/Recall Methods to Increase Immunization Rates in Young Children
Condition: Immunization Rates
Study type: Interventional

Summary: 
      The purpose of this study is to determine if a collaborative centralized population-based
      reminder/recall intervention is more effective than a traditional practice-based
      reminder/recall intervention at increasing immunizations among young children.
    

Detailed description: 
      The study proposed is of immense importance in directing future methodology for bringing
      children who have not received needed immunizations up to date. The proposed study builds on
      the success of a previous trial and incorporates data from providers and patients to further
      improve the intervention. In this study the investigators aim to increase the effectiveness,
      cost effectiveness, and acceptability to practices and families of population-based R/R by
      introducing a strong private-public collaboration and maximizing health information
      technologies that allow practices to interface with Colorado's Immunization Services System
      (CIIS). Two real-world approaches will be compared: one approach will provide primary care
      practices the tools to conduct recall and educational interventions. In the other approach,
      population-based centralized recall by the state immunization registry will be conducted in
      collaboration with practices. Determining which of these methods is most effective in
      reaching the most children and comparing the cost of each will provide data critical in
      guiding future national efforts to assure that children entering school are fully vaccinated.
      Because the trial will be conducted at the level of both urban and rural counties throughout
      the state and will include all types of providers, the investigators expect our findings to
      be nationally generalizable.
    

Intervention name(s): Collaborative Pop-Based R/R: Phone/Mail Group; Collaborative Pop-Based R/R: Mail-Only Group; Practice-based Recall
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Within each county, half of patients will be randomized to a phone/mail group (2 auto-dialer calls and 2 postcards) and the other half of patients will be put in a mail-only group (4 mailings). The following collaborative approaches will be utilized: patient addresses and phone numbers will be updated prior to recall for electronic Flat File Format practices; all notices to parents (auto-dialer calls and mailings) will appear to come both from the local public health department and providers who choose to have their name listed; all bad addresses and phone numbers will be updated by calling the last provider of care. Up to 4 notices will be sent to parents of children who are still not up to date for recommended immunizations.; Parents will receive up to four mailings if their child appears in need of immunizations according to CIIS. The Collaborative method is the same as in the auto-dialer/mail group; however patients in this group will not receive telephone calls.; All practices will receive training on how to conduct practice-based recall using CIIS and educational materials to use within their practices to promote compliance with the infant vaccination schedule. Individual practices will make their own decisions about the extent to which they follow the recommendations and implement recall within their practice. Although the study team will not provide them with any additional interventions, we will track any other interventions they independently do (websites, newsletters, telephone) in order to assess the effect of these additional interventions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Immunization reminder/recall; Reminder/Recall systems; Population based Recall; Practice based Recall