Email-based Reminders Promoting Recommended Pediatric Preventative Visits

Study Overview
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Brief Summary
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The purpose of this study is to assess, prospectively, the effect of email reminders for well-child check (WCC) visits on adherence to these visits among those who have not yet scheduled the visit. The investigators hypothesize that sending reminders will increase scheduling WCC visits, attending WCC visits, and being up to date for the child's required immunizations beyond what occurs in the absence of these reminders.

Detailed Description
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Regular attendance at recommended WCC visits is associated with having up-to-date immunizations. Standard care involves scheduling a follow-up WCC visit at the end of the current visit. However, if the child's parents do not choose to schedule a follow-up visit at that time or miss a WCC visit, they may not be offered another easy opportunity to schedule one. That is, they would have to remember to schedule a visit and contact the clinic proactively. In this study, 30 days before a child is due for their WCC visit, parents who have not yet scheduled a WCC visit for up to 30 days (for 5-month-olds) or 60 days (for all other ages) after their child is due for a visit will be randomly assigned to two groups with a random number generator. One group will receive an email reminder, while the other group will not receive any reminder. The randomization of participants to different conditions will be in place until 800 participants have been identified and randomly assigned to one of the arms (estimated sample to detect at least a 10% absolute difference) or 180 days, whichever comes first. To account for delays in updating clinical databases, the final outcome data will be checked 90 days after the last eligible visit (for a maximum study period of 270 days).

Official Title
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Evaluation of Email-based Reminders in Promoting Adherence to the Recommended Pediatric Preventative-visit Schedule Among Rural Patients

Conditions
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Immunization Programs

Intervention / Treatment
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* Behavioral: Reminder


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents (or contact on record) of children aged 5, 8, 11, 14, or 17 months No WCC visits scheduled 30 days after the child's monthly birthday (for 5 month-olds) or 60 days (for all other ages) ahead of their due date for a WCC (i.e., month 6, 9, 12, 15, or 18) Has an email address on record Child is currently seen in Pediatric clinics under the Geisinger umbrella (has at least one prior visit) Exclusion Criteria: Did not opt out of emails

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: No reminder group vs. reminder group
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: No Contact<br>No reminder sent | |
| Experimental: Reminder<br>Reminder email with contact information to set an appointment will be sent 12 weeks before the appointment. | Behavioral: Reminder<br>* Email<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| WCC visit scheduled | Binary variable of scheduling a WCC visit as established by visit type, visit reasons, and billing codes (if available) | 30-60 days from the email send date | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| WCC visit made | Binary variable of going to a WCC visit as established by billing codes | 30-60 days from the email send date | 
| Immunization status | Binary variable indicating whether pediatric vaccinations are up to date, defined as having no current immunization care gaps | 60 days from the email send date | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pediatrics, Reminder Systems, Preventive Medicine, Child Health, Appointments and Schedules