Adolescent Vaccination Reminder Study

Study Overview
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Brief Summary
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This protocol describes a study about vaccination uptake among adolescents. The purpose of the study is to determine whether parents who receive email reminders will be more likely to obtain Tdap (tetanus-diphtheria-acellular pertussis), HPV (human papilloma virus), meningococcal, and influenza vaccines for their adolescent children than parents who do not receive email reminders.

Detailed Description
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Adolescents are a reservoir population for a variety of vaccine preventable diseases (VPDs). Despite this, adolescent vaccination rates lag substantially behind national goals of 80% coverage for adolescent vaccines set forth by Healthy People 2020. This has been particularly the case for the vaccines most recently recommended for adolescents, such as the HPV (human papilloma virus) and seasonal influenza (flu) vaccines; national coverage levels in 2010 for HPV were 32% (for series completion among females only) and 35% for flu vaccine. Uptake levels for the two other adolescent-targeted vaccines, Tdap and meningococcal conjugate (MCV4) vaccines are currently at 69% and 63%, respectively. A major barrier to increased adolescent vaccination levels is the lack of parental and provider recognition that an adolescent is due for vaccine doses. For providers, there are the dual challenges of getting adolescents to come in for annual preventive care visits and also minimizing missed opportunities for vaccination (i.e. clinical interactions with a patient where a needed vaccine could have been provided but was not). Reminder/recall systems are one mechanism to help address both of these challenges for providers while also informing parents about the need for adolescent vaccines.

Official Title
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Adolescent Vaccination Reminders Using Email

Conditions
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Adolescent Vaccination Status

Intervention / Treatment
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* Behavioral: Email Notification


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents of adolescents (Ages 11-18) have children who attend one of 4 participating pediatric practices, Parents are able to read and converse in English, Parents have an active email address that is associated with their child's medical record, Parents have an adolescent whose medical record can be matched with their MCIR record. Exclusion Criteria: Parent age <18 years, Parents have an invalid or non-working parent email address, Parents have opted out of email communication, Prisoners, Decisionally challenged participants.

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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Vaccination Email Reminder<br>This group of parents in the study will receive email notifications about due/overdue vaccines for their adolescents. Vaccination records will be reviewed to identify adolescent patients in both practices who are newly eligible for a vaccine and/or overdue for a vaccine at the start of every other month. Email notifications will then be sent to the parents of these children. | Behavioral: Email Notification<br>* This study will use a targeted email reminder/recall intervention that addresses specific aspects of adolescent under-immunization.<br>|
| No Intervention: Usual Care<br>This group of parents in the study will not receive email notifications about due/overdue vaccines for their adolescents. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| New immunization doses | To examine the effect of email vaccination reminders, new immunization doses of children of parents who receive email vaccination reminders, versus those who do not receive email reminders during the study period will be determined. New doses are those for any of four adolescent vaccines which are administered following the reminder notification, and are subsequently recorded following reminder notifications. | New immunizations within 60 days of reminder notification | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Waived immunization doses | To examine the effect of email vaccination reminders, waived immunization doses of children of parents who receive email vaccination reminders, versus those who do not receive email reminders during the study period will be determined. Waived doses are those for any of four adolescent vaccines for which medical, religious, or philosophical waivers are subsequently recorded following reminder notifications. | Waived immunizations within 60 days of reminder notification | 
| Historical immunization doses | To examine the effect of email vaccination reminders, historical immunization doses of children of parents who receive email vaccination reminders, versus those who do not receive email reminders during the study period will be determined. Historical doses are those for any of four adolescent vaccines which are administered prior to the reminder notification and are subsequently recorded following reminder notifications. | Historical immunizations within 60 days of reminder notification | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adolescent vaccination, Immunization rates, Barriers to vaccination, Attitudes, Intentions