Short Message Service Reminders to Parents for Increasing Adolescent Human Papillomavirus Vaccination Rates in a Secondary School Vaccine Program: A Randomized Control Trial

Abstract

A B S T R A C TPurpose: In Victoria (Australia), the human papillomavirus (HPV) vaccine is delivered within a state-wide secondary school vaccine program, administered by local government. This study aimed to test the hypothesis that sending a short message service (SMS) reminder to parents who had consented to their child's receiving the HPV vaccine would lead to greater uptake of the vaccine within the program. The secondary aim was to assess the effect of self-regulatory versus motivational message content in the SMS. Methods: A randomized control trial design was used across 31 schools within seven local government areas. Parents of 4,386 consented adolescents were randomized into three study conditions: motivational SMS versus self-regulatory SMS versus no SMS. Follow-up extended beyond the final school visit to the end of the calendar year to capture those who may have attended a catch-up vaccination session. Results: On the day of the final school visit, 85.71% of consented students in the control condition received the HPV vaccine, compared with 88.35% (2.64% point increase) in the motivational message condition, and 89.00% (3.29% point increase) in the self-regulatory message condition, c 2 (2, N ¼ 4,386) ¼ 8.31, p ¼ .016. Both intervention messages were similarly effective at increasing vaccination rates. This effect was maintained in the extended follow-up period. Conclusions: The trial findings supported the hypothesis that SMS reminders to parents/guardians would lead to greater uptake of the HPV vaccine in adolescents participating in school-based vaccination. Also, this effect was observed whether we used a motivational or self-regulatory message framework.

Immunization Campaigns and Strategies against Human Papillomavirus in Italy: The Results of a Survey to Regional and Local Health Units Representatives

“…Some studies investigated interventions to improve HPV vaccine uptake but each of them was evaluated separately [18–23]. Other studies and recommendations on factors influencing VC integrated the evaluation of many interventions but rarely specific for HPV vaccine, that is critical for the variety of targets and healthcare professionals implicated in vaccine counselling, the involvement of parents, and the relevance of indications including cancers [24–27].…”

“…Organizational aspects to improve HPV vaccine uptake were also investigated, in particular the implementation of immunization services' accessibility, the role of reminder systems, and communication technologies. Nevertheless, previous evaluations were rarely comprehensive or specific, thus compromising the estimate of the effect of interventions' interaction and the consideration of HPV vaccine peculiarities (i.e., the variety of involved targets and healthcare professionals, the role of parents, and the range and seriousness of HPV-related diseases, including cancers) [18–29].…”

The INSPIRE Framework: How Public Administrators Can Increase Compliance with Written Requests Using Behavioral Techniques

“…Results showed that incorporating ease and procedural justice principles in a letter asking a driver to attend a medical examination increased compliance with the request by 23 percent (Faulkner et al ). Similarly, the Victorian Department of Health and Human Services has used INSPIRE to increase vaccination rates (Borg et al 2018; Tull et al ). Borg and colleagues (2018) found that sending a letter designed using INSPIRE principles informing parents of Aboriginal children about a free influenza vaccination increased their vaccination rates by 34 percent.…”

“…Borg and colleagues (2018) found that sending a letter designed using INSPIRE principles informing parents of Aboriginal children about a free influenza vaccination increased their vaccination rates by 34 percent. Tull et al () found that sending an SMS message developed using INSPIRE techniques (specifically, implementation intentions) to parents of secondary school students increased the percentage of students who received the human papillomavirus vaccine. Furthermore, members of the authorship team, along with their colleagues at BehaviourWorks Australia, Monash University, have been invited to deliver INSPIRE training sessions to a range of Australian government agencies, many of whom have gone on to use INSPIRE principles in their written materials.…”

A feasibility trial of parent HPV vaccine reminders and phone-based motivational interviewing

“…Specifically for adolescent vaccination, however, reminders produce moderate increases in vaccination rates: a Cochrane review found only a 7% increase in vaccination rates from reminders across 10 studies with 30,868 participants [15][16][17]. Preliminary evidence suggests reminder effectiveness may be boosted with strategies like allowing parents to request a clinic call back, including educational information, and combining reminders with other interventions such as phone calls or navigator home visit [12,13,15,[18][19][20][21].…”