Understanding the use of digital technology to promote human papillomavirus vaccination – A RE-AIM framework approach

Abstract

The human papillomavirus virus (HPV) vaccine is effective at preventing various cancers, but coverage falls short of targets that are needed for community protection. Here, we use the RE-AIM implementation framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) to understand how text, email, and electronic health record (EHR) reminders and social media campaigns can be used as part of policy and practice interventions to increase HPV vaccination. These technology-based interventions could be used together and mainstreamed into clinical and system-based practice to have the greatest impact. Of the interventions explored, text-based, email-based, and EHR reminders have the most evidence behind them to support their effectiveness. While there are several studies of promotion of the HPV vaccine on social media, more studies are needed to demonstrate their effects and better methods are needed to be able to attribute results to these interventions.

Using provider–parent strategies to improve influenza vaccination in children and adolescents with special risk medical conditions: a randomised controlled trial protocol

“…Text-message reminders sent by immunisation providers are a low-cost alternative and have been shown to increase vaccine uptake in some increased-risk groups. [25][26][27][28] Notably no studies have investigated the impact of electronic reminders on influenza immunisation coverage in children with SRMC.…”

“…However, most studies were conducted in the USA, focused only on children with asthma and used traditional reminder/recall systems (eg, written correspondence and telephone calls) that are financially costly, difficult to track receipt and labour intensive to administer. Text-message reminders sent by immunisation providers are a low-cost alternative and have been shown to increase vaccine uptake in some increased-risk groups 25–28. Notably no studies have investigated the impact of electronic reminders on influenza immunisation coverage in children with SRMC.…”

“…Based in the USA, the Text4Health programme implements and evaluates, using randomised control trials, tailored, targeted vaccine text message reminders, with a focus on influenza in urban paediatric and pregnant populations 27 28 32 33. Other research targeted at the diverse and complex information needs of pregnant women34 35 and other special-risk groups25 26 demonstrate text-messaging interventions improve coverage. Barriers to influenza immunisation in children with SRMC include: (i) a lack of ready access to immunisation services; (ii) a lack of healthcare provider recommendation; (iii) providers advising against immunisation; (iv) safety concerns; (v) competing priorities; (vi) a lack of understanding of the need to immunise and (vii) being unaware of the recommendation to immunise 11–13 36.…”

There’s Much Yet to be Done: Diverse Perspectives on HPV Vaccination

“…Eight articles in this special issue focus on pre-interventional and interventional research to improve vaccine initiation and series completion, including a review of technology-based interventions (e.g., text messaging and electronic health record reminders) designed to improve vaccination rates. 25 Three papers involve evaluations of a patient navigator program, 26 a quality improvement intervention, 27 and a tablet-based tailored messaging intervention, 28 respectively, in terms of their effects on vaccine initiation and series completion. An additional article reports on the acceptability to caregivers of the patient navigator program.…”

Personalized Reminders for Immunization Using Short Messaging Systems to Improve Human Papillomavirus Vaccination Series Completion: Parallel-Group Randomized Trial

“…Studies have demonstrated the effectiveness of mHealth SMS text message interventions on vaccination coverage and timeliness at levels in line with other forms of reminder or recall, particularly in low-income populations for whom other forms of reminder recall have been less successful [9][10][11][12][13]. SMS text message reminders have been found to increase HPV vaccine uptake in various populations, particularly in the adolescent cohort [11,[14][15][16][17][18][19][20][21]. However, their effect has not been as robust as needed.…”