Related Experiment Video
Updated: May 20, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Feasibility of a randomized controlled trial to evaluate Text Reminders for Immunization Compliance in Kids (TRICKs)
Carolyn R Ahlers-Schmidt1, Amy K Chesser, Tuan Nguyen
1University of Kansas School of Medicine-Wichita, Department of Pediatrics, Wichita, KS 67214, United States. cschmidt3@kumc.edu
Insights
Text message reminders for childhood immunizations show promise in improving vaccination rates. The Text Reminders for Immunization Compliance in Kids (TRICKs) program demonstrated high parent satisfaction and increased on-time immunizations.
Area of Science:
- Pediatric Health
- Public Health Interventions
- Health Communication
Background:
- Childhood immunizations are crucial for public health.
- Ensuring timely vaccination coverage remains a challenge.
- Innovative strategies are needed to improve immunization compliance.
Purpose of the Study:
- To pilot test the Text Reminders for Immunization Compliance in Kids (TRICKs) program.
- To evaluate the feasibility and potential of text message reminders to increase immunization coverage.
- To assess parent satisfaction with the TRICKs program.
Main Methods:
- A randomized controlled trial (RCT) was conducted in a pediatric clinic.
- Parents of newborns were enrolled.
- The intervention group received text message reminders before immunization due dates.
Main Results:
- While not statistically significant, higher immunization rates and timeliness were observed in the intervention group.
- Post-intervention interviews revealed strong parent support, with 83% finding reminders very helpful.
- Limitations included sample size and software issues, but parent interest was high.
Conclusions:
- The TRICKs program is a feasible and well-supported intervention for improving immunization rates.
- Improvements in text messaging software and study design are needed for future large-scale RCTs.
- Further research with a fully powered RCT is recommended to confirm the effectiveness of text message reminders.
Objective:
To pilot test the Text Reminders for Immunization Compliance in Kids (TRICKs) program to evaluate its feasibility and potential to increase immunization coverage.
Design:
Randomized controlled trial (RCT).
Setting:
Pediatric clinic.
Participants:
Parents of newborns being discharged from a local hospital who intended to seek child health care at the University-sponsored pediatric resident and faculty clinic.
Intervention:
Text message immunization reminders prior to immunization due dates.
Main Outcome Measures:
Receipt and timeliness of immunizations at 2, 4 and 6 months of age.
Results:
Participants (N=90) were English (83%) or Spanish (17%) speaking. The majority were female (83%), on public insurance (59%), and had adequate health literacy (96%). Parents were married or a member of an unmarried couple (62%). Over 66% had a high school diploma or less. Greater numbers of intervention children received immunizations and were "on time" using per protocol analysis; though not statistically significance. Limitations include sample size, problematic text messaging software, and loss of phone service at 7 months for 40% of intervention parents. However, post-intervention interviews (N=18) indicated strong support for TRICKs; 83% found the text message reminders very helpful and 17% somewhat helpful.
Discussion:
Pilot testing allowed us to assess processes, including recruitment, retention, and software, which will increase the success of an RCT. Software with built-in backup systems is needed for follow-up when mobile service is interrupted. However, in spite of limitations, immunization rates were higher in the text message reminder group, though not statistically significant. Parent support and interest was high. A fully powered RCT is needed with follow-up over the full 4-3-1-3-3-1 series. Based on our results, for 80% power where we expected 90% compliance in the intervention group and 80% in the control group we need 219 per group, plus increases to address drop out and loss of follow-up.
Related Concept Videos
Randomized Experiments
Simple randomization
Simple...
What is an Experiment?
Blinding
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Regression Toward the Mean
