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Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial
Melissa S Stockwell1, Carolyn Westhoff, Elyse Olshen Kharbanda
1Melissa S. Stockwell is with the Departments of Pediatrics and Population and Family Health, Columbia University, and New York-Presbyterian Hospital, New York, NY. Carolyn Westhoff is with the Departments of Obstetrics and Gynecology and Epidemiology, Columbia University. Elyse Olshen Kharbanda is with HealthPartners Institute for Education and Research, Minneapolis, MN. Celibell Y. Vargas and Stewin Camargo are with the Department of Pediatrics, Columbia University. David K. Vawdrey is with the Department of Biomedical Informatics, Columbia University, and New York-Presbyterian Hospital. Paula M. Castaño is with the Department of Obstetrics and Gynecology, Columbia University.
Objectives:
We evaluated the impact of influenza vaccine text message reminders in a low-income obstetric population.
Methods:
We conducted a randomized controlled trial that enrolled 1187 obstetric patients from 5 community-based clinics in New York City. The intervention group received 5 weekly text messages regarding influenza vaccination starting mid-September 2011 and 2 text message appointment reminders. Both groups received standard automated telephone appointment reminders. The prespecified endpoints were receipt of either pre- or postpartum influenza vaccination calculated cumulatively at the end of each month (September-December 2011).
Results:
After adjusting for gestational age and number of clinic visits, women who received the intervention were 30% more likely to be vaccinated as of December 2011 (adjusted odds ratio [AOR] = 1.30; 95% confidence interval [CI] = 1.003, 1.69 end of September: AOR = 1.34; 95% CI = 0.98, 1.85; October: AOR = 1.35; 95% CI = 1.05, 1.75; November: AOR = 1.27; 95% CI = 0.98, 1.65). The subgroup of women early in the third trimester at randomization showed the greatest intervention effect (December 31: 61.9% intervention vs 49.0% control; AOR = 1.88; 95% CI = 1.12, 3.15).
Conclusions:
In this low-income obstetric population, text messaging was associated with increased influenza vaccination, especially in those who received messages early in their third trimester.
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