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Childhood immunization appointment reminders and recalls: strengths, weaknesses and opportunities to increase vaccine
K M Jong1, C A Sikora2, S E MacDonald3
1Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Insights
Childhood immunization reminders and recalls improve appointment attendance but are resource-intensive. Modernizing delivery methods, like text messaging, and tailoring strategies to diverse populations can enhance effectiveness.
Area of Science:
- Public Health
- Immunization Programs
- Health Communication
Background:
- Parental forgetfulness is a significant barrier to childhood immunization coverage.
- Reminder and recall systems are evidence-based strategies to address this barrier.
- Existing reminder/recall strategies in Alberta, Canada, were examined to identify strengths and weaknesses.
Purpose of the Study:
- To identify current reminder/recall strategies for childhood immunizations in Alberta.
- To determine the perceived strengths and weaknesses of these strategies.
- To identify areas for improvement in reminder/recall systems.
Main Methods:
- An environmental scan was conducted in Alberta in 2018.
- Phase 1 involved interviews with public health leaders across five zones.
- Phase 2 included an online survey of public health centers province-wide.
Main Results:
- Strengths included increased appointment attendance and timely immunization reminders.
- A key weakness was the time-consuming and resource-intensive nature of current systems.
- Modernization of delivery methods and incorporation of educational/language support were identified as improvements.
Conclusions:
- There is support for integrating automated and text-based reminder/recall systems.
- Tailoring strategies to population needs, including language barriers and educational content, is crucial.
- Flexibility in local management of reminder/recall systems is recommended for maximized effectiveness.
Objectives:
Childhood immunization coverage has been shown to be greatly impacted by parental forgetfulness regarding immunizations and appointments. Evidence supports the use of reminders and recalls to overcome this barrier, which remind parents about upcoming immunization appointments and inform them once their child is overdue for an immunization. In this study, we sought to identify reminder/recall strategies used throughout a large Canadian province and determine the perceived strengths, weaknesses and areas of improvement of existing strategies.
Study Design And Methods:
An environmental scan was performed in 2018 in two phases: (1) interviews with public health leaders from the five zones of Alberta and (2) an online survey of public health centres across the province. Data analysis occurred in 2018 and 2019.
Results:
Commonly reported strengths of reminders and recalls included their ability to increase appointment attendance and remind parents about immunizations, respectively. A major identified weakness was their time-consuming/resource-intensive nature. Many participants believed reminder/recalls could be improved by modernizing delivery methods. Educational information or strategies to overcome language barriers were rarely incorporated into reminder/recall systems.
Conclusions:
There was support for incorporating text messaging and automation into reminder/recall systems while encouraging continued exploration of novel reminder/recall delivery methods. Tailoring reminder/recalls to the needs and preferences of target populations can maximize the effectiveness of these systems. This includes modernizing methods of delivery, addressing language barriers, providing educational information, and allotting some degree of flexibility to local level management of reminder/recalls.
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