Impact of awareness reminders on our teens

image: Figure 1: Example of awareness messages
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Credit: Cincinnati Children’s Hospital Medical Center

Denver, April 22, 2022 – Researchers at Cincinnati Children’s Hospital Medical Center conducted a randomized clinical trial to determine the effectiveness of awareness reminders on teen and child visits and coronavirus vaccination rates. The trial results will be presented during the Pediatric Academic Societies (PAS) 2022 meeting, which will be held April 21-25 in Denver.

Many teens have delayed preventive services during the COVID-19 pandemic. Communication is a proven strategy for increasing preventive services, but it has been uncertain whether this would be effective amid the pandemic.

The experience determined that outreach messages were minimally effective in re-engaging adolescents in preventive services. Efforts are needed to address the widening inequalities.

“We provide a primary care home to low-income black residents who have been severely affected by the pandemic,” said Mary Burkhardt, MD, MHA, director of primary care at Children’s Hospital Medical Center in Cincinnati. “We conducted this trial to better understand the impact of reminders to adolescents about care. “We found that our interventions boosted the scheduling of quality adolescent care visits, but were less effective in improving completion of visits. Aggressive interventions may be needed to re-engage patients and address widening disparities.”

The trial included outreach text and telephone messages, with and without information about the availability of the COVID-19 vaccine, about scheduling and completing quality adolescent care visits among eligible adolescents for preventive services.

will present Dr. Burckhardt “Effect of outreach reminders on visits to healthy children and rates of COVID-19 vaccination: a randomized clinical trial” Sunday, April 24 at 8 a.m. Correspondents interested in interviewing Dr. Burckhardt should contact PAS2022@piercom.com.

The PAS meeting connects thousands of pediatricians and other healthcare providers around the world. For more information about the PAS meeting, please visit www.pas-meeting.org.

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About the Pediatric Academic Societies Meeting

The Pediatric Academic Societies (PAS) meeting is the premiere academic meeting on child health in North America. The PAS meeting connects thousands of pediatricians and other healthcare providers around the world. The PAS meeting is produced by a partnership of four pediatric organizations leading in the advancement of pediatric research and advocacy for children: the American Pediatric Association, the Society for Pediatric Research, the Academic Association of Pediatrics, and the American Academy of Pediatrics. For more information, please visit www.pas-meeting.org. Follow us on TwitterTweet embedand Instagram PASMeeting and #PAS2022and like us on Facebook PASMeeting.

a summary: Impact of awareness reminders on visits to healthy children and rates of COVID-19 vaccination: a randomized clinical trial.

Title

General Pediatrics: Primary Care / Prevention

Writer’s Scholarship

Mary Burckhardt, MD, MHA

organisation

Cincinnati Children’s Hospital Medical Center

background

Many teens have delayed preventive services during the COVID-19 pandemic. Communication is a proven strategy for increasing preventive services, but it has been uncertain whether this would be effective amid the pandemic.

objective

To determine the effectiveness of text and telephone outreach messages, with and without information about COVID-19 vaccine availability, on scheduling and completing Adolescent Health Care (AWC) visits among adolescents eligible for preventive services.

Design / Methods

We conducted a randomized, intent-to-treat, multi-arm clinical trial from May 28 to August 5, 2021 in three Academic Pediatric Primary Care practices serving 36,000 predominantly minority and low-income children. We randomly assigned 1235 adolescents between 12 and 17 years of age to the Standard Message Group, the COVID-19 Vaccine Message Group, or the No Message (control) group. We delivered two automated text or phone call reminders (based on family preference) to message groups using a HIPAA compliant platform (Fig. 1). As some patients did not receive messages as intended, we also performed an analysis of every protocol except for these patients. We used logistic regression models to examine scheduled AWC visit within 2 weeks, AWC visit completed within 8 weeks (primary outcome), and vaccine receipts (Tdap, HPV, MCV4, COVID-19) within 8 weeks.

consequences

The groups were similar (meaning [SD] age = 14 [1.5] years, 52% male, 77% black, 4.1% Hispanic, 88% generally insured) (Table 1). The scheduling rates for AWC visits were 10.4%, 6.6%, and 5.3% in the standard message, COVID-19 vaccine message, and control group, respectively. The standard message group had higher odds of scheduling an AWC visit than the COVID-19 vaccine message groups (Table 2). Despite the relative differences in the rate of completed AWC visits via the standard message (13.6%), COVID-19 vaccine message (13.4%), and control groups (10.4%), the odds did not differ significantly. Among those in the standard message, the COVID-19 vaccine message, and control groups that received Tdap (13% vs. 17% vs. 2%), HPV (12% vs. 10% vs. 7%) and MCV4 (12%) vs. 10% vs. 2%), the odds of receiving Tdap and MCV4 differed significantly within 8 weeks, with the message groups outperforming the control group. In per-protocol analyses, but not intent-to-treat analyses, adolescents in the standard message group (4.7%) were twice as likely than the control group (1.9%) to receive the COVID-19 vaccine (OR, 2.48) [95% CI: 1.05-5.86]).

Conclusion(s)

Awareness messages were minimally effective in re-engaging adolescents in preventive services. Efforts are needed to address the widening inequalities.

Tables and pictures

Figure 1: Awareness messages

Table 1: Baseline Characteristics

Table 2: Intent to treat analysis


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