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The impact of computer-generated messages on childhood immunization coverage.

AbstractINTRODUCTION:
Recent evaluations of computer-generated reminder/recall messages have suggested that they are an inexpensive, labor-saving method of improving office visitation rates of childhood immunization providers. This study assesses the sustained impact of computer-generated messages on immunization coverage during the first two years of life.
DESIGN:
Randomized, controlled trial.
SETTING:
County health department in the Denver metropolitan area.
STUDY PARTICIPANTS:
Children (n = 1227) 60 to 90 days of age who had received the first dose of diphtheria-tetanus-pertussis (DTP) and/or poliovirus vaccines.
INTERVENTION:
Households of children were randomized into four groups to receive: telephone messages followed by letters (Group A); telephone messages alone (Group B); letters only (Group C); or no notification (Group D). Households in the intervention groups (A, B, and C) received up to five computer-generated telephone messages and/or up to four letters each time their children became due for immunization(s).
MAIN OUTCOME MEASURE:
Immunization series completion at 24 months of age.
RESULTS:
Children whose families were randomized to receive any of the interventions were 21% more likely to have completed the immunization series by 24 months of age than were children randomized into the control group (49.2% vs 40.9%; RR [rate ratio] = .21; CI [confidence interval] = 1.01, 1.44). While not statistically significant, children in Group A were 23% more likely to complete their immunization series by 24 months of age than those in the control group (50.2% vs 40.9%; RR = 1.23; CI = 1.00, 1.52). No differences were detected among the intervention groups. The costs per additional child completing the series by 24 months of age in Group A was $226 ($79 after start-up costs were discounted).
CONCLUSION:
Computer-generated contacts, either by phone or by mail (or both combined), used each time vaccines become due, are efficacious in increasing immunization coverage of children under 2 years of age.
AuthorsE F Dini, R W Linkins, J Sigafoos
JournalAmerican journal of preventive medicine (Am J Prev Med) Vol. 18 Issue 2 Pg. 132-9 (Feb 2000) ISSN: 0749-3797 [Print] Netherlands
PMID10698243 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Poliovirus Vaccine, Inactivated
Topics
  • Child Health Services (organization & administration)
  • Colorado
  • Computer Systems
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Humans
  • Immunization (statistics & numerical data)
  • Immunization Schedule
  • Infant
  • Patient Compliance
  • Poliovirus Vaccine, Inactivated
  • Reminder Systems (economics)
  • Urban Population

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