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Randomized Controlled Trial
. 2015 Oct;49(4):563-72.
doi: 10.1016/j.amepre.2015.04.029. Epub 2015 Jul 29.

Encouraging Influenza Vaccination Among Text4baby Pregnant Women and Mothers

Elizabeth T Jordan  1 , Jessica A Bushar  2 , Juliette S Kendrick  3 , Pamela Johnson  4 , Jiangxia Wang  5
Affiliations
Randomized Controlled Trial

Encouraging Influenza Vaccination Among Text4baby Pregnant Women and Mothers

Elizabeth T Jordan et al. Am J Prev Med. 2015 Oct.

Abstract

Introduction: Pregnant women, postpartum women, and infants are at high risk for complications from influenza. From October to November 2012, Text4baby, a free national text service for pregnant women and mothers of infants aged <1 year, implemented a module of interactive messages encouraging maternal influenza vaccination. A program evaluation examined whether a text-based reminder or tailored education improved self-reported influenza vaccination or intent to be vaccinated later in the influenza season among Text4baby participants.

Methods: Nearly one third (28,609/89,792) of enrollees responded to a text asking about their vaccination plans. Those planning to receive vaccination were randomly assigned to receive an encouragement message or an encouragement message plus the opportunity to schedule a reminder (n=3,021 at follow-up). Those not planning to be vaccinated were randomly assigned to receive general education or education tailored to their reason for non-vaccination (n=3,820 at follow-up). The effect of the enhanced messages was assessed using multinomial logistic regression in 2013-2014.

Results: A reminder increased the odds of vaccination at follow-up among mothers (AOR=2.0, 95% CI=1.4, 2.9) and of continued intent to be vaccinated later in the season (pregnant, AOR=2.1, 95% CI=1.4, 3.1; mother, AOR=1.7, 95% CI=1.1, 2.5). Among mothers not planning to be vaccinated because of cost, those who received a tailored message about low-cost vaccination had higher odds of vaccination at follow-up (AOR=1.9, 95% CI=1.1, 3.5). Other tailored messages were not effective.

Conclusions: Text reminders and tailored education may encourage influenza vaccination among this vulnerable population; both have now been incorporated into Text4baby.

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Figures

Figure 1.
Figure 1.
Overview of Text4baby influenza module flow, message content and participant response.
Figure 2.
Figure 2.
Tailored education message content for Text4baby participants not planning at baseline to get vaccinated.
See this image and copyright information in PMC

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