Text, phone messages minimally effective in re-engaging adolescents in primary care

DENVER — Text and phone messages were minimally effective at re-engaging adolescents in preventive services, according to data presented at the Pediatric Academic Societies Meeting.

Researchers sought to determine the effectiveness of text and telephone outreach messages — with and without information about COVID-19 vaccine availability — on the scheduling and completion of well-care visits among adolescents due for preventive services during the spring and summer of 2021.

Co-author Mary Burkhardt, MD, MHA, associate division director of primary care at

Cincinnati Children's Hospital Medical Center, said in a Healio interview that the idea for the study came from a practical issue for many primary care practices during the pandemic.

“We take care of a majority low-income, majority Black population that clearly suffered a lot during the pandemic, we had many visits that were canceled and delayed,” Burkhardt said. “And we were looking for different ways to reengage our patients in care, as well as alert them that the COVID-19 vaccine was available for kids 12 and older.”

Burkhardt and colleagues conducted an intent-to-treat, multiarm, randomized clinical trial from May 28 to Aug. 5, 2021, at three academic pediatric primary care practices serving 36,000 predominantly minority, low-income children. A total of 1,235 adolescents aged between 12 and 17 were randomly assigned to a 412-patient standard message group, which would receive a phone or text message requesting to be called back to make an appointment; a 411-patient COVID-19 vaccine message group, receiving the same message mentioned but with the addition of COVID-19 vaccine availability; or a 412-person no message group that served as the control group.

The researchers then delivered two automated text reminders or phone calls — based on family preference — to the message groups over the course of the study period.

Ultimately, the standard message groups (10.4%) had higher rates of scheduling an adolescent well-care visit within 2 weeks compared with the COVID-19 (6.6%) and control (5.3%) groups, although the odds did not differ significantly. Further, the researcher found only mild differences in the rates of completing their well-care visit or receipt of COVID-19 vaccine within 8 weeks.

“I think we were surprised in that the interventions that we had were fairly low-cost, low-intensity interventions, and they were helpful in getting patients to schedule their visits, but they were not as effective as we had hoped in the completion of visit,” Burkhardt said. “It really showed that more intensive and more diverse sorts of interventions are needed to reengage patients in care after the pandemic.”

Reference:

Burkhardt M, et al. Effect of outreach reminders on adolescent well child visits and COVID-19 vaccination rates: a randomized clinical trial. Presented at: Pediatric Academic Societies Meeting; April 21-25, 2022.