Text message reminders to promote human papillomavirus vaccination.

OBJECTIVE: To implement and evaluate text message reminders for the second (HPV2) and third (HPV3) vaccine doses. DESIGN: Site-based intervention. SETTING: Nine pediatric sites (5 academic and 4 private) located in New York City. PARTICIPANTS: Parents of adolescents 9-20 years who received HPV1 or HPV2 during the intervention period- January-June 2009. INTERVENTION: Parents who enrolled received up to three weekly text message reminders that their daughter was due for her next vaccine dose. OUTCOME MEASURE: On-time receipt of the next vaccine dose- within one month of its due date. RESULTS: During the intervention period- of 765 eligible HPV vaccine events- 434 enrollment instructions were distributed to parents (56.7% of doses). Parents of 124 adolescent girls (28.6% of those handed instructions) activated text message reminders. Comparing children of parents who enrolled versus those who did not- on-time receipt of next HPV vaccine dose occurred among 51.6% (95% CI 42.8-60.4%) versus 35.0% (95% CI 29.6-40.2%) of adolescents (p=.001). Similarly- among a historical cohort of adolescents- receiving HPV1 or HPV2 in the six months prior to the intervention period- on-time receipt of next vaccine dose was noted for 38.1% (95% CI 35.2-41.0%) (p=.003). Increases in receipt of next vaccine dose among intervention subjects were sustained at 4 months following the vaccine due date. Using a logistic regression model- after controlling for insurance and site of care- intervention subjects were significantly more likely than either control population to receive their next HPV vaccine dose on-time. CONCLUSION: Among those choosing to enroll- text message reminders were an effective intervention to increase on-time receipt of HPV2 or HPV3.