Patient Portal Reminder/Recall for Influenza Vaccination in a Health System- RCT 2
NCT ID: NCT04110314
Last Updated: 2022-05-05
Study Results
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View full resultsBasic Information
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COMPLETED
NA
430636 participants
INTERVENTIONAL
2019-10-18
2020-04-01
Brief Summary
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Despite the Advisory Committee on Immunization Practices (ACIP) recommendation in 2010 that all people above 6 months of age should receive an annual flu vaccine, vaccination rates remain low. The investigators will assess the effectiveness of message-framing (gain-framed, loss-framed messages, no messages), as well as the effectiveness of a pre-commitment prompt (pre-commitment prompt, no prompt) asking about a patient's intention to get the influenza vaccination, using a 3 x 2 factorial design.
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Detailed Description
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Reminder/recall (R/R), sent by phone, mail or other modality, can improve child and adult influenza vaccination rates. However, the majority of pediatric or adult primary care practices to not conduct R/R. Barriers are lack of finances, personnel, and algorithms to identify eligible patients.
A technological breakthrough that might overcome these barriers involves patient portals-- secure, web-based communication systems, embedded within electronic health records (EHRs), for patients and providers to communicate with each other via email and the internet. Portals are used by about half of Americans and half of UCLA patients.
There has been considerable research on how best to communicate about vaccines with families. A number of studies have examined the impact of gain-framed (messages emphasizing the benefits of vaccination) versus loss-framed (messages emphasizing the risks of not getting vaccinated); however, the findings have been inconsistent across studies and by sub-population.
In addition to framing, another potential influence on the decision to vaccinate is pre-commitment. Previous studies suggest that, upon being prompted, indicating an intention to do something increases the likelihood of following through. Therefore, a pre-commitment prompt is being asked of half the participants in each arm to evaluate its impact on influenza vaccination.
The purpose of this randomized controlled trial is to evaluate the impact of gain-framed and loss-framed reminder-recall messages sent via the patient portal, pre-commitment prompts sent via the patient portal, and the interactions between the two type of messages and pre-commitment on influenza vaccination among UCLA Health System's primary care patients aged 6 months and older.
The proposed design of this randomized-controlled trial is a 3 x 2 factorial design.
Standard of care control (no reminder messages, no pre-commitment prompt) No portal messages, pre-commitment prompt Gain-framed portal messages, pre-commitment prompt Gain-framed portal messages, no pre-commitment prompt Loss-framed portal messages, pre-commitment prompt Loss-framed portal messages, no pre-commitment prompt
Hyp 1. Vaccination rates will differ by receipt of no reminders, gain-framed reminders and loss-framed reminders.
1a. Vaccination rates will be higher among patients receiving gain-framed reminders than among patients receiving no reminders.
1b. Vaccination rates will be higher among patients receiving loss-framed reminders than among patients receiving no reminders.
1c. Vaccination rates will be higher among patients receiving gain-framed reminders than among patients receiving loss-framed reminders.
Hyp 2. Vaccination rates will be higher among patients receiving a pre-commitment prompt than among patients not receiving any prompt.
For relevant study arms, the first R/R messages will be sent in October 2019.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
HEALTH_SERVICES_RESEARCH
SINGLE
Study Groups
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Gain-framed portal reminders + Pre-commitment Prompts
Participants receive gain-framed reminder/recall messages regarding influenza vaccination via the patient portal and a pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
Portal Reminders for Influenza Vaccination: Gain-framed
Patients receive gain-framed reminder/recall messages via the patient portal to get an influenza vaccination.
Pre-commitment prompt
Patients receive a pre-commitment prompt asking about their intention to get an influenza vaccination
Gain-framed portal reminders + No pre-commitment prompt
Participants receive gain-framed reminder/recall messages regarding influenza vaccination via the patient portal and no pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
Portal Reminders for Influenza Vaccination: Gain-framed
Patients receive gain-framed reminder/recall messages via the patient portal to get an influenza vaccination.
Loss-framed portal reminders + Pre-commitment prompt
Participants receive loss-framed reminder/recall messages regarding influenza vaccination via the patient portal and a pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
Portal Reminders for Influenza Vaccination: Loss-framed
Patients receive loss-framed reminder/recall messages via the patient portal to get an influenza vaccination.
Pre-commitment prompt
Patients receive a pre-commitment prompt asking about their intention to get an influenza vaccination
Loss-framed portal reminders + No pre-commitment prompt
Participants receive loss-framed reminder/recall messages regarding influenza vaccination via the patient portal and a no pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
Portal Reminders for Influenza Vaccination: Loss-framed
Patients receive loss-framed reminder/recall messages via the patient portal to get an influenza vaccination.
No portal reminder + Pre-commitment prompt
Participants do not receive any reminder/recall messages regarding influenza vaccination via the patient portal but do receive a pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
Pre-commitment prompt
Patients receive a pre-commitment prompt asking about their intention to get an influenza vaccination
No portal reminders + No pre-commitment prompt
Participants do not receive any reminder/recall messages regarding influenza vaccination via the patient portal and do not receive a pre-commitment prompt asking if they plan to receive the influenza vaccine in the upcoming season
No interventions assigned to this group
Interventions
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Portal Reminders for Influenza Vaccination: Gain-framed
Patients receive gain-framed reminder/recall messages via the patient portal to get an influenza vaccination.
Portal Reminders for Influenza Vaccination: Loss-framed
Patients receive loss-framed reminder/recall messages via the patient portal to get an influenza vaccination.
Pre-commitment prompt
Patients receive a pre-commitment prompt asking about their intention to get an influenza vaccination
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
4 Months
ALL
No
Sponsors
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University of California, Los Angeles
OTHER
Responsible Party
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Peter G Szilagyi, MD MPH
Principal Investigator
Principal Investigators
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Peter G Szilagyi, MPH, MD
Role: PRINCIPAL_INVESTIGATOR
University of California, Los Angeles
Locations
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University of California LA
Los Angeles, California, United States
Countries
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References
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Szilagyi PG, Albertin CS, Casillas A, Valderrama R, Duru OK, Ong MK, Vangala S, Tseng CH, Humiston SG, Evans S, Sloyan M, Bogard JE, Fox CR, Lerner C. Effect of Personalized Messages Sent by a Health System's Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial. J Gen Intern Med. 2022 Feb;37(3):615-623. doi: 10.1007/s11606-021-07023-w. Epub 2021 Sep 1.
Lerner C, Albertin C, Casillas A, Duru OK, Ong MK, Vangala S, Humiston S, Evans S, Sloyan M, Fox CR, Bogard JE, Friedman S, Szilagyi PG. Patient Portal Reminders for Pediatric Influenza Vaccinations: A Randomized Clinical Trial. Pediatrics. 2021 Aug;148(2):e2020048413. doi: 10.1542/peds.2020-048413.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
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