Improving Vaccine Acceptance Through EHR Integrated Patient- and Provider-Facing Decision Support

NCT ID: NCT06482450

Last Updated: 2025-07-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-11

Study Completion Date

2026-06-30

Brief Summary

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The goal of this project is to establish the technical feasibility of a scalable, integrated platform to improve patient informed decision-making and increase vaccine uptake and to evaluate the effectiveness of the integrated platform to improve vaccine uptake.

Detailed Description

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The first study objective is to establish the technical feasibility of a scalable, integrated platform to improve patient informed decision-making and increase vaccine uptake. The investigators have established a partnership between vaccine safety and hesitancy experts at the Institute for Vaccine Safety at Johns Hopkins and clinical informatics and implementation experts at Emory University and Children's Healthcare of Atlanta (CHOA). This team will design a technology architecture to accomplish the following goals: (1) provide patients/parents with tailored vaccine messaging videos through the LetsTalkShots (LTS) platform; (2) leverage the same LTS logic that determines which videos are shown in LTS and push associated talking points into the EHR; (3) display patient-specific talking points at the right time in clinical workflows to promote an evidence-based vaccine conversation; (4) centralize maintenance of this messaging with the LTS application; (5) minimize resources required from each healthcare institution to go live with the integrated platform; and (6) establish revenue-generating mechanisms for LTS (e.g. licensing fees) and each healthcare institution (e.g. billing for vaccine counseling).

The second study objective is to evaluate the effectiveness of the integrated platform to improve vaccine uptake. First, providers at the CHOA Hughes Spalding Primary Care clinic will have two opportunities to participate in a 1 hour Continuing Medical Education (CME) session on evidence-based vaccine communication. For intervention visits, parents of undervaccinated patients with upcoming appointments will receive a text message appointment reminder with a link to an EHR-integrated questionnaire on vaccine intent and concerns. This questionnaire will drive the patient/parent to view tailored LTS videos, while pushing the associated talking points back to the clinician at the time of the appointment. For control visits, parents will receive appointment reminders per usual care. Primary outcome: Administration of recommended vaccines at the index appointment. Mixed effects multivariable logistic regression will evaluate the influence of the integrated platform on the primary outcome, adjusted for demographics.

The study hypothesis is that among visits with integrated decision support, vaccination rates will be 10% higher (absolute) than control visits with no such decision support.

Conditions

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Vaccine Hesitancy Vaccine Refusal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The investigators will perform a pseudo-randomized controlled trial in which parents of patients with odd birthdates (e.g. April 13) and vaccines due at the index appointment who also have a MYchart account will receive a text message directing the parent to the LTS server with integration into the provider workflow. Patients with an even birthdate (e.g. April 14) who have a MYchart account will receive a regular text message and e-mail appointment reminder with a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Among patients without a MYchart account, those with odd birthdates will receive a link to the LTS website (patient-facing CDS) but no integration into the provider workflow. As in the control group above, those without a MYchart account and an even birthdate (e.g. April 14) will receive a text message and e-mail appointment reminder with a vaccine primer but no patient- or provider-facing CDS.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Patient- and Provider-Facing CDS

Parents of patients with odd birthdates (e.g. April 13) and vaccines due at the index appointment who also have a MYchart account will receive a text message directing the parent to the LTS server with integration into the provider workflow

Group Type EXPERIMENTAL

LetsTalkShots (patient-facing CDS)

Intervention Type OTHER

LetsTalkShots is a website which provides patients/parents with tailored videos addressing vaccine concerns.

LetsTalkShots (provider-facing CDS)

Intervention Type OTHER

The provider-facing CDS component will propagate patient concerns obtained from LetsTalkShots (and the appropriate talking points to address the talking points) into the electronic health record (EHR) for the provider at the point of care.

Appointment Reminder Message

Intervention Type OTHER

The regular text message and e-mail appointment reminder includes a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Patient-Facing CDS Only

Among patients without a MYchart account, those with odd birthdates will receive a link to the LTS website (patient-facing CDS) but no integration into the provider workflow.

Group Type EXPERIMENTAL

LetsTalkShots (patient-facing CDS)

Intervention Type OTHER

LetsTalkShots is a website which provides patients/parents with tailored videos addressing vaccine concerns.

Appointment Reminder Message

Intervention Type OTHER

The regular text message and e-mail appointment reminder includes a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Control (MYchart account)

Patients with an even birthdate (e.g. April 14) who have a MYchart account will receive a regular text message and e-mail appointment reminder with a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Group Type PLACEBO_COMPARATOR

Appointment Reminder Message

Intervention Type OTHER

The regular text message and e-mail appointment reminder includes a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Control (no MYchart account)

As in the other control group, those without a MYchart account and an even birthdate (e.g. April 14) will receive a text message and e-mail appointment reminder with a vaccine primer but no patient- or provider-facing CDS.

Group Type PLACEBO_COMPARATOR

Appointment Reminder Message

Intervention Type OTHER

The regular text message and e-mail appointment reminder includes a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Interventions

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LetsTalkShots (patient-facing CDS)

LetsTalkShots is a website which provides patients/parents with tailored videos addressing vaccine concerns.

Intervention Type OTHER

LetsTalkShots (provider-facing CDS)

The provider-facing CDS component will propagate patient concerns obtained from LetsTalkShots (and the appropriate talking points to address the talking points) into the electronic health record (EHR) for the provider at the point of care.

Intervention Type OTHER

Appointment Reminder Message

The regular text message and e-mail appointment reminder includes a vaccine primer (e.g. "Vaccines are due and reserved for the participant's child"), but no patient- or provider-facing CDS.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient has an upcoming appointment in 2 business days at Children's Healthcare of Atlanta Hughes Spalding Primary Care Clinic.
* A valid mobile phone number or e-mail address is available in the EHR as of 2 business days prior to the appointment date.

Phase 1: COVID-19 Vaccine only:

* Due for a COVID-19 vaccine based on Epic Systems© COVID-19 vaccine health maintenance topic.

Phase 2: All Vaccines:

* Due for any vaccines based on Epic Systems© implementation using health maintenance topics of the Centers for Disease Control CDS for Immunization (CDSi) specifications.

Exclusion Criteria

* None
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Children's Healthcare of Atlanta

OTHER

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role collaborator

Merck & Company

UNKNOWN

Sponsor Role collaborator

Johns Hopkins Bloomberg School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Daniel Salmon, PhD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Locations

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Children's Healthcare of Atlanta Hughes Spalding Primary Care Clinic

Atlanta, Georgia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Michelle Goryn

Role: CONTACT

919-357-2484

Facility Contacts

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Role: primary

404-785-9850

Other Identifiers

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IRB00024984

Identifier Type: -

Identifier Source: org_study_id

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