JMIR Publications

ABSTRACT

Background:

Mobile health (MHealth) is quickly expanding as a method of health promotion, but some interventions may not be familiar or comfortable for potential users. Text-messaging has been investigated as a low-cost, accessible way to provide vaccine reminders. Most (97%) U.S. adults own a cellphone and of those most use text messaging. However, understanding patterns of text message plan type and use in diverse primary care populations needs more investigation.

Objective:

We sought to use a survey to examine baseline text messaging and data plan patterns among families willing to accept text message vaccine reminders.

Methods:

As part of an NIH-funded national study (Flu2Text) conducted during the 2017-18 and 2018-19 influenza seasons, families of children needing a 2nd seasonal influenza vaccine dose were recruited in pediatric primary care offices at the time of their 1st dose. Practices were from the American Academy of Pediatrics’ PROS research network, the Children’s Hospital of Philadelphia, and Columbia University. A survey was administered via telephone (Season 1) or electronically (Season 2) at enrollment. Standardized (adjusted) proportions for text message plan type and texting frequency were calculated using logistic regression that adjusted for child and caregiver demographics.

Results:

Responses were collected from 1,439 participants (69.0% of enrolled). Mean caregiver age was 32 (± 6 years), and most children (94.2%) were 6 to 23 months old. Most (94.3%) families were English-speaking. Most (92.8%) but not all participants had an unlimited texting plan and sent/received texts at least once daily (91.5%). Text-messaging plan type and use at baseline was uniform across most but not all subgroups. However, there were some differences in the study population’s text message plan type and usage. Caregivers who wanted Spanish text messages were less likely than those who chose English to have an unlimited text-messaging plan (86.7% vs. 94.0%) (risk difference -7.2%; 95% confidence interval (CI) [-27.1, -1.8]). There were no significant differences in having an unlimited plan associated with child’s race, ethnicity, age, health status, insurance type, or caregiver education level. Text messaging use at baseline was not uniform across all subgroups. Nearly three-quarters (71.2%) of participants had received some form of text message from their doctor’s office; most common were appointment reminders (98.5%), prescription (28.6%) and laboratory notifications (11.5%). Even the majority (62.1%) of those who did not have unlimited plans and who texted less than daily (60.1%) reported receipt of these text messages.

Conclusions:

In this study, most participants had access to unlimited texting plans and texted at least once daily. However, infrequent texting and lack of access to an unlimited text-messaging plan did not preclude enrolling to receive text message reminders in pediatric primary care settings.