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JMIR Res Protoc. 2016 May 17;5(2):e72. doi: 10.2196/resprot.5030.
Gibson DG1 Kagucia EW Ochieng B Hariharan N Obor D Moulton LH Winch PJ Levine OSOdhiambo F OBrien KL Feikin DR.
Text message (short message service SMS) reminders and incentives are two demand-side interventions that have been shown to improve health care-seeking behaviors by targeting participant characteristics such as forgetfulness lack of knowledge and transport costs. Applying these interventions to routine pediatric immunizations may improve vaccination coverage and timeliness.
The Mobile Solutions for Immunization (M-SIMU) trial aims to determine if text message reminders either with or without mobile phone-based incentives sent to infants parents can improve immunization coverage and timeliness of routine pediatric vaccines in rural western Kenya.
This is a four-arm cluster randomized controlled trial. Villages are randomized to one of four study arms prior to enrollment of participants. The study arms are: (1) no intervention (a general health-related text message will be texted to this group at the time of enrollment) (2) text message reminders only (3) text message reminders and a 75 Kenyan Shilling (KES) incentive or (4) text message reminders and a KES200 incentive. Participants assigned to study arms 2-4 will receive two text message reminders; sent 3 days before and one day before the scheduled immunization visit at 6 10 and 14 weeks for polio and pentavalent (containing diphtheria tetanus pertussis hepatitis B and Haemophilus influenza type b antigens) type b antigens) vaccines and at 9 months for measles vaccine. Participants in incentive arms will in addition to text message reminders as above receive mobile phone-based incentives after each timely vaccination where timely is defined as vaccination within 2 weeks of the scheduled date for each of the four routine expanded program immunization (EPI) vaccination visits. Mother-infant pairs will be followed to 12 months of age where the primary outcome a fully immunized child will be ascertained. A fully immunized child is defined as a child receiving vaccines for bacille Calmette-Guerin three doses of pentavalent and polio and measles by 12 months of age. General estimating equation (GEE) models that account for clustering will be employed for primary outcome analyses.
Enrollment was completed in October 2014. Twelve month follow-up visits to ascertain immunization status from the maternal and child health booklet were completed in February 2016.
This is one of the first studies to examine the effect of text message reminders on immunization coverage and timeliness in a lower income country and is the first study to assess the effect of mobile money-based incentives to improve immunization coverage.
Clinicaltrials.gov NCT01878435; https://clinicaltrials.gov/ct2/show/NCT01878435 (Archived by WebCite at http://www.webcitation.org/6hQlwGYJR)