378 - Pediatric Practices’ Perceptions of Text Message Communication with Families: An AAP Pediatric Research in Office Settings (PROS) Study

Poster Board #: 378
Publication #: 3912-HP-QA.378

Background: Text messages can be an effective, low-cost and scalable mechanism of reminding patients about appointments, vaccinations, and other health information; however, they are yet to be consistently integrated into pediatric primary care.


Objective: To explore pediatric primary care clinicians and staff perceptions of pediatric office text message communication with families.


Design/Methods: As part of the NIH-funded Flu2Text randomized controlled trial (RCT) of 2^nd dose influenza vaccine text message reminders, in July-August 2019 we conducted 7 focus groups and 4 individual interviews (up to 1 hour each) with pediatric clinicians (16 pediatricians, 9 nurse practitioners), registered nurses (n=3), medical assistants (n=5) and staff (n=5). Overall, 10 PROS pediatric primary care practices in 10 states were selected for participation based on stratified sampling of those with the highest (n=5) and lowest (n=5) effect sizes out of 37 primary care practices in the RCT (Table 1). Semi-structured discussion guides included possible uses, perceived usefulness and ease of use of text messages; practice’s current text messaging infrastructure; and barriers/facilitators to future use of texting. Utilizing conceptual content analyses based on the Technology Acceptance Model transcripts were independently coded by 2 investigators using NVIVO 12 Plus. Inter-coder reliability was high (K= .86); discrepancies were resolved by consensus.


Results: Overall, participants were supportive of text reminders for 2^nd dose influenza vaccine, for other vaccines (e.g. HPV vaccine), and appointments (Table 2). Participants perceived text messaging as a preferred method of communication for caregivers. Health information privacy and patient confidentiality were the main concerns cited by clinicians and staff. Only practices with no internal appointment text-message reminder system (n=5) prior to the study, expressed concerns about technology implementation logistics, time and financial commitment. Themes did not differ between practices based on effect sizes in the RCT.

Conclusion(s): Text message reminders, for various uses, appear to be well accepted among a relatively diverse group of pediatric practices after participation in a trial of text message reminders for the 2^nd dose influenza vaccine. Pediatric practices expressed interest in using text messages; however, they also expressed the need to address privacy, confidentiality and resource barriers to facilitate successful implementation.

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Authors/Institutions: Ekaterina Nekrasova, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Alexander Fiks, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Chelsea S. Wynn, Columbia University, New York, New York, United States; Alessandra Torres, American Academy of Pediatrics, Itasca, Illinois, United States; Miranda Griffith, American Academy of Pediatrics, Itasca, Illinois, United States; Laura P. Shone, American Academy of Pediatrics, Itasca, Illinois, United States; Russell Localio, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States; Justine Shults, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States; Rebecca Unger, Northwestern Children’s Practice, Chicago, Illinois, United States; Leigh Ann Ware, Building Blocks Pediatrics, Pleasanton, Texas, United States; Melissa S. Stockwell, Columbia University Irving Medical Center, New York, New York, United States