Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

Text 4 Health: The Use of text message reminder-recalls to counter disparities in adolescent immunization coverage

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Project Number: R40 MC 08961-02
Grantee: Columbia University
Department/Center: General Pediatrics/Pediatrics
Project Date: 2/1/2008

Final Report

Text 4 Health: The Use of text message reminder-recalls to counter disparities in adolescent immunization coverage Final Report (PDF) Exit Disclaimer

Principal Investigator

Elyse Olshen-Kharbanda, MD, MPH
Assistant Clinical Professor
622 W 168th Street, VC402
New York, NY  10032-3727
Phone: (212) 305-7573


  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)


The introduction of three new vaccines to the routine adolescent immunization schedule provides an opportunity to greatly improve the health of our youth, by preventing meningitis, pertussis, genital warts and cervical cancer. However, these new vaccine recommendations also present significant challenges for medical providers and public health officials. Adolescents are the least frequent users of preventive health services and immunization coverage among adolescents has lagged far behind that of infants. Reminder recall systems have been shown to be an effective method for improving immunization coverage in pediatric and adult populations. The use of reminder recalls for the new adolescent vaccines has not been evaluated. Presently, 76% of Americans use the cellular network. Prior research by our team members suggests that text messages reminder recalls have the potential to impact immunization coverage by more effectively targeting low-income and increasingly mobile populations. In this proposal, we plan to implement and evaluate two unique complementary text messaging reminder recall strategies tailor-made to address adolescent-specific barriers to immunizations. We will target samples of parents of children 10-18 years old in a variety of communities and practice settings. Electronic and paper medical records will be used to assess responses to these reminder-recalls. These proposed interventions address many of the MCH strategic issues. First, we will be able to assess the feasibility of setting up an infrastructure linking immunization registries and text messaging platforms to increase immunization rates. Furthermore, the proposed reminder-recalls may help eliminate disparities in immunization coverage by using a method that may be more effective in reaching low-income populations. Finally, our interventions may improve quality of care for adolescents by increasing their protection against communicable infections and reconnecting them with a medical home, thus promoting the healthy development of this MCH population.


Listed is descending order by year published.

Kharbanda EO, Stockwell MS, Fox H, Ipp LS, Rickert VI. The role of human papillomavirus vaccination in promoting delivery of other preventive and medical services. Acad Pediatr. 2011 Jul-Aug;11(4):326-32.

Kharbanda EO, Stockwell M, Fox H, Rickert VI. Text4Health: a qualitative evaluation of parental readiness for text message immunization reminders. Am J Public Health. 2009 Dec;99(12):2176-8. Epub 2009 Oct 15.


Immunization, Health Information Technology, Health Disparities, Health Care Quality, Primary Care

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