KEYWORDS:
reminder/recall, vaccination coverage, immunization registry

BACKGROUND:
Studies are needed to determine the most effective way to use immunization registry-generated reminders among diverse populations.

OBJECTIVE(S):
To test the effectiveness of registry reminders on use of services and immunization status in an inner city population.

METHOD(S):
We are conducting a 6-month, randomized, controlled trial of registry-generated postcard reminder/recalls at 5 practices in New York City. At the outset, registry data for children <18 months was 99% concordant with medical charts. A random sample of 2,007 children <16 months due/ overdue for any DTaP were randomized to a control group (n=662) and a reminder/recall group for 3-6 months (n=1,345). Children with a visit within 1 month of recommended AAP schedule prior to enrollment were considered active. Outcome measures were visits, immunizations delivered, and 4:3:1:3 up-to-date status 2 months after enrollment.

RESULT(S):
At enrollment, 60% were <12 months; 77% were Hispanic and 13% African American. 28% were sent 1 reminder, 44% 2, and 28% 3+. 11% of postcards were returned. After 2 months , there was no difference between the control and the reminder groups in the percentage making a visit (45% vs. 46%), receiving immunizations (34% vs. 35%), or being up-to-date (52% vs. 51%). In both groups, active patients were more likely to make a visit (63% vs. 20%) (OR=3.2, 95% CI=2.8–3.6). The effect of the reminders varied significantly by practice, with a greater effect in smaller practices. At smaller practices, active patients were 1.2 times more likely to receive an immunization (95% CI=1.0-1.4).

CONCLUSIONS(S):
In inner city practices, the effect of registry-generated postcard reminders appears to be practice dependent. Postcards are not effective to recall inactive patients.

LEARNING OBJECTIVES:
examine the effectiveness of registry generated reminders/recalls.