학술논문

Effectiveness of digital technologies at improving vaccine uptake and series completion – A systematic review and meta-analysis of randomized controlled trials.
Document Type
Article
Source
Vaccine. May2019, Vol. 37 Issue 23, p3050-3060. 11p.
Subject
*DIGITAL technology
*RANDOMIZED controlled trials
*META-analysis
*VACCINES
*PARENT-child relationships
*PUBLICATION bias
Language
ISSN
0264-410X
Abstract
• 13 RCTs from 2012 to 2016 examined digital push interventions on vaccination. • Digital push arms had 1.18[1.11,1.25] the odds of vaccination compared to controls. • Heterogeneity was high (i2 = 86%) and certainty of evidence was moderate to very low. • While promising, further evaluation of digital push for vaccination is warranted. Recent outbreaks and renewed concerns about immunization coverage call for new and effective interventions to improve vaccine uptake. Digital technologies have the potential to help address both suboptimal vaccine uptake and series completion. However, the effectiveness of pushing information and reminders to patients through digital technologies to address vaccination is not known. The aim of this study is to determine if digital push interventions are effective in increasing vaccine uptake and series completion compared to non-digital interventions. We searched for RCTs where adults or parents of children were eligible for vaccination, the intervention was digital-push and the comparison group was non-digital. We included outcomes of vaccine uptake or series completion. We estimated summary effect sizes, heterogeneity using the χ2 test and quantified using the I2 statistic. Where heterogeneity remained significant, we conducted subgroup analyses. We assessed risk of bias, certainty of evidence and publication bias. The search identified 159 peer-reviewed scientific publications. After review, a total of 12 manuscripts representing 13 empirical studies published between 2012 and 2016 were included. When comparing digital push interventions to non-digital ones, patients had 1.18[1.11,1.25] the odds of receiving vaccination or series completion compared to controls. In parents of children aged 18 and younger, those receiving digital push had a 1.22[1.15,1.30] increased odds compared to controls. Both analyses had high statistical heterogeneity, with I2 values of 86% and 79% respectively. The risk of bias was low with 10 of 13 studies considered low risk in five or more domains. The certainty of evidence for series completion was very low and for vaccine uptake was assessed to be moderate. This study provides evidence that digital push technologies have a modest, positive impact on vaccine uptake and series completion compared to non-digital interventions. [ABSTRACT FROM AUTHOR]