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CC BY-NC-ND 4.0 · ACI open 2023; 07(01): e8-e15
DOI: 10.1055/s-0043-1763270
Original Article

Pediatric Practices' Perceptions of Text Message Communication with Families: An American Academy of Pediatrics (AAP), Pediatric Research in Office Settings (PROS) Study

Ekaterina Nekrasova
1   Clinical Futures & Department of Pediatrics, The Children's Hospital of Philadelphia, Pennsylvania, United States
,
Alexander G. Fiks
1   Clinical Futures & Department of Pediatrics, The Children's Hospital of Philadelphia, Pennsylvania, United States
,
Chelsea Wynn
2   Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, United States
,
Alessandra Torres
3   Department of Research, American Academy of Pediatrics, Itasca, Illinois, United States
,
Miranda Griffith
3   Department of Research, American Academy of Pediatrics, Itasca, Illinois, United States
,
Laura P. Shone
3   Department of Research, American Academy of Pediatrics, Itasca, Illinois, United States
,
Russell Localio
4   Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Justine Shults
4   Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Rebecca Unger
5   Northwestern Children's Practice, Chicago, Illinois, United States
,
Leigh Ann Ware
6   Building Blocks Pediatrics, Pleasanton, Texas, United States
,
Melissa S. Stockwell
2   Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, United States
7   Department of Population and Family Health, Columbia University Irving Medical Center, New York City, New York, United States
› Author Affiliations Funding The authors thank all Flu2Text practices (see list of below), pediatricians, nurse practitioners, other physicians, staff, parents, and families who participated in our overall study, and the Survey Research Lab at the University of South Carolina's Institute for Public Service and Policy Research. This work was supported by the National Institutes of Health (NIH) National Institute of Child Health and Health Development (NICHD) grant number R01HD086045 (PI: Stockwell, Fiks). Additional infrastructure funding was provided by the American Academy of Pediatrics and the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under UA6MC15585 - National Research Network to Improve Children's Health and U5DMC39344 - Pediatric Research Network Program. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government. Flu2Text practices participating in the overall, larger study, who agreed to be acknowledged included: ABC Pediatrics, PC; Advanced Pediatrics, PC; All Pediatrics, PC; Altru Health System; Anaconda Pediatrics; Anchorage Pediatric Group; Ashley Clinic; Atlantic Coast Pediatrics; Bethesda Pediatrics; Bozeman Health Pediatrics; Building Blocks Pediatrics; Burlington Pediatrics; Cambridge Pediatrics; Child Health Partners, PC; Childhood Health Associates of Salem; Clinch Valley Physicians Associates; Dowd Medical Associates; Elmwood Pediatric Group, LLP; Fishing Bay Family Practice; Goshen - Columbus Pediatrics & Adolescent Care; Hirsch Pediatrics, LLC; Holyoke Pediatric Associates; Ivancic Pediatric Clinic, PA; Mesa Pediatrics; One Hanson Place Pediatrics, PC; OHSU Doernbecher Pediatrics - Westside Clinic; Pediatric & Adolescent Healthy Lifestyle Center; Pediatric Associates of Davidson County, PA; Pediatric Associates of Medford; Pediatrics by the Sea; Pennridge Pediatric Associates; Prattville Pediatrics; Priority Care Pediatrics; Purohit Pediatric Clinic; Quality Kids Kare, PC; Scarano & Taylor Pediatrics; Southeastern Pediatric Associates; Southwest Montana (SW MT) Clinic; Springfield Pediatrics; Sunset Park Family Health Center at NYU Langone; Swafford Pediatrics; The Child & Teen Wellness Center; UNM Pediatrics - 3ACC Faculty Clinic; Zaheer Pediatrics & Associates, SC; Zimble & Reinstein Pediatrics.
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Abstract

Background Text messages can be an effective and low-cost mechanism for patient reminders; however, they are yet to be consistently integrated into pediatric primary care.

Objective The aim of this study was to explore pediatric primary care clinician and staff perceptions of pediatric office text message communication with families.

Methods As part of the National Institutes of Health–funded Flu2Text randomized controlled trial of second-dose influenza vaccine text message reminders, we conducted 7 focus groups and 4 individual interviews in July–August 2019 with primary care pediatric clinicians and staff (n = 39). Overall, 10 Pediatric Research in Office Settings (PROS) pediatric practices in 10 states were selected using stratified sampling. Semi-structured discussion guides included perspectives on possible uses, perceived usefulness, and ease of use of text messages; practices' current text messaging infrastructure; and perceived barriers/facilitators to future use of texting. Two investigators independently coded and analyzed transcripts based on the technology acceptance model using NVIVO 12 Plus (intercoder reliability, K = 0.86).

Results Overall, participants were supportive of text reminders for the second-dose influenza vaccine, other vaccines, and appointments and perceived texting as a preferred method of communication for caregivers. Health information privacy and patient confidentiality were the main concerns cited. Only respondents from practices with no internal appointment text message reminder system prior to the study expressed concerns about technology implementation logistics, time, and cost.

Conclusion Text message reminders, for various uses, appear to be well accepted among a group of geographically widespread pediatric practices after participation in a trial of influenza vaccine text message reminders. Privacy, confidentiality, and resource barriers need to be addressed to facilitate successful implementation.

Keywords

text message reminders - texting in pediatrics - Pediatric Research in Office Settings (PROS) - primary care

Protection of Human and Animal Subjects Protections

The study was approved by the Institutional Review Boards of the Children's Hospital of Philadelphia (CHOP), Columbia University, and the AAP.


Supplementary Material



Publication History

Received: 19 May 2022

Accepted: 26 December 2022

Article published online:
16 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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