Novel Immunization Reminder/Recall Approaches: Rural and Urban Differences in Parent Perceptions

OBJECTIVE: To assess the following among parents of young children: 1) preferences about the source of immunization reminder/recall (R/R) messages, 2) the degree of acceptability of different R/R modalities, and 3) factors that influence preferences, including rural and urban characteristics. METHODS: We conducted a survey among parents of children 19 to 35 months old who needed immunization according to the Colorado Immunization Information System (CIIS). Equal numbers of urban and rural respondents were randomly selected. Up to 4 surveys were mailed to each parent who had a valid address. RESULTS: After removing invalid addresses, the response rate was 55% (334 of 607). Half of parents (49.7%) had no preference about whether the public health department or their child's doctor sent reminders. Urban parents were more likely to prefer R/R come from their child's doctor (46.7%) compared to rural parents (33.7%), P =.003. Mail was the preferred R/R method (57.7%), then telephone (17.0%), e-mail (12.7%), and text message (10.7%). Although not preferred, 60.1% reported it would be acceptable to receive R/R by e-mail and 46.2% by text message. Factors associated with preferring to receive R/R. from their child's doctor were urban residence and educational level of college graduate or greater. CONCLUSIONS: A large portion of parents are willing to be reminded about vaccinations by their health department rather than their child's provider and via novel modalities, such as e-mail or text messaging. Urbanicity and higher educational level were associated with preferring that FIR come from a provider.