Text Message Reminders for the Second Dose of Influenza Vaccine for Children: An RCT.

BACKGROUND AND OBJECTIVES: Among children requiring 2 influenza doses in a given season, second dose receipt nearly halves the odds of influenza. Nationally, many children do not receive both needed doses. This study sought to compare the effectiveness of text message reminders with embedded interactive educational information versus usual care on receipt and timeliness of the second dose of influenza vaccine. METHODS: This trial took place over the 2017 to 2018 and 2018 to 2019 influenza seasons among 50 pediatric primary care offices across 24 states primarily from the American Academy of Pediatrics' Pediatric Research in Office Settings practice-based research network. Caregiver-child dyads of children 6 months to 8 years in need of a second influenza vaccination that season were individually randomized 1:1 into intervention versus usual care, stratified by age and language within each practice. Intervention caregivers received automated, personalized text messages, including educational information. Second dose receipt by April 30 (season end) and by day 42 (2 weeks after second dose due date) were assessed using Mantel Haenszel methods by practice and language. Analyses were intention to treat. RESULTS: Among 2086 dyads enrolled, most children were 6 to 23 months and half publicly insured. Intervention children were more likely to receive a second dose by season end (83.8% versus 80.9%; adjusted risk difference (ARD) 3.8%; 95% confidence interval [0.1 to 7.5]) and day 42 (62.4% versus 55.7%; ARD 8.3% [3.6 to 13.0]). CONCLUSIONS: In this large-scale trial of primary care pediatric practices across the United States, text message reminders were effective in promoting increased and timelier second dose influenza vaccine receipt.

Food Marketing to Children Online: A Content Analysis of Food Company Websites.

Since 2006, many U.S. food and beverage companies have pledged to market healthier foods to children to help combat the childhood obesity epidemic. Despite this, companies' expenditures on online advertising have increased of late. To explore this seemingly contradictory situation, the authors conducted a content analysis of approximately 100 food and beverage brand websites, examining a multitude of online marketing practices across a variety of different products, as well as the relationship between marketing techniques and the nutritional profile of promoted foods. This is the first study to examine if nutrition varied by marketing technique. Few brands maintained child-oriented websites, but the brands that did have child-oriented websites included a large number of games promoting particularly obesogenic food products. Somewhat surprisingly, games with many brand identifiers were paired with slightly less obesogenic foods. These findings present a mixed picture of the threat posed by online child-oriented food marketing.