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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. Parental Reminder and Recall Systems

Approach. Utilize parental reminder and recall systems to increase childhood vaccinations.

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Overview. Utilizing parental reminder and recall systems involves employing technology or communication strategies to remind parents about upcoming vaccinations and follow up with them if their child misses a scheduled immunization.[1] This approach offers an effective tool to increase childhood vaccination rates by prompting timely action and closing immunization gaps.[1] The system should utilize reliable communication methods, such as text messages, emails, or phone calls, to reach parents and guardians.[1] The reminders should be clear, concise, and provide information about the vaccine due, location of the appointment, and contact details for any questions.[1] A robust recall system should be established to identify children who miss appointments and proactively reach out to parents to reschedule vaccinations [1]. Examples of successful public health programs utilizing reminder and recall systems include initiatives by state immunization registries sending automated text message reminders to parents before appointments, and similar programs by healthcare providers offering online scheduling tools with built-in reminder notifications.[2] Peer-reviewed research has shown that reminder and recall systems can be a cost-effective strategy to improve childhood vaccination rates.[2] Studies have found that these systems can significantly increase on-time vaccination completion and reduce missed appointments, ultimately leading to higher overall immunization coverage.[3]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

This strategy is also supported as "Vaccination Programs: Client Reminder and Recall Systems" in The Community Guide.

This strategy is also supported as "Clinic-Based Interventions for Human Papillomavirus (HPV) Vaccination" in the What Works for Health database.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Electronic health record (EHR) data on reminders
  • Parent/caregiver satisfaction surveys
  • Parent/caregiver qualitative data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of healthcare practices and systems implementing parental reminder and recall systems for childhood vaccinations. (Measures adoption of evidence-based strategy)
  • Number of reminder and recall messages sent to parents about upcoming or overdue vaccinations for their children. (Shows outreach efforts)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of reminder and recall messages that are personalized with the child's name, recommended vaccines, and due dates. (Assesses tailoring and specificity of communication)
  • Percent of reminders and recalls delivered to parents using their preferred method of contact and at their preferred frequency. (Measures family-centered approach)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of healthcare organizations partnered with Title V that integrate their reminder and recall systems with regional or state immunization registries for seamless data exchange that results in improved efficiency. (Promotes data interoperability)
  • Number of partnerships led by Title V formed with community organizations, schools, and childcare centers to extend the reach and reinforcement of vaccination reminders to parents that report high levels of engagement. (Builds supportive ecosystem)
  • Number of healthcare provider teams that consistently achieve and sustain childhood vaccination rates through the use of parental reminder and recall systems. (Measures care team performance)
  • Number of related quality measures that show improvement across multiple payers and provider networks implementing reminder and recall. (Indicates system-wide impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of healthcare organizations partnered with Title V that integrate their reminder and recall systems with regional or state immunization registries for seamless data exchange that results in improved efficiency. (Promotes data interoperability)
  • Percent of partnerships led by Title V formed with community organizations, schools, and childcare centers to extend the reach and reinforcement of vaccination reminders to parents that report high levels of engagement. (Builds supportive ecosystem)
  • Percent of healthcare provider teams that consistently achieve and sustain childhood vaccination rates through the use of parental reminder and recall systems. (Measures care team performance)
  • Percent of related quality measures that show improvement across multiple payers and provider networks implementing reminder and recall. (Indicates system-wide impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Immunization Information Systems (IIS) | CDC. (n.d.). https://www.cdc.gov/vaccines/programs/iis/index.html

[2] Vann, J. C. J., Jacobson, R. M., Coyne‐Beasley, T., Asafu‐Adjei, J. K., & Szilagyi, P. G. (2018). Patient reminder and recall interventions to improve immunization rates. Cochrane Database of Systematic Reviews, (1).

[3] Pich, J. (2018). Patient reminder and recall interventions to improve immunization rates: A Cochrane review summary. International Journal of Nursing Studies, 91, 144-145.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.