Twilio Well-Child Visit Pilot Open Trial

Not Applicable

Completed

• Conditions: Child Health; Text Messaging
• Interventions: Other: Text message reminders; Other: Interviews; Other: Survey

• Registration Number: NCT05189080
• Lead Sponsor: Wake Forest University Health Sciences

Brief Summary

This project will use Twilio as a platform for a text messaging campaign to implement timely follow up with parents/guardians of children ages 0 to 17 years who have no-showed for WCVs. The first phase of the study will be an open trial to assess feasibility and acceptability of three different reminder messages, analyze preliminary data, and collect feedback from participants using interviews to identify the top one or two performing messages. Each reminder message will at minimum direct parents/guardians to reschedule by phone or by the patient portal. These findings will be used to conduct the second phase of the study, a randomized controlled trial.

Detailed Description

Well-Child visits (WCV) are an opportunity to maximize the health and future well-being and development of children. Missed visits, however, can result in negative outcomes for patients and families and for the healthcare system. For patients, missed primary care visits can result in greater Emergency Department (ED) visits and hospitalizations, and in delays in diagnosing a variety of medical conditions, including identification of child abuse and neglect. For healthcare systems, missed visits result in decreased efficiency, lower quality measures, decreased provider productivity, and loss in revenue. Although smart phones are nearly ubiquitous, even among more economically disadvantaged populations, literature to date has reported only on using text messages for pre-visit reminders. There is a tremendous opportunity to study use of text messaging to engage families in follow-up for missed WCV. Even more so, testing the use of text messages with different content is missing, as well as using text messages to invite patients to share reasons for missing the last WCV.

Study Timeline

• Study Start: 2021-12-17
• Study First Submitted: 2021-12-29
• Study First Submitted QC: 2021-12-29
• Study First Posted: 2022-01-12
• Primary Completion: 2022-04-08
• Study Completion: 2022-04-08
• Status Verified: 2022-05
• Last Update Submitted: 2022-06-30
• Last Update Posted: 2022-07-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 500

Inclusion Criteria

Patients included in text messaging campaign (caregivers receive text messages):

• Are 0-17 years
• No-showed for a well-child visit scheduled at one of five locations: Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, or Pediatrics-Clemmons
• Have a phone number on record for a primary caregiver
• With primary language for contact that is English or Spanish

Caregivers must be 18 years or older

Exclusion Criteria

Patients who:

• Are 18+ years old
• No-showed for a different type of visit, or no-showed for a WCV at a different practice location
• Already rescheduled their appointment by the time the sample list was generated
• Have primary language specified that is not English or Spanish.

Caregivers who are under 18 years old

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Open Trial	Interviews	Patients within the Wake Forest Baptist Health system who no-showed for scheduled well child visits at Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, and Pediatrics-Clemmons.
Open Trial	Text message reminders	Patients within the Wake Forest Baptist Health system who no-showed for scheduled well child visits at Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, and Pediatrics-Clemmons.
Open Trial	Survey	Patients within the Wake Forest Baptist Health system who no-showed for scheduled well child visits at Pediatrics-Downtown Health Plaza, Family Medicine-Piedmont Plaza, Pediatrics-Winston East, Family Medicine-Peace Haven, and Pediatrics-Clemmons.

Primary Outcome Measures

Name	Time	Method
Number of rescheduled well child visits	6 weeks after no-showed well child visit	If parent/guardian rescheduled well child visit
Number of completed (rescheduled) well child visits	6 weeks after no-showed well child visit	If parent/guardian completed (rescheduled) well child visit

Secondary Outcome Measures

Name	Time	Method
Number of child patient emergency department visits	6 weeks after no-showed well child visit	If child patient had an emergency department visit
Number of child patient hospitalizations	6 weeks after no-showed well child visit	If child patient required hospitalization

Trial Locations

Locations (1)

Wake Forest University Health Sciences; 🇺🇸 Winston-Salem, North Carolina, United States