The Effect of Short Message Service (SMS)-Reminders on Child Health in Parents of Newborns: A Pilot Randomised Controlled Trial

Background Incomplete vaccination in Australia is greatly due to vaccine hesitancy, which is driven by multiple factors. Studies analysing the effect of behavioural ‘nudges’ on vaccine uptake have shown promising results. Although there is some evidence for positively framed SMS vaccine messages, evidence is lacking for loss-based framed messages which may be highly effective but may paradoxically risk increasing vaccine hesitancy. This pilot study aimed to evaluate the effect of loss-based framed SMS messages on vaccine hesitancy. Methods This single-blinded randomised controlled trial enrolled pregnant women from antenatal clinics in King Edward Memorial Hospital, Perth, WA which delivers approximately 6000 higher-risk infants per year. Participants were randomised to receive either a loss-based framed SMS message warning of the risks of failure to vaccinate, or a sham SMS message unrelated to vaccination, and were asked to complete the short-scale vaccine hesitancy questionnaire before and after the intervention. Discussion The application of behavioural sciences through SMS-reminders has the potential to improve vaccination rates. There are difficulties in engaging with parents of newborns about vaccine hesitancy. Further research is warranted using other approaches to recruitment. Highlights Pilot randomised controlled trial on the use of SMS reminders to influence vaccine hesitancy Application of behavioural economics, nudge techniques and mobile health Vaccine hesitancy measured using the short-scale PACV questionnaire There are difficulties in engaging with parents of newborns about vaccine hesitancy Further research needed to optimise message framing, timing and reduce vaccine hesitancy Trial Registration The trial is registered with the Australia and New Zealand Clinical Trials Register (ACTRN12618001510235).