Mobile and Scalable Innovations for Measles Immunization: a Randomized Controlled Trial (M-SIMI)

Johns Hopkins Bloomberg School of Public Health

Status: Completed

Conditions: Measles

Treatments: Behavioral: SMS reminder; Behavioral: Unconditional Incentive

Study type: Interventional

Funder types: Other

Identifiers

NCT02904642

KEMRI SERU-3311

Details and patient eligibility

About

The overall objective is to test the impact of short message service (SMS) reminders, with or without unconditionally provided mobile-money incentives, can improve measles vaccination coverage in rural western Kenyan infants.

Full description

Primary Objective The primary objective is to determine if text message reminders, with or without unconditionally provided incentives, can increase the proportion of children who receive measles vaccination by 15% at age ten months as compared to control arm children.

Secondary Objectives

1. To conduct a secondary analysis of the primary outcome using survival analysis and time-to-immunization curves.
2. To determine if there is a differential effect on measles vaccine coverage based on mobile phone ownership and distance to the clinic.
3. To examine the effect of the interventions on measles coverage measured at twelve months of age.
4. To examine the completeness and costs of identifying children through a CHW approach versus the standard HDSS approach.
5. To evaluate the effect of the interventions on coverage of second dose of measles vaccine at 24 months. This secondary objective is contingent on receiving additional funding.

Enrollment: 537 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Caregiver of infant aged 6-8 months at time of enrollment
• Self-reported resident of one of the study villages; where the definition of a resident is defined by caregiver
• Willing to sign informed consent for the study

Exclusion criteria

• Child of enrolled caregiver has already received one dose of measles vaccine, not including any supplemental measles vaccines
• Caregiver plans to move away in the next 6 months

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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537 participants in 3 patient groups

Control

No Intervention group

Description:

All enrolled caregivers will receive a congratulatory text message at enrollment which indicates who is conducting the study and which also includes a general-health related saying, "The greatest wealth is health". No additional text messages or travel subsidies will be sent to caregivers randomized to the control arm.

SMS reminder

Experimental group

Description:

At enrollment, participants will be told to expect 2 SMS reminders for measles vaccine; first, at 3 days before and second, on the day before the scheduled measles vaccine at 9 months of age. At most, enrolled caregivers will receive three text messages (two for the measles vaccine and one for welcoming mother to the study). Text messages will be sent in English, Kiswahili or Dholuo language, according to the mother's preference. These reminders will have information about the child's scheduled immunization date.

Treatment:

Behavioral: SMS reminder

SMS reminder + Unconditional Incentive

Experimental group

Description:

Participants will receive SMS reminders as described in the SMS reminder arm. Additionally, participants will be sent a 150 Kenyan Shillings (KES) incentive to the mobile phone number they provided at enrollment. The incentive will be delivered three days before the child turns nine months (i.e. sent on the same day as the first SMS reminder). Caregivers will receive the mobile-money incentive unconditionally. The intent of the incentive is to help offset the costs associated with transportation to the clinic. The transaction costs associated with mobile-money transactions will be borne by the study such that mothers will receive the full 150 KES.

Treatment:

Behavioral: SMS reminder

Behavioral: Unconditional Incentive