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  • 1
    Online Resource
    Online Resource
    Text vs Patient Portal Messaging to Improve Influenza Vaccination Coverage : A Health System–Wide Randomized Clinical Trial
    American Medical Association (AMA) ; 2024
    In:  JAMA Internal Medicine Vol. 184, No. 5 ( 2024-05-01), p. 519-
    Details
    In: JAMA Internal Medicine, American Medical Association (AMA), Vol. 184, No. 5 ( 2024-05-01), p. 519-
    Abstract: Increasing influenza vaccination rates is a public health priority. One method recommended by the US Centers for Disease Control and Prevention and others is for health systems to send reminders nudging patients to be vaccinated. Objective To evaluate and compare the effect of electronic health record (EHR)–based patient portal reminders vs text message reminders on influenza vaccination rates across a health system. Design, Setting, and Participants This 3-arm randomized clinical trial was conducted from September 7, 2022, to April 30, 2023, among primary care patients within the University of California, Los Angeles (UCLA) health system. Interventions Arm 1 received standard of care. The health system sent monthly reminder messages to patients due for an influenza vaccine by portal (arm 2) or text (arm 3). Arm 2 had a 2 × 2 nested design, with fixed vs responsive monthly reminders and preappointment vs no preappointment reminders. Arm 3 had 1 × 2 design, with preappointment vs no preappointment reminders. Preappointment reminders for eligible patients were sent 24 and 48 hours before scheduled primary care visits. Fixed reminders (in October, November, and December) involved identical messages via portal or text. Responsive portal reminders involved a September message asking patients about their plans for vaccination, with a follow-up reminder if the response was affirmative but the patient was not yet vaccinated. Main Outcomes and Measures The primary outcome was influenza vaccination by April 30, 2023, obtained from the UCLA EHR, including vaccination from pharmacies and other sources. Results A total of 262 085 patients (mean [SD] age, 45.1 [20.7] years; 237 404 [90.6%] adults; 24 681 [9.4%] children; 149 349 [57.0%] women) in 79 primary care practices were included (87 257 in arm 1, 87 478 in arm 2, and 87 350 in arm 3). At the entire primary care population level, none of the interventions improved influenza vaccination rates. All groups had rates of approximately 47%. There was no statistical or clinically significant improvement following portal vs text, preappointment reminders vs no preappointment reminders (portal and text reminders combined), or responsive vs fixed monthly portal reminders. Conclusions and Relevance At the population level, neither portal nor text reminders for influenza vaccination were effective. Given that vaccine hesitancy may be a major reason for the lack of impact of portal or text reminders, more intensive interventions by health systems are needed to raise influenza vaccination coverage levels. Trial Registration ClinicalTrials.gov Identifier: NCT05525494
    Type of Medium: Online Resource
    ISSN: 2168-6106
    URL: Article
    DOI: 10.1001/jamainternmed.2024.0001
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2024
    detail.hit.zdb_id: 2699338-7
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  • 2
    Online Resource
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    Evaluation of behavioral economic strategies to raise influenza vaccination rates across a health system: Results from a randomized clinical trial
    Elsevier BV ; 2023
    In:  Preventive Medicine Vol. 170 ( 2023-05), p. 107474-
    Details
    In: Preventive Medicine, Elsevier BV, Vol. 170 ( 2023-05), p. 107474-
    Type of Medium: Online Resource
    ISSN: 0091-7435
    URL: Article
    DOI: 10.1016/j.ypmed.2023.107474
    RVK:
    XF 1500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 184600-0
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  • 3
    Online Resource
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    Eastertime
    Informa UK Limited ; 1994
    In:  Liturgy Vol. 11, No. 4 ( 1994-03), p. 47-47
    Details
    In: Liturgy, Informa UK Limited, Vol. 11, No. 4 ( 1994-03), p. 47-47
    Type of Medium: Online Resource
    ISSN: 0458-063X , 1557-3001
    URL: Article
    DOI: 10.1080/0458063X.1994.10392248
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 1994
    detail.hit.zdb_id: 895152-4
    detail.hit.zdb_id: 2113154-5
    SSG: 1
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  • 4
    Online Resource
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    Effect of Patient Portal Reminders Sent by a Health Care System on Influenza Vaccination Rates : A Randomized Clinical Trial
    American Medical Association (AMA) ; 2020
    In:  JAMA Internal Medicine Vol. 180, No. 7 ( 2020-07-01), p. 962-
    Details
    In: JAMA Internal Medicine, American Medical Association (AMA), Vol. 180, No. 7 ( 2020-07-01), p. 962-
    Type of Medium: Online Resource
    ISSN: 2168-6106
    URL: Article
    DOI: 10.1001/jamainternmed.2020.1602
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2020
    detail.hit.zdb_id: 2699338-7
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  • 5
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    Patient Portal Reminders for Pediatric Influenza Vaccinations: A Randomized Clinical Trial
    American Academy of Pediatrics (AAP) ; 2021
    In:  Pediatrics Vol. 148, No. 2 ( 2021-08-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 148, No. 2 ( 2021-08-01)
    Abstract: In a large health system, we evaluated the effectiveness of electronic health record patient portal reminders in increasing pediatric influenza vaccination rates. METHODS We conducted an intention-to-treat randomized clinical trial of 22 046 children from 6 months to & lt;18 years of age in 53 primary care practices. Patients (or parent and/or proxies) who were active portal users were randomly assigned to receive reminder messages framed as gains or losses or no messages. They were separately randomly assigned to receive a precommitment message before the influenza season. The primary outcome was receipt of ≥1 seasonal influenza vaccinations. Additionally, children 6 months to & lt;3 years of age due for a second influenza vaccine were randomly assigned to receive a reminder or no reminder for the second vaccination. RESULTS First-dose influenza vaccination rates were 56.9% in the control group, 58.0% in the loss-frame reminders group (P = .07), and 58.0% in the gain-frame group (P = .47). Rates were 58.3% in the precommitment group versus 57.0% in the control group (P = .11). Adjusted risk ratios for first vaccination were 1.02 (95% confidence interval [CI]: 1.00–1.04) for loss-frame reminders, 1.01 (95% CI: 0.98–1.05) for gain-frame reminders, and 1.02 (95% CI: 1.00–1.04) for precommitment messages versus controls. Second-dose vaccination rates were 44.1% in the control group and 55.0% in the reminder group, with an adjusted risk ratio of 1.25 (95% CI: 1.07–1.45). CONCLUSIONS Patient portal reminders for influenza vaccines in children, whether framed as gains or losses, did not increase first-dose influenza vaccination rates but were highly effective for the second dose of the vaccine.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2020-048413
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2021
    detail.hit.zdb_id: 1477004-0
    detail.hit.zdb_id: 207677-9
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  • 6
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    Effect of Personalized Messages Sent by a Health System’s Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial
    Springer Science and Business Media LLC ; 2022
    In:  Journal of General Internal Medicine Vol. 37, No. 3 ( 2022-02), p. 615-623
    Details
    In: Journal of General Internal Medicine, Springer Science and Business Media LLC, Vol. 37, No. 3 ( 2022-02), p. 615-623
    Abstract: Adult influenza vaccination rates are low. Tailored patient reminders might raise rates. Objective Evaluate impact of a health system’s patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults. Design Pragmatic 6-arm randomized trial across a health system during the 2019–2020 influenza vaccination season. The setting was one large health system—53 adult primary care practices. Participants All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18–64 years, without diabetes), older adults (≥65 years, without diabetes), and those with diabetes (≥18 years). Interventions Patients were randomized within strata to either (1) pre-commitment reminder alone (1 message, mid-October), (2) pre-commitment + loss frame messages, (3) pre-commitment + gain frame messages, (4) loss frame messages alone, (5) gain frame messages alone, or (6) standard of care control. Patients in the pre-commitment group were sent a message in mid-October, asking if they planned on getting an influenza vaccination. Patients in loss or gain frame groups were sent up to 3 portal reminders (late October, November, and December, if no documented influenza vaccination in the EHR) about importance and safety of influenza vaccine. Main Measures Receipt of 1 influenza vaccine from 10/01/2019 to 03/31/2020. Key Results 196,486 patients (145,166 young adults, 29,795 older adults, 21,525 adults with diabetes) were randomized. Influenza vaccination rates were as follows: for young adults 36.8%, for older adults 55.6%, and for diabetics 60.6%. On unadjusted and adjusted (for age, gender, insurance, race, ethnicity, and prior influenza vaccine history) analyses, influenza vaccination rates were not statistically different for any study group versus control. Conclusions Patient reminders sent by a health system’s patient portal that were tailored to patient demographics (young adults, older adults, diabetes) and that incorporated two behavioral economic messaging strategies (pre-commitment and loss/gain framing) were not effective in raising influenza vaccination rates. Trial Registration This trial was registered with ClinicalTrials.gov (NCT04110314).
    Type of Medium: Online Resource
    ISSN: 0884-8734 , 1525-1497
    URL: Article
    DOI: 10.1007/s11606-021-07023-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2006784-7
    detail.hit.zdb_id: 639008-0
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  • 7
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    Behavioural nudges increase COVID-19 vaccinations
    Springer Science and Business Media LLC ; 2021
    In:  Nature Vol. 597, No. 7876 ( 2021-09-16), p. 404-409
    Details
    In: Nature, Springer Science and Business Media LLC, Vol. 597, No. 7876 ( 2021-09-16), p. 404-409
    Abstract: Enhancing vaccine uptake is a critical public health challenge 1 . Overcoming vaccine hesitancy 2,3 and failure to follow through on vaccination intentions 3 requires effective communication strategies 3,4 . Here we present two sequential randomized controlled trials to test the effect of behavioural interventions on the uptake of COVID-19 vaccines. We designed text-based reminders that make vaccination salient and easy, and delivered them to participants drawn from a healthcare system one day (first randomized controlled trial) ( n  = 93,354 participants; clinicaltrials number NCT04800965) and eight days (second randomized controlled trial) ( n  = 67,092 individuals; clinicaltrials number NCT04801524) after they received a notification of vaccine eligibility. The first reminder boosted appointment and vaccination rates within the healthcare system by 6.07 (84%) and 3.57 (26%) percentage points, respectively; the second reminder increased those outcomes by 1.65 and 1.06 percentage points, respectively. The first reminder had a greater effect when it was designed to make participants feel ownership of the vaccine dose. However, we found no evidence that combining the first reminder with a video-based information intervention designed to address vaccine hesitancy heightened its effect. We performed online studies ( n  = 3,181 participants) to examine vaccination intentions, which revealed patterns that diverged from those of the first randomized controlled trial; this underscores the importance of pilot-testing interventions in the field. Our findings inform the design of behavioural nudges for promoting health decisions 5 , and highlight the value of making vaccination easy and inducing feelings of ownership over vaccines.
    Type of Medium: Online Resource
    ISSN: 0028-0836 , 1476-4687
    URL: Article
    DOI: 10.1038/s41586-021-03843-2
    RVK:
    TA 1000
    RVK:
    UA 1000
    RVK:
    WA 15000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 120714-3
    detail.hit.zdb_id: 1413423-8
    SSG: 11
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  • 8
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    OceanGliders: A Component of the Integrated GOOS
    Frontiers Media SA ; 2019
    In:  Frontiers in Marine Science Vol. 6 ( 2019-10-2)
    Details
    In: Frontiers in Marine Science, Frontiers Media SA, Vol. 6 ( 2019-10-2)
    Abstract: The OceanGliders program started in 2016 to support active coordination and enhancement of global glider activity. OceanGliders contributes to the international efforts of the Global Ocean Observation System (GOOS) for Climate, Ocean Health, and Operational Services. It brings together marine scientists and engineers operating gliders around the world: (1) to observe the long-term physical, biogeochemical, and biological ocean processes and phenomena that are relevant for societal applications; and, (2) to contribute to the GOOS through real-time and delayed mode data dissemination. The OceanGliders program is distributed across national and regional observing systems and significantly contributes to integrated, multi-scale and multi-platform sampling strategies. OceanGliders shares best practices, requirements, and scientific knowledge needed for glider operations, data collection and analysis. It also monitors global glider activity and supports the dissemination of glider data through regional and global databases, in real-time and delayed modes, facilitating data access to the wider community. OceanGliders currently supports national, regional and global initiatives to maintain and expand the capabilities and application of gliders to meet key global challenges such as improved measurement of ocean boundary currents, water transformation and storm forecast.
    Type of Medium: Online Resource
    ISSN: 2296-7745
    URL: Article
    DOI: 10.3389/fmars.2019.00422
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2019
    detail.hit.zdb_id: 2757748-X
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  • 9
    Online Resource
    Online Resource
    Australian Northwest Cloudbands and Their Relationship to Atmospheric Rivers and Precipitation
    American Meteorological Society ; 2021
    In:  Monthly Weather Review Vol. 149, No. 4 ( 2021-04), p. 1125-1139
    Details
    In: Monthly Weather Review, American Meteorological Society, Vol. 149, No. 4 ( 2021-04), p. 1125-1139
    Abstract: Large-scale cloud features referred to as cloudbands are known to be related to widespread and heavy rain via the transport of tropical heat and moisture to higher latitudes. The Australian northwest cloudband is such a feature that has been identified in simple searches of satellite imagery but with limited investigation of its atmospheric dynamical support. An accurate, long-term climatology of northwest cloudbands is key to robustly assessing these events. A dynamically based search algorithm has been developed that is guided by the presence and orientation of the subtropical jet stream. This jet stream is the large-scale atmospheric feature that determines the development and alignment of a cloudband. Using a new 40-yr dataset of cloudband events compiled by this search algorithm, composite atmospheric and ocean surface conditions over the period 1979–2018 have been assessed. Composite cloudband upper-level flow revealed a tilted low pressure trough embedded in a Rossby wave train. Composites of vertically integrated water vapor transport centered around the jet maximum during northwest cloudband events reveal a distinct atmospheric river supplying tropical moisture for cloudband rainfall. Parcel backtracking indicated multiple regions of moisture support for cloudbands. A thermal wind anomaly orientated with respect to an enhanced sea surface temperature gradient over the Indian Ocean was also a key composite cloudband feature. A total of 300 years of a freely coupled control simulation of the ACCESS-D system was assessed for its ability to simulate northwest cloudbands. Composite analysis of model cloudbands compared reasonably well to reanalysis despite some differences in seasonality and frequency of occurrence.
    Type of Medium: Online Resource
    ISSN: 0027-0644 , 1520-0493
    URL: Article
    URL: Article
    DOI: 10.1175/MWR-D-20-0308.1
    DOI: 10.1175/MWR-D-20-0308.s1
    RVK:
    RA 1000
    Language: Unknown
    Publisher: American Meteorological Society
    Publication Date: 2021
    detail.hit.zdb_id: 2033056-X
    detail.hit.zdb_id: 202616-8
    SSG: 14
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  • 10
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    Pediatric patient portal use in one health system
    Oxford University Press (OUP) ; 2020
    In:  Journal of the American Medical Informatics Association Vol. 27, No. 3 ( 2020-03-01), p. 444-448
    Details
    In: Journal of the American Medical Informatics Association, Oxford University Press (OUP), Vol. 27, No. 3 ( 2020-03-01), p. 444-448
    Abstract: The study sought to assess, for children in one large health system, (1) characteristics of active users of the patient portal (≥1 use in prior 12 months), (2) portal use by adolescents, and (3) variations in pediatric patient portal use. Materials and Methods We analyzed data from the electronic health record regarding pediatric portal use during 2017-2018 across a health system (39 871 pediatric patients). Results Altogether, 63.5% of pediatric patients were active portal users. Children (proxies) who were boys, privately insured, white, and spoke English were more likely to be active users. Common uses involved messaging with physicians, medications, allergies, letters, and laboratory results. By 15 years of age, & gt;50% of adolescents used the portal by themselves (without a proxy). Pediatric portal use varied widely across practices. Discussion Pediatric or adolescent portal use is quite high, but large variations exist. Conclusion Use of the portal for pediatric care may reflect varying pediatric patient engagement.
    Type of Medium: Online Resource
    ISSN: 1527-974X
    URL: Article
    DOI: 10.1093/jamia/ocz203
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2018371-9
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