Evidence map›Paper›PMID 27581655›Full record

Trial reportBMC public health2016

Effectiveness of a smartphone app on improving immunization of children in rural Sichuan Province, China: a cluster randomized controlled trial.

Li Chen, Xiaozhen Du, Lin Zhang, Michelle Helena van Velthoven, Qiong Wu, Ruikan Yang, Ying Cao, Wei Wang, Lihui Xie, Xiuqin Rao and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  10. Patient reminder and recall interventions to improve immunization rates.The Cochrane database of systematic reviews · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Li ChenDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Xiaozhen DuDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Lin ZhangSave the Children China Program, 1202 Block B Huaxi Buling, 5 Linyin Street, Wuhou District, Chengdu City, Sichuan Province, China.
Michelle Helena van VelthovenGlobal eHealth Unit, Department of Primary Care and Public Health, Imperial College London, Reynolds building 3rd floor, St Dunstans road, London, W68RP, UK.
Qiong WuDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Ruikan YangSave the Children China Program, 2-2-52 Jianwai Diplomatic Compound, Chaoyang District, Beijing, 100600, China.
Ying CaoSave the Children China Program, 2-2-52 Jianwai Diplomatic Compound, Chaoyang District, Beijing, 100600, China.
Wei WangDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Lihui XieDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Xiuqin RaoDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China.
Yanfeng ZhangDepartment of Integrated Early Childhood Development, Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, Beijing, 100020, China. summyzh@126.com.
Jeanne Catherine KoepsellSave the Children, 2000 L Street NW, Suite 500, Washington, DC, 20036, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to assess the effectiveness of an EPI smartphone application (EPI app) on improving vaccination coverage in rural Sichuan Province, China.

methodsThis matched-pair cluster randomized controlled study included 32 village doctors, matched in 16 pairs, and took place from 2013 to 2015. Village doctors in the intervention group used the EPI app and reminder text messages while village doctors in the control group used their usual procedures and text messages. The primary outcome was full vaccination coverage with all five vaccines (1 dose of BCG, 3 doses of hepatitis B, 3 doses of OPV, 3 doses of DPT and 1 dose of measles vaccine), and the secondary outcome was coverage with each dose of the five individual vaccines. We also conducted qualitative interviews with village doctors to understand perceptions on using the EPI app and how this changed their vaccination work.

resultsThe full vaccination coverage increased statistically significant from baseline to end-line in both the intervention (67 % [95 % CI:58-75 %] to 84 % [95 % CI:76-90 %], P = 0.028) and control group (71 % [95 % CI:62-79 %] to 82 % [95 % CI:74-88 %], P = 0.014). The intervention group had higher increase in full vaccination coverage from baseline to end-line compared to the control group (17 % vs 10 %), but this was not statistically significant (P = 0.164). Village doctors found it more convenient to use the EPI app to manage child vaccination and also reported saving time by looking up information of caregivers and contacting caregivers for overdue vaccinations quicker. However, village doctors found it hard to manage children who migrated out of the counties.

conclusionsThis study showed that an app and text messages can be used by village doctors to improve full vaccination coverage, though no significant increase in vaccination coverage was found when assessing the effect of the app on its own. Village doctors using EPI app reported having improved their working efficiency of managing childhood vaccination. Future studies should be conducted to evaluate the impact of more integrated approach of mHealth intervention on child immunization.

trial registrationChinese Clinical Trials Registry (ChiCTR): ChiCTR-TRC- 13003960 , registered on December 6, 2013.

Indexed as

Mobile ApplicationsRural Health ServicesChildChild, PreschoolChinaCluster AnalysisFemaleHumansImmunizationImmunization ProgramsMaleProgram EvaluationSmartphoneChild immunizationCluster randomized controlled studySmartphone

Identifiers

PMID27581655
PMCPMC5006404

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.