{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T16:05:09Z","timestamp":1767715509771,"version":"3.48.0"},"reference-count":43,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Seasonal influenza causes morbidity and mortality in vulnerable communities. Narrative reminder recall (ie, digital stories using multimodal narratives that uplift community voices) may be scalable as an equity-promoting intervention to increase vaccination rates.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To assess (1) the reach of texts with pediatric influenza vaccine digital stories among caregivers of young children and (2) associations of caregiver intervention assignment with time to child influenza vaccination.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This pilot randomized clinical trial included caregivers and their children (aged 6 months to 5 years) from 2 safety-net clinics in historically Black neighborhoods in Denver, Colorado between September 16, 2024, and March 31, 2025. Caregivers aged 18 years and older who preferred English and their children, provided they had 1 well visit in the past 18 months and would be aged 6 to 71 months during the influenza season, were included.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The digital storytelling intervention included texts with links to 5 stories (3 featuring caregivers who identified as Black or African American) sent in October 2024. Usual care included 1 message sent via an electronic health record messaging portal to caregivers of all children eligible for influenza vaccines.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was digital story reach (ie, the proportion of caregivers viewing 1 or more digital stories for any length of time). Time to first influenza vaccination was recorded for children. Adjusted Cox proportional hazards modeling (with 95% CI) fit time to vaccination by group and baseline covariates. Kaplan-Meier curves analyzed the proportions of children remaining unvaccinated by group over time.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Intention-to-treat analyses included 200 children (100 per group; mean [SD] age, 29.1 [16.1] months; 96 male [48%]; 77 Black or African American [39%]; 90 Hispanic or Latino\/a [45%]; 54 White [27%]) and their 198 caregivers (100 usual care; 98 intervention; mean [SD] age, 30.5 [7.5] years; 176 mothers [89%]; 77 Black or African American [39%]; 87 Hispanic or Latino\/a [44%]; 25 White [13%]). Overall, 686 of 686 texts (100%) were delivered; digital stories were viewed by 7 caregivers (7%). More children of intervention caregivers were vaccinated when influenza activity peaked on February 15, 2025, (percentage unvaccinated, 62% [95% CI, 53%-72%] in intervention vs 74% [95% CI, 66%-83%] in usual care; Z test, 1.82;\n P<\/jats:italic>\n \u2009=\u2009.03). In adjusted analyses, children of intervention caregivers were 63% more likely to be vaccinated compared with children of caregivers receiving usual care (adjusted hazard ratio, 1.63; 95% CI, 1.01-2.64).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this pilot randomized clinical trial of a text message digital storytelling intervention centering Black families, intervention receipt was associated with improved pediatric influenza vaccination, although intervention reach was low.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT06274359<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.52149","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T16:00:46Z","timestamp":1767715246000},"page":"e2552149","source":"Crossref","is-referenced-by-count":0,"title":["Narrative Reminder Recall to Improve Pediatric Influenza Vaccination"],"prefix":"10.1001","volume":"9","author":[{"given":"Joshua T. B.","family":"Williams","sequence":"first","affiliation":[{"name":"Denver Health, Denver, Colorado"},{"name":"Department of Pediatrics, University of Colorado School of Medicine, Aurora"},{"name":"Center for Health Systems Research, Denver Health, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Kurlandsky","sequence":"additional","affiliation":[{"name":"Denver Health, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy B.","family":"Stein","sequence":"additional","affiliation":[{"name":"Center for Health Systems Research, Denver Health, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine, University of Colorado School of Medicine, Aurora"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon J.","family":"Hambidge","sequence":"additional","affiliation":[{"name":"Denver Health, Denver, Colorado"},{"name":"Department of Pediatrics, University of Colorado School of Medicine, Aurora"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocio I.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Denver Health, Denver, Colorado"},{"name":"Department of Medicine, Division of Endocrinology, Metabolism & Diabetes, University of Colorado School of Medicine, Aurora"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja C.","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Denver Health, Denver, Colorado"},{"name":"Department of Pediatrics, University of Colorado School of Medicine, Aurora"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deidre","family":"Johnson","sequence":"additional","affiliation":[{"name":"Center for African American Health, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean T.","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine, Aurora"},{"name":"Adult & Child Center for Outcomes Research and Delivery Science, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"issue":"8","key":"zoi251391r2","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/j.annepidem.2011.03.002","article-title":"Racial and ethnic disparities in hospitalizations and deaths associated with 2009 pandemic Influenza A (H1N1) virus infections in the United States.","volume":"21","author":"Dee","year":"2011","journal-title":"Ann Epidemiol"},{"issue":"1","key":"zoi251391r3","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1186\/1471-2458-14-214","article-title":"Ethnic disparities in acquiring 2009 pandemic H1N1 influenza: a case-control study.","volume":"14","author":"Navaranjan","year":"2014","journal-title":"BMC Public Health"},{"issue":"9","key":"zoi251391r4","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.2105\/AJPH.2011.300224","article-title":"Neighborhood socioeconomic status and influenza hospitalizations among children: New Haven County, Connecticut, 2003-2010.","volume":"101","author":"Yousey-Hindes","year":"2011","journal-title":"Am J Public Health"},{"issue":"9","key":"zoi251391r5","first-page":"1","article-title":"Deaths: Final Data for 2017.","volume":"68","author":"Kochanek","year":"2019","journal-title":"Natl Vital Stat Rep"},{"issue":"7","key":"zoi251391r6","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1093\/aje\/kws299","article-title":"Disparities between Black and White children in hospitalizations associated with acute respiratory illness and laboratory-confirmed influenza and respiratory syncytial virus in 3 US counties\u20132002-2009.","volume":"177","author":"Iwane","year":"2013","journal-title":"Am J Epidemiol"},{"issue":"4","key":"zoi251391r7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-068507","article-title":"Recommendations for prevention and control of influenza in children, 2024-2025: policy statement.","volume":"154","author":"Committee on Infectious Diseases","year":"2024","journal-title":"Pediatrics"},{"issue":"4","key":"zoi251391r8","doi-asserted-by":"publisher","first-page":"e103","DOI":"10.1016\/j.amepre.2016.10.040","article-title":"Parental-reported full influenza vaccination coverage of children in the U.S.","volume":"52","author":"Zhai","year":"2017","journal-title":"Am J Prev Med"},{"issue":"5","key":"zoi251391r9","doi-asserted-by":"publisher","first-page":"e998","DOI":"10.1542\/peds.2009-3514","article-title":"Association between Medicaid reimbursement and child influenza vaccination rates.","volume":"126","author":"Yoo","year":"2010","journal-title":"Pediatrics"},{"issue":"41","key":"zoi251391r10","doi-asserted-by":"publisher","first-page":"913","DOI":"10.15585\/mmwr.mm6841e2","article-title":"Vaccination coverage by age 24 months among children born in 2015 and 2016\u2014National Immunization Survey\u2014Child, United States, 2016-2018.","volume":"68","author":"Hill","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5","key":"zoi251391r11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-4244","article-title":"Influenza vaccine effectiveness against pediatric deaths: 2010-2014.","volume":"139","author":"Flannery","year":"2017","journal-title":"Pediatrics"},{"issue":"38","key":"zoi251391r12","doi-asserted-by":"publisher","first-page":"844","DOI":"10.15585\/mmwr.mm7338a3","article-title":"Decline in vaccination coverage by age 24 months and vaccination inequities among children born in 2020 and 2021\u2014National Immunization Survey\u2014Child, United States, 2021-2023.","volume":"73","author":"Hill","year":"2024","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"zoi251391r13","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2024.102496","article-title":"Multilevel approaches to immunization equity.","volume":"91","author":"Williams","year":"2024","journal-title":"Curr Opin Immunol"},{"issue":"3","key":"zoi251391r14","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1542\/peds.108.3.661","article-title":"Prevalence and predictors of immunization among inner-city infants: a birth cohort study.","volume":"108","author":"Brenner","year":"2001","journal-title":"Pediatrics"},{"issue":"2 Pt 1","key":"zoi251391r15","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1542\/peds.96.2.295","article-title":"Factors related to immunization status among inner-city Latino and African-American preschoolers.","volume":"96","author":"Wood","year":"1995","journal-title":"Pediatrics"},{"issue":"2","key":"zoi251391r16","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1542\/peds.91.2.308","article-title":"Risk factors for delayed immunization in a random sample of 1163 children from Oregon and Washington.","volume":"91","author":"Bobo","year":"1993","journal-title":"Pediatrics"},{"issue":"2 Pt 1","key":"zoi251391r17","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1542\/peds.94.2.213","article-title":"Risk factors for delayed immunization against measles, mumps, and rubella in Colorado two-year-olds.","volume":"94","author":"Miller","year":"1994","journal-title":"Pediatrics"},{"issue":"1","key":"zoi251391r18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3852","article-title":"Parental hesitancy about routine childhood and influenza vaccinations: a national survey.","volume":"146","author":"Kempe","year":"2020","journal-title":"Pediatrics"},{"issue":"7","key":"zoi251391r19","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1016\/j.acap.2021.05.017","article-title":"Parental vaccine hesitancy and risk of pediatric influenza under-vaccination in a safety-net health care system.","volume":"21","author":"Williams","year":"2021","journal-title":"Acad Pediatr"},{"issue":"6","key":"zoi251391r20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0390","article-title":"A call to action: strengthening vaccine confidence in the United States.","volume":"145","author":"Mbaeyi","year":"2020","journal-title":"Pediatrics"},{"issue":"2","key":"zoi251391r21","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1177\/1524839909332600","article-title":"Digital storytelling: an emergent method for health promotion research and practice.","volume":"10","author":"Gubrium","year":"2009","journal-title":"Health Promot Pract"},{"issue":"2","key":"zoi251391r22","doi-asserted-by":"publisher","first-page":"77","DOI":"10.7326\/0003-4819-154-2-201101180-00004","article-title":"Culturally appropriate storytelling to improve blood pressure: a randomized trial.","volume":"154","author":"Houston","year":"2011","journal-title":"Ann Intern Med"},{"issue":"8","key":"zoi251391r23","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.24781","article-title":"Digital storytelling intervention for hemoglobin A1c control among Hispanic adults with type 2 diabetes: a randomized clinical trial.","volume":"7","author":"Wieland","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi251391r24","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1177\/1090198119894589","article-title":"A storytelling intervention in a mobile, web-based platform: a pilot randomized controlled trial to evaluate the preliminary effectiveness to promote human papillomavirus vaccination in Korean American college women.","volume":"47","author":"Kim","year":"2020","journal-title":"Health Educ Behav"},{"issue":"7","key":"zoi251391r25","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1158\/1940-6207.CAPR-21-0618","article-title":"A digital storytelling intervention for Vietnamese American mothers to promote their children\u2019s HPV vaccination.","volume":"15","author":"Chen","year":"2022","journal-title":"Cancer Prev Res (Phila)"},{"key":"zoi251391r26","doi-asserted-by":"publisher","DOI":"10.2196\/45696","article-title":"Developing a culturally and linguistically congruent digital storytelling intervention in Vietnamese and Korean American mothers of human papillomavirus\u2013vaccinated children: feasibility and acceptability study.","volume":"7","author":"Kim","year":"2023","journal-title":"JMIR Form Res"},{"key":"zoi251391r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2024.126572","article-title":"Staff and caregivers\u2019 perceptions of digital storytelling to increase influenza vaccine confidence in an urban safety-net healthcare system.","volume":"45","author":"Williams","year":"2025","journal-title":"Vaccine"},{"key":"zoi251391r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2025.126866","article-title":"Co-creation of pediatric influenza digital stories via rapid community translation.","volume":"51","author":"Williams","year":"2025","journal-title":"Vaccine"},{"issue":"22","key":"zoi251391r29","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1001\/jama.2025.4347","article-title":"CONSORT 2025 statement: updated guideline for reporting randomized trials.","volume":"333","author":"Hopewell","year":"2025","journal-title":"JAMA"},{"issue":"2","key":"zoi251391r30","doi-asserted-by":"publisher","first-page":"143","DOI":"10.7326\/0003-4819-138-2-200301210-00016","article-title":"Denver Health: a model for the integration of a public hospital and community health centers.","volume":"138","author":"Gabow","year":"2003","journal-title":"Ann Intern Med"},{"issue":"2","key":"zoi251391r31","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"13","key":"zoi251391r32","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.1016\/j.vaccine.2021.02.039","article-title":"A validated modification of the vaccine hesitancy scale for childhood, influenza and HPV vaccines.","volume":"39","author":"Helmkamp","year":"2021","journal-title":"Vaccine"},{"issue":"16","key":"zoi251391r34","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1001\/jama.2012.502","article-title":"Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: a randomized controlled trial.","volume":"307","author":"Stockwell","year":"2012","journal-title":"JAMA"},{"issue":"1","key":"zoi251391r35","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003941.pub3","article-title":"Patient reminder and recall interventions to improve immunization rates.","volume":"1","author":"Jacobson Vann","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"zoi251391r36","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.acap.2019.10.015","article-title":"Centralized reminder\/recall to increase influenza vaccination rates: a two-state pragmatic randomized trial.","volume":"20","author":"Kempe","year":"2020","journal-title":"Acad Pediatr"},{"issue":"5","key":"zoi251391r37","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1001\/jamainternmed.2024.0001","article-title":"Text vs patient portal messaging to improve influenza vaccination coverage: a health system-wide randomized clinical trial.","volume":"184","author":"Szilagyi","year":"2024","journal-title":"JAMA Intern Med"},{"key":"zoi251391r41","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13012-015-0209-1","article-title":"A refined compilation of implementation strategies: results from the expert recommendations for implementing change (ERIC) project.","volume":"10","author":"Powell","year":"2015","journal-title":"Implement Sci"},{"issue":"2","key":"zoi251391r42","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1001\/archpedi.158.2.162","article-title":"Strategies to improve immunization rates and well-child care in a disadvantaged population: a cluster randomized controlled trial.","volume":"158","author":"Hambidge","year":"2004","journal-title":"Arch Pediatr Adolesc Med"},{"key":"zoi251391r43","doi-asserted-by":"crossref","DOI":"10.1542\/9781610020831","volume-title":"Bright Futures Pocket Guide","author":"Hagan","year":"2017","edition":"4th ed"},{"key":"zoi251391r1","unstructured":"Centers for Disease Control and Prevention. Flu and children. Published September 5, 2024. Accessed May 12, 2025. https:\/\/www.cdc.gov\/flu\/highrisk\/children.html"},{"key":"zoi251391r33","unstructured":"Colorado Department of Public Health & Environment. Viral respiratory diseases report. Accessed June 4, 2025. https:\/\/cdphe.colorado.gov\/viral-respiratory-diseases-report"},{"key":"zoi251391r38","unstructured":"Gonzalez? R. The spectrum of community engagement to ownership. Facilitating Power. Published 2020. Accessed July 2, 2025. https:\/\/d3n8a8pro7vhmx.cloudfront.net\/facilitatingpower\/pages\/53\/attachments\/original\/1596746165\/CE2O_SPECTRUM_2020.pdf?1596746165"},{"key":"zoi251391r39","unstructured":"Oladipo? T. LinkedIn leads in engagement at 6.50%\u2014here\u2019s how other platforms stack up. Buffer. Published April 7, 2025. Accessed July 2, 2025. https:\/\/buffer.com\/resources\/average-engagement-rate\/"},{"key":"zoi251391r40","unstructured":"Feehan? B. 2024 TikTok benchmark report. Rival IQ. Published May 1, 2024. Accessed July 2, 2025. https:\/\/www.rivaliq.com\/blog\/tiktok-benchmark-report\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2843498\/williams_2026_oi_251391_1766526072.8035.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T16:00:48Z","timestamp":1767715248000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2843498"}},"subtitle":["A Pilot Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.52149","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}