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Tailored patient reminders might raise rates.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>Evaluate impact of a health system\u2019s patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Design<\/jats:title>\n                <jats:p>Pragmatic 6-arm randomized trial across a health system during the 2019\u20132020 influenza vaccination season. The setting was one large health system\u201453 adult primary care practices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Participants<\/jats:title>\n                <jats:p>All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18\u201364 years, without diabetes), older adults (\u226565 years, without diabetes), and those with diabetes (\u226518 years).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Interventions<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main Measures<\/jats:title>\n                <jats:p>Receipt of 1 influenza vaccine from 10\/01\/2019 to 03\/31\/2020.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Results<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patient reminders sent by a health system\u2019s 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial Registration<\/jats:title>\n                <jats:p>This trial was registered with <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> (NCT04110314).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11606-021-07023-w","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T16:03:28Z","timestamp":1630512208000},"page":"615-623","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effect of Personalized Messages Sent by a Health System\u2019s Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-0644","authenticated-orcid":false,"given":"Peter G.","family":"Szilagyi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina S.","family":"Albertin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Casillas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Valderrama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. 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Dr. Humiston\u2019s employer gets grant money for her work sponsored by the Pediatric Infectious Diseases Society Foundation, a not-for-profit organization. PIDS is funded for the project through unrestricted joint educational grants from Sanofi Pasteur US, Merck & Co., Inc., Pfizer, Inc., GlaxoSmithKline, and Seqirus USA, Inc.All other authors have no conflicts of interest to report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}