{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:06:45Z","timestamp":1792094805018,"version":"4.4.0"},"reference-count":37,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer is currently the leading female cancer in Uganda. Most women are diagnosed with late-stage disease. Human papillomavirus (HPV) vaccination is the single most important primary preventive measure. While research regarding text message vaccine reminder use is strong in the United States, their use has not yet been demonstrated in a preteen and adolescent population in subSaharan Africa or other low- and middle-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this pilot randomized controlled trial was to assess the impact of vaccine reminders with embedded interactive educational information on timeliness of HPV vaccination in Kampala, Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this randomized controlled trial conducted in 2022, caregivers of adolescents needing a first or second HPV vaccine dose were recruited from an adolescent clinic and three community health centres in Kampala, Uganda. Families (n=154) were randomized 1:1 into intervention versus usual care, stratified by dose (ie, initiation, completion) and language (ie, English, Luganda) within each site. Intervention caregivers received a series of automated, personalized text messages or automated phone calls based on family preference. Five messages were sent before the due date, including both static and interactive educational information, with five follow-up messages for those unvaccinated. Receipt of the needed dose by 24 weeks postenrollment was assessed by\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , regression, and Kaplan-Meier with log-rank test. All analyses were conducted using intention-to-treat principles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 154 caregivers were enrolled (51.3% for dose 1; 48.7% for dose 2) and 64.3% (n=99) spoke Luganda. Among individuals in the intervention arm, 62% (48\/78) requested SMS text message reminders and 38% (n=30) requested automated phone reminders. There was no significant difference in requested mode by HPV vaccine dose or language. Intervention adolescents were more likely to receive the needed dose by 24 weeks (51\/78, 65.4% vs 27\/76, 35.5%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001; RR 1.8; 95% CI 1.3\u20102.6). There was no interaction by dose or language. There was no difference in vaccination between those requesting SMS text message versus phone reminders (32\/49, 65.3% vs 19\/30, 63.3%;\n                      <jats:italic>P<\/jats:italic>\n                      =.86). The number needed to message for one additional vaccination was 3.4 (95% CI 2.2\u20106.8). Kaplan-Meier curves demonstrated more timely vaccination in the intervention arm (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this novel trial, SMS text message and automated phone reminders were effective in promoting more timely HPV vaccination in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/63527","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T11:50:07Z","timestamp":1742212207000},"page":"e63527-e63527","source":"Crossref","is-referenced-by-count":11,"title":["SEARCH Study: Text Messages and Automated Phone Reminders for HPV Vaccination in Uganda: Randomized Controlled Trial"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-8287","authenticated-orcid":false,"given":"Sabrina B","family":"Kitaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9485-8790","authenticated-orcid":false,"given":"Joseph","family":"Rujumba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-6110","authenticated-orcid":false,"given":"Sarah K","family":"Zalwango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1818-4736","authenticated-orcid":false,"given":"Betsy","family":"Pfeffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2705-1735","authenticated-orcid":false,"given":"Lubega","family":"Kizza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4757-8905","authenticated-orcid":false,"given":"Juliane P","family":"Nattimba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0588-1463","authenticated-orcid":false,"given":"Ashley B","family":"Stephens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7194-2001","authenticated-orcid":false,"given":"Nicolette","family":"Nabukeera-Barungi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6048-4073","authenticated-orcid":false,"given":"Chelsea S","family":"Wynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-2920","authenticated-orcid":false,"given":"Juliet N","family":"Babirye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9208-0313","authenticated-orcid":false,"given":"John","family":"Mukisa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-9009","authenticated-orcid":false,"given":"Ezekiel","family":"Mupere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2113-7247","authenticated-orcid":false,"given":"Melissa S","family":"Stockwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"issue":"24","key":"R1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16245000","article-title":"Prevalence of human papillomavirus (HPV) and other sexually transmitted infections (STIs) among Italian women referred for a colposcopy","volume":"16","author":"Martinelli","journal-title":"Int J Environ Res Public Health"},{"issue":"25","key":"R2","doi-asserted-by":"publisher","first-page":"3629","DOI":"10.1016\/j.vaccine.2018.05.022","article-title":"Assessing university students\u2019 sexual risk behaviors as predictors of human papillomavirus (HPV) vaccine uptake behavior","volume":"36","author":"Rohde","journal-title":"Vaccine (Auckl)"},{"key":"R3","unstructured":"Human papillomavirus and cancer. World Health Organization. 2024. URL: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/human-papilloma-virus-and-cancer [Accessed 10-09-2023]"},{"key":"R4","unstructured":"Bruni L Albero G Serrano B et al. Human papillomavirus and related diseases in the world. summary report. ICO\/IARC information centre on HPV and cancer (HPV information centre); 2023. URL: https:\/\/hpvcentre.net\/statistics\/reports\/XWX.pdf [Accessed 10-09-2023]"},{"key":"R5","unstructured":"Shaping a strategy to introduce HPV vaccines in uganda-formative research results from the HPV vaccines: evidence for impact project. PATH and Child Health and Development Centre (CHDC). 2009. URL: https:\/\/screening.iarc.fr\/doc\/PATH_FRTS_Uganda.pdf [Accessed 10-09-2023]"},{"issue":"9","key":"R6","doi-asserted-by":"publisher","first-page":"1808","DOI":"10.1038\/sj.bjc.6602540","article-title":"Cancer survival in Kampala, Uganda","volume":"92","author":"Gondos","journal-title":"Br J Cancer"},{"issue":"RR-2","key":"R7","first-page":"1","volume":"56","author":"Markowitz","journal-title":"MMWR Recomm Rep"},{"key":"R8","unstructured":"Human papillomavirus (HPV). World Health Organization. 2017. URL: https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/human-papillomavirus-(hpv) [Accessed 20-09-2023]"},{"issue":"49","key":"R9","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.15585\/mmwr.mm6549a5","article-title":"Use of a 2-dose schedule for human papillomavirus vaccination - updated recommendations of the Advisory Committee on Immunization Practices","volume":"65","author":"Meites","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1093\/cid\/ciw354","article-title":"Impact and effectiveness of the quadrivalent human papillomavirus vaccine: a systematic review of 10 years of real-world experience","volume":"63","author":"Garland","journal-title":"Clin Infect Dis"},{"key":"R11","unstructured":"Human papillomavirus (HPV) vaccination coverage. World Health Organization. 2023. URL: https:\/\/immunizationdata.who.int\/pages\/coverage\/hpv.html [Accessed 07-10-2023]"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0269655","article-title":"Encouraging improvement in HPV vaccination coverage among adolescent girls in Kampala, Uganda","volume":"17","author":"Patrick","journal-title":"PLoS ONE"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Nakendo A Busingye R Kakaire O . Prevalence and factors associated with uptake of the second dose of the human papilloma virus vaccine among adolescent girls in kawempe division, kampala. In Review. Preprint posted online on2022. [doi: 10.21203\/rs.3.rs-1921193\/v1]","DOI":"10.21203\/rs.3.rs-1921193\/v1"},{"key":"R14","unstructured":"HPV vaccination in Africa: lessons learned from a pilot program in Uganda. PATH, Child Health and Development Centre (CHDC), and the Uganda National Expanded Program on Immunization (UNEPI). 2011. URL: https:\/\/media.path.org\/documents\/RH_hpv_lessons_learned_uganda.pdf [Accessed 27-10-2023]"},{"key":"R15","unstructured":"Gavi Full Country Evaluations Team. Gavi full country evaluations: 2017\u20132018 dissemination report, uganda. Kampala, Uganda: IDRC; 2018. URL: https:\/\/media.path.org\/documents\/IDRC_Uganda_Annual_Report_062718_FINAL.pdf"},{"issue":"1","key":"R16","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","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/26356","article-title":"Personalized reminders for immunization using short messaging systems to improve human papillomavirus vaccination series completion: parallel-group randomized trial","volume":"9","author":"Wynn","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.jadohealth.2016.09.011","article-title":"Effects of phone and text message reminders on completion of the human papillomavirus vaccine series","volume":"60","author":"Rand","journal-title":"J Adolesc Health"},{"issue":"5","key":"R19","doi-asserted-by":"publisher","first-page":"e1220","DOI":"10.1542\/peds.2015-1089","article-title":"Effectiveness and cost of bidirectional text messaging for adolescent vaccines and well care","volume":"136","author":"O\u2019Leary","journal-title":"Pediatrics"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-015-1470-6","article-title":"Effectiveness of short message services reminder on childhood immunization programme in Kadoma, Zimbabwe - a randomized controlled trial, 2013","volume":"15","author":"Bangure","journal-title":"BMC Public Health"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"e428","DOI":"10.1016\/S2214-109X(17)30072-4","article-title":"Mobile phone-delivered reminders and incentives to improve childhood immunisation coverage and timeliness in Kenya (M-SIMU): a cluster randomised controlled trial","volume":"5","author":"Gibson","journal-title":"Lancet Glob Health"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-2823-5","article-title":"Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014","volume":"16","author":"Haji","journal-title":"BMC Public Health"},{"issue":"2","key":"R23","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s10900-015-0092-3","article-title":"Effects of community health nurse-led intervention on childhood routine immunization completion in primary health care centers in Ibadan, Nigeria","volume":"41","author":"Brown","journal-title":"J Community Health"},{"issue":"1","key":"R24","first-page":"3","volume":"34","author":"Eze","journal-title":"West Afr J Med"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14822-1","article-title":"Implementing SMS reminders for routine immunization in Northern Nigeria: a qualitative evaluation using the RE-AIM framework","volume":"22","author":"Obi-Jeff","journal-title":"BMC Public Health"},{"issue":"21","key":"R26","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.1016\/j.vaccine.2016.03.065","article-title":"SMS text message reminders to improve infant vaccination coverage in Guatemala: a pilot randomized controlled trial","volume":"34","author":"Domek","journal-title":"Vaccine (Auckl)"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.vaccine.2015.11.024","article-title":"Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh","volume":"34","author":"Uddin","journal-title":"Vaccine (Auckl)"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","DOI":"10.2196\/publichealth.7026","article-title":"Effect of mobile phone text message reminders on routine immunization uptake in Pakistan: randomized controlled trial","volume":"4","author":"Kazi","journal-title":"JMIR Public Health Surveill"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-1100-y","article-title":"Communication around HPV vaccination for adolescents in low- and middle-income countries: a systematic scoping overview of systematic reviews","volume":"8","author":"Foss","journal-title":"Syst Rev"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","journal-title":"J Biomed Inform"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","journal-title":"J Biomed Inform"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jadohealth.2018.12.026","article-title":"Short message service reminders to parents for increasing adolescent human papillomavirus vaccination rates in a secondary school vaccine program: a randomized control trial","volume":"65","author":"Tull","journal-title":"J Adolesc Health"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-017-2749-8","article-title":"Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study","volume":"10","author":"Turiho","journal-title":"BMC Res Notes"},{"key":"R34","unstructured":"Digital 2023: Uganda. Datareportal. 2023. URL: https:\/\/datareportal.com\/reports\/digital-2023-uganda [Accessed 10-09-2023]"},{"issue":"3","key":"R35","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2857","article-title":"Parental choice of recall method for HPV vaccination: a pragmatic trial","volume":"137","author":"Kempe","journal-title":"Pediatrics"},{"issue":"2","key":"R36","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ypmed.2013.04.007","article-title":"Parental and provider preferences and concerns regarding text message reminder\/recall for early childhood vaccinations","volume":"57","author":"Hofstetter","journal-title":"Prev Med"},{"issue":"50","key":"R37","first-page":"645","volume":"97","author":"World Health Organization","journal-title":"Weekly Epidemiological Record"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e63527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:30:59Z","timestamp":1785537059000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e63527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,5]]},"references-count":37,"URL":"https:\/\/doi.org\/10.2196\/63527","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,5]]},"article-number":"v13i24e63527"}}