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Date Available

4-27-2026

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Committee Member

Jerod Stapleton

Faculty

Marc Kiviniemi

Faculty

Corrine Williams

Abstract

Childhood vaccination remains a critical public health priority, yet measles, mumps, and rubella (MMR) vaccination rates in several rural Kentucky counties fall below the 95% threshold required for herd immunity. Recent declines in coverage, compounded by socioeconomic disparities and barriers to healthcare access, place children at increased risk for vaccine-preventable diseases and outbreaks. This capstone project proposes the implementation of an evidence-based reminder/recall (R/R) text messaging intervention utilizing the Kentucky Immunization Registry (KYIR) to improve timely MMR vaccination among children aged 4–6 years before kindergarten entry.

The proposed program targets thirteen Kentucky counties with vaccination rates below 70% and documented declines greater than 5%. Using a prospective, population-based intervention design, the program will identify children who are due or overdue for MMR vaccination and deliver tailored, phased text messages to parents and guardians. Messaging will include reminders, recalls, educational content, and links to local vaccination resources. A Community Advisory Group will guide culturally appropriate messaging and implementation strategies to ensure relevance and community trust.

Process evaluation will assess program feasibility, acceptability, and fidelity through monitoring message delivery metrics, stakeholder feedback, and participant surveys. Outcome evaluation will compare pre- and post-intervention MMR vaccination rates using KYIR data, to achieve at least a 5 percentage point increase in two-dose MMR completion by kindergarten entry.

This intervention leverages existing infrastructure to provide a scalable, cost-effective strategy to address immunization gaps in underserved populations. This program has the potential to improve vaccination coverage, reduce health disparities, and serve as a sustainable model for statewide implementation.

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