Cunningham Maureen, Bull Sheana, McNulty Monica C, Colborn Kathryn, Chavez Catia, Berman Stephen, McSpadden Jean, Wigdor Jared, Allison Mandy A
Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO, USA.
Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
Mhealth. 2018 Nov 29;4:55. doi: 10.21037/mhealth.2018.11.03. eCollection 2018.
Bright by Three (BB3), a non-profit organization that promotes caregiver behaviors to support language development in young children was augmented with a text-messaging program, Bright by Text (BBT), in 2015. While some evidence suggests that text-messaging can promote early development, it is unknown if these interventions are reaching children at increased sociodemographic risk for developmental delay. The purpose of this study is to compare socio-demographic characteristics of caregivers who did and did not enroll in BBT.
Retrospective analysis of caregivers who received BB3 written materials and were eligible to sign up for BBT in 2016. Outcomes: (I) provision of a mobile phone number; (II) enrollment in BBT (receipt of 3+ messages). Predictors: education, marital status, race/ethnicity, insurance, language, and urban rural residence. A multivariable generalized linear model was used to determine characteristics of caregivers more likely to sign up for BBT.
A total of 18,145 caregivers received BB3 written materials; 10,843 (60%) provided a mobile phone number and 2,314 (21%) enrolled in BBT. The relative risk (RR) of enrollment was higher for caregivers who were non-minority (RR 1.15, 95% CI, 1.04-1.28), had higher education (1.60, 1.35-1.89), had private insurance (1.15, 1.15-1.28) and lived in urban areas (1.21, 1.06-1.37). Non-English speaking caregivers were less likely to enroll (0.73, 0.59-0.90).
Caregivers with lower incomes and education, minorities and non-English speakers were less likely to enroll in BBT. Future research could identify ways to increase engagement among these populations and determine if BBT is effective in changing parent behavior and improving children's development.
“三岁前启智”（BB3）是一个非营利组织，致力于推广照顾者行为以支持幼儿语言发展。2015年，该组织增加了一个短信项目“短信启智”（BBT）。虽然有证据表明短信可以促进早期发展，但尚不清楚这些干预措施是否能惠及社会人口统计学上发育迟缓风险增加的儿童。本研究的目的是比较参与和未参与BBT的照顾者的社会人口学特征。
对2016年收到BB3书面材料且有资格报名参加BBT的照顾者进行回顾性分析。结果：（I）提供手机号码；（II）注册BBT（收到3条及以上信息）。预测因素：教育程度、婚姻状况、种族/民族、保险、语言以及城乡居住情况。使用多变量广义线性模型来确定更有可能报名参加BBT的照顾者的特征。
共有18145名照顾者收到了BB3书面材料；10843名（60%）提供了手机号码，2314名（21%）注册了BBT。非少数族裔照顾者注册的相对风险（RR）更高（RR 1.15，95%置信区间，1.04 - 1.28），教育程度较高者（1.60，1.35 - 1.89）、拥有私人保险者（1.15，1.05 - 1.28）以及居住在城市地区者（1.21，1.06 - 1.37）也是如此。说非英语的照顾者注册的可能性较小（0.73，0.59 - 0.90）。
收入和教育程度较低的照顾者、少数族裔以及说非英语的照顾者注册BBT的可能性较小。未来的研究可以确定增加这些人群参与度的方法，并确定BBT是否能有效改变家长行为并改善儿童发展。
