Silverman-Lloyd Luke G, Dominguez Cortez Jose, Godage Sashini K, Valenzuela Araujo Doris, Rivera Tatiahna, Polk Sarah, DeCamp Lisa Ross
University of California, Berkeley-University of California, San Francisco Joint Medical Program, Berkeley, CA, USA.
Johns Hopkins Center for Health/Salud and Opportunity for Latinos, Baltimore, MD, USA.
Mhealth. 2020 Oct 5;6:45. doi: 10.21037/mhealth.2020.01.06. eCollection 2020.
The majority of Latino immigrants have been shown to have a mobile phone. Cellular phones offer a low-cost method of reaching larger populations and have the potential for increased tailoring and interactivity. This supports the development of mHealth interventions to address healthcare disparities in this population. In this study we sought to evaluate the feasibility and acceptability of interactive Spanish-language text messages sent throughout a child's first year of life in a low-income, limited-English proficient (LEP) Latino population to support families in accessing and using pediatric primary care more effectively.
Participants (n=79) received interactive text messages over a period of 12 months as a part of a multi-modal mHealth intervention conducted at an urban academic pediatric primary care practice. Inclusion criteria were: singleton infant <2 months of age, enrollment in public health insurance, parent age >18, parent preferred healthcare language of Spanish, and at least one household cellular phone. Interactive text messages were designed to promote increased healthcare engagement and prompted participant responses through preprogramed algorithms. Text message sequences included clinic appointment reminders, support for obtaining medicine and completing referral appointments, monitoring of illness care needs and use, and parent support program reminders. Descriptive analyses were used to examine text message volume, usability, and participant response to text sequences.
Among participants, mean parent age was 30.1 years (SD: 6.1 years); mean years in the US was 7.5 years (SD: 5.1 years). 63.3% of parents had less than a high school education and 84.8% of parents had possible/high likelihood of limited health literacy. Participants completed the majority of sequences with appointment reminder sequences having the quickest response time. The top quartile of responders completed 88.3% of sequences; lower educational attainment was associated with lower text message sequence completion. Participants rated the program positively, especially the appointment reminders.
LEP Latino parents successfully engaged with interactive Spanish-language text sequences and parent acceptability was high. This study demonstrates feasibility for interventions employing this technology. Text message interventions may be a feasible approach to reduce healthcare disparities and costs for vulnerable populations.
大多数拉丁裔移民都拥有手机。手机提供了一种低成本的方式来覆盖更多人群，并且具有增强针对性和互动性的潜力。这为开发移动健康干预措施以解决该人群的医疗保健差距提供了支持。在本研究中，我们试图评估在低收入、英语水平有限（LEP）的拉丁裔人群中，在孩子出生后的第一年发送交互式西班牙语短信以支持家庭更有效地获得和利用儿科初级保健的可行性和可接受性。
作为在城市学术性儿科初级保健机构进行的多模式移动健康干预的一部分，参与者（n = 79）在12个月的时间内接收交互式短信。纳入标准为：单胎婴儿<2个月大、参加公共医疗保险、父母年龄>18岁、父母首选的医疗保健语言为西班牙语以及至少有一部家庭手机。交互式短信旨在促进更高的医疗保健参与度，并通过预编程算法促使参与者做出回应。短信序列包括诊所预约提醒、获取药物和完成转诊预约的支持、疾病护理需求和使用情况的监测以及家长支持计划提醒。描述性分析用于检查短信数量、可用性以及参与者对短信序列的反应。
参与者中，父母的平均年龄为30.1岁（标准差：6.1岁）；在美国的平均居住年限为7.5年（标准差：5.1年）。63.3%的父母受教育程度低于高中，84.8%的父母健康素养可能有限/很可能有限。参与者完成了大部分序列，其中预约提醒序列的响应时间最快。响应最快的四分之一参与者完成了88.3%的序列；教育程度较低与短信序列完成率较低相关。参与者对该项目评价积极，尤其是预约提醒。
英语水平有限的拉丁裔父母成功参与了交互式西班牙语短信序列，家长的接受度很高。本研究证明了采用该技术进行干预的可行性。短信干预可能是减少弱势群体医疗保健差距和成本的一种可行方法。
