Division of General Pediatrics, University of Washington School of Medicine (TR Coker, JW Stout, and KS Liljenquist), Seattle, Wash; Seattle Children's Hospital Research Institute (TR Coker, SJ Mitchell, SJ Lowry, EJ Klein, J Brown, KS Liljenquist, E Wingfield, and IB Horn), Seattle, Wash.
Seattle Children's Hospital Research Institute (TR Coker, SJ Mitchell, SJ Lowry, EJ Klein, J Brown, KS Liljenquist, E Wingfield, and IB Horn), Seattle, Wash.
Acad Pediatr. 2023 Jan-Feb;23(1):123-129. doi: 10.1016/j.acap.2022.05.004. Epub 2022 May 13.
Mobile health technology offers promise for reducing disparities in pediatric asthma care and outcomes by helping parents more effectively communicate with their children's primary care providers and manage their children's asthma. This study tested the impact of a text messaging program on emergency department utilization and asthma morbidity.
A randomized controlled trial enrolled 221 parents of Medicaid-insured children visiting the emergency departments of 2 urban children's hospitals in the Pacific Northwest for an asthma-related concern between September 2015 and February 2019. Standardized surveys were administered to parents at baseline and 12 months later to assess the primary outcomes of emergency department utilization and morbidity as well as primary care utilization, parent communication self-efficacy, and asthma self-management knowledge. The intervention group received brief in-person education on partnering with primary care providers, followed by 3 months of educational text messages.
Participants were mostly female, English speakers, of minority race and ethnicity, and living below 200% of the federal poverty level. Negative binomial and linear regressions indicated no significant group differences in annual number of emergency department visits, morbidity, parent communication self-efficacy, or asthma self-management knowledge at 12 months' follow-up, adjusting for baseline covariates. Average annual rate of primary care visits for asthma was 35% higher in the intervention group compared to control group at follow-up (95% confidence interval 1.03-1.76, P = .03).
This parent-focused text message intervention did not impact emergency department utilization or asthma morbidity; however, results suggest its potential for enhancing use of primary care for management of pediatric chronic conditions.
移动健康技术有望通过帮助父母更有效地与子女的初级保健提供者沟通并管理子女的哮喘，从而减少儿科哮喘护理和结果方面的差距。本研究测试了短信计划对急诊就诊和哮喘发病率的影响。
一项随机对照试验招募了 2015 年 9 月至 2019 年 2 月期间在西北太平洋地区两家儿童医院因哮喘相关问题就诊的 221 名有医疗补助保险的儿童的父母。在基线和 12 个月后，向父母进行标准化调查，以评估急诊就诊和发病率以及初级保健利用率、父母沟通自我效能和哮喘自我管理知识的主要结果。干预组接受了有关与初级保健提供者合作的简短面对面教育，随后接受了 3 个月的教育短信。
参与者主要为女性、英语使用者、少数族裔和种族、生活在联邦贫困线以下 200%以下。负二项式和线性回归表明，在调整基线协变量后，在 12 个月的随访中，两组在急诊就诊次数、发病率、父母沟通自我效能或哮喘自我管理知识方面没有显著差异。干预组在随访时哮喘的平均年度初级保健就诊率比对照组高 35%（95%置信区间 1.03-1.76，P=0.03）。
这种以父母为中心的短信干预措施并未影响急诊就诊或哮喘发病率；然而，结果表明其有可能增强对初级保健的利用，以管理儿科慢性疾病。
