Abstract
Objective
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.
Methods
A randomized controlled trial enrolled 221 parents of Medicaid-insured children visiting
the emergency departments of two 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.
Results
Participants were mostly female, English speakers, of minority race/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% CI 1.03-1.76, p=0.03).
Conclusions
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.
Key Words
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Article Info
Publication History
Accepted:
May 7,
2022
Received:
October 15,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
Funding/Support: Research reported in this article was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under award number R01MD007740. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Academic Pediatric Association
