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Text2Breathe: Text-Message Intervention for Parent Communication and Pediatric Asthma

  • Tumaini R. Coker
    Affiliations
    University of Washington School of Medicine, Division of General Pediatrics, 6200 NE 74th St., Suite 110, Seattle, WA 98115-8160

    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105
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  • Stephanie J. Mitchell
    Correspondence
    Address correspondence to: Stephanie J. Mitchell; Seattle Children's Hospital Research Institute (under contract agreement), c/o Tumaini Coker, M/S CURE-3, 1920 Terry Ave, Seattle, WA 98101
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105
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  • Sarah J. Lowry
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105
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  • Eileen J. Klein
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105

    University of Washinton School of Medicine Department of Pediatrics, Division of Emergency Medicine, 4800 Sand Point Way NE, MB.7.520, Seattle, WA 98105
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  • James W. Stout
    Affiliations
    University of Washington School of Medicine, Division of General Pediatrics, 6200 NE 74th St., Suite 110, Seattle, WA 98115-8160

    University of Washington, Department of Health Services, 1959 NE Pacific St, Seattle, WA 98195
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  • Julie C. Brown
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105

    University of Washinton School of Medicine Department of Pediatrics, Division of Emergency Medicine, 4800 Sand Point Way NE, MB.7.520, Seattle, WA 98105
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  • Kendra S. Liljenquist
    Affiliations
    University of Washington School of Medicine, Division of General Pediatrics, 6200 NE 74th St., Suite 110, Seattle, WA 98115-8160

    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105

    University of Washington, Department of Health Services, 1959 NE Pacific St, Seattle, WA 98195
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  • Elizabeth Wingfield
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105
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  • Author Footnotes
    1 Currently serving as Director of Health Equity & Product Inclusion for Google but not affiliated with that institution when this research was conducted.
    Ivor B. Horn
    Footnotes
    1 Currently serving as Director of Health Equity & Product Inclusion for Google but not affiliated with that institution when this research was conducted.
    Affiliations
    Seattle Children's Hospital Research Institute, 4800 Sand Point Way NE, RB.2.401, Seattle, WA 98105
    Search for articles by this author
  • Author Footnotes
    1 Currently serving as Director of Health Equity & Product Inclusion for Google but not affiliated with that institution when this research was conducted.

      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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