Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study.
Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study.
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通过移动的健康将父母的信心和住院联系起来：一项多地点试点研究。
DOI：
10.1016/j.jpeds.2020.11.049
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Chung PJ
中科院分区：
文献类型：
--
作者：
Coller RJ;Lerner CF;Berry JG;Klitzner TS;Allshouse C;Warner G;Nacht CL;Thompson LR;Eickhoff J;Ehlenbach ML;Bonilla AJ;Venegas M;Garrity BM;Casto E;Bowe T;Chung PJ
评估父母避免住院的信心和有医疗复杂性(CMC)的儿童随后住院之间的联系；以及短信平台ACTIV收集父母信心的重复测量的可行性/可接受性。这项前瞻性队列研究在人口多样性的三个复杂护理计划之一中有目的地抽样了75名亲子二人组，以试行为期3个月的活动。在每两周随机的几天/几次，父母们会收到短信，要求他们对孩子在下个月避免住院的信心进行评分，从1(不自信)到10(完全自信)。未调整和调整的带有重复测量的广义估计方程评估了信心与未来14天住院之间的关系。研究后问卷和焦点小组评估了Activ的可行性/可接受性。父母是77.3%的母亲，20%的人说西班牙语。短信回复率为95.6%。18人在短信后14天内住院，中位数(IQR)为8(2-10)天。当置信度为<；5vs.≥5时，调整后的2周内住院的优势比(95%CI)高4.02(1.2-13.51)倍。几乎所有人(96.8%)都表示没有短信负担，三分之一的人希望更频繁地发短信，93.7%的人很可能会继续发短信。焦点小组探索了回应的意义，并提出了积极的改进建议。在这项人口统计学多样化的多中心试验中，父母信心低预示着即将到来的CMC住院。短信是可行的，也是可以接受的。未来的工作将测试由父母报告的低自信引发的实时干预的有效性。
To evaluate the associations between parent confidence in avoiding hospitalization and subsequent hospitalization in children with medical complexity (CMC); and feasibility/acceptability of a texting platform, ACTIV, to collect repeated measures of parent confidence. This prospective cohort study purposively sampled parent-child dyads (n=75) in one of three complex care programs for demographic diversity to pilot test ACTIV for 3 months. At random days/times every 2 weeks, parents received text messages asking them to rate confidence in their child avoiding hospitalization in the next month, from 1 (not confident) to 10 (fully confident). Unadjusted and adjusted generalized estimating equations with repeated measures evaluated associations between confidence and hospitalization in the next 14 days. Post-study questionnaires and focus groups assessed ACTIV’s feasibility/acceptability. Parents were 77.3% mothers and 20% Spanish-speaking. Texting response rate was 95.6%. Eighteen hospitalizations occurred within 14 days after texting, median (IQR) 8 (2-10) days. When confidence was <5 vs. ≥5, adjusted odds (95% CI) of hospitalization within 2 weeks were 4.02 (1.20-13.51) times higher. Almost all (96.8%) reported no burden texting, one-third desired more frequent texts, and 93.7% were very likely to continue texting. Focus groups explored the meaning of responses and suggested ACTIV improvements. In this demographically diverse multicenter pilot, low parent confidence predicted impending CMC hospitalization. Text messaging was feasible and acceptable. Future work will test efficacy of real-time interventions triggered by parent-reported low confidence.
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3.2
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通讯作者：
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