A Texting Intervention in Latino Families to Reduce ED Use: A Randomized Trial
A Texting Intervention in Latino Families to Reduce ED Use: A Randomized Trial
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DOI：
10.1542/peds.2019-1405
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发表时间：
2020-01-01
期刊：
影响因子：
8
通讯作者：
Polk, Sarah
中科院分区：
文献类型：
--
作者：
DeCamp, Lisa Ross;Godage, Sashini K.;Polk, Sarah
背景和后果：移民家庭中的拉丁裔儿童经历了医疗保健方面的差距。针对这一人群的短信干预措施可能会解决不平等问题。本研究的目的是评估西班牙语短信干预对婴儿急诊室使用和良好护理以及疫苗依从性的影响。方法：Salud al Dia干预是一个教育视频和互动短信，贯穿儿童生命的第一年，通过2016年2月至2017年12月在城市学术儿科初级保健实践中进行的随机对照试验进行了评估。入选标准为：有公共保险的独生子女，年龄< 2个月;父母年龄> 18岁，西班牙语为首选卫生保健语言;至少有一部家用手机。主要结果是从15个月大时的电子病历中提取的。使用意向治疗分析。结果：共有157对亲子配对被随机分配到Salud al Dia组（n = 79）或对照组（n = 78）。在所有参与者中，父母的平均年龄为29.3岁（标准差：6.2岁），美国的平均年龄为7.3岁（标准差：5.3岁），87%的父母的健康素养有限或边缘。对照组与干预组急诊使用的发生率比为1.48（95%置信区间：1.04-2.12）。与对照组相比，干预组婴儿接受2剂流感疫苗的比例更高（81% vs 67%; P = 0.04）。结论：这种西班牙语短信干预减少了急诊室的使用，并增加了医疗保健差异高风险人群的流感疫苗接种。量身定制的短信干预是解决差距的一个有前途的方法。
BACKGROUND AND OBJECTIVES: Latino children in immigrant families experience health care disparities. Text messaging interventions for this population may address disparities. The objective of this study was to evaluate the impact of a Spanish-language text messaging intervention on infant emergency department use and well care and vaccine adherence. METHODS: The Salud al Dia intervention, an educational video and interactive text messages throughout the child's first year of life, was evaluated via randomized controlled trial conducted in an urban, academic pediatric primary care practice from February 2016 to December 2017. Inclusion criteria were publicly insured singleton infant < 2 months of age; parent age > 18, with Spanish as the preferred health care language; and at least 1 household cellular phone. Primary outcomes were abstracted from the electronic medical record at age 15 months. Intention-to-treat analyses were used. RESULTS: A total of 157 parent-child dyads were randomly assigned to Salud al Dia (n = 79) or control groups (n = 78). Among all participants, mean parent age was 29.3 years (SD: 6.2 years), mean years in the United States was 7.3 (SD: 5.3 years), and 87% of parents had limited or marginal health literacy. The incidence rate ratio for emergency department use for the control versus intervention group was 1.48 (95% confidence interval: 1.04-2.12). A greater proportion of intervention infants received 2 flu vaccine doses compared with controls (81% vs 67%; P = .04). CONCLUSIONS: This Spanish-language text messaging intervention reduced emergency department use and increased flu vaccine receipt among a population at high risk for health care disparities. Tailored text message interventions are a promising method for addressing disparities.