Text2Breathe: Enhance Parent Communication to Reduce Pediatric Asthma Disparities

描述(申请人提供)：慢性疾病，如哮喘，对非裔美国人(AA)儿童的影响不成比例。国家哮喘教育和预防计划(NAEPP)哮喘诊断和管理指南的一个关键建议是医疗保健提供者和患者(以及他们的父母，针对儿童)之间的合作。促进父母就医疗保健状况和关注事项与提供者进行公开沟通，可以帮助他们更有效地与孩子的初级保健提供者(PCP)合作。因此，提高非裔美国人(AA)父母的健康沟通技能可以提高父母对治疗建议的依从性，包括对哮喘护理的初级保健的利用，并最终改善他们孩子的哮喘健康结局。我们的团队最近完成了一项面对面健康沟通干预的随机对照试验，结果是在哮喘护理方面与PCP建立了更多的合作伙伴关系，并降低了紧急护理的使用率，但干预后2个月后效果并未持续。移动技术，例如短消息服务(短消息服务，“文本消息”)，是扩大这种干预的剂量和范围的低成本手段，并且可能在对其广泛使用短消息服务的AA中特别有用。拟议的研究涉及短信增强的医疗沟通干预(Text2Breathe)，旨在为城市低收入再生障碍性贫血的父母配备工具/技术，使父母能够更有效地与子女的初级保健计划进行沟通。在急诊科哮喘教育诊所就诊的268名AA儿童的父母将被随机分配到常规护理或Text2Breathe。Text2Breathe小组将收到持续的个性化短信，在长达一年的干预期内提供有关哮喘护理沟通的指导。关于父母的自我效能和结果期望、对哮喘护理治疗建议的遵守情况(例如，初级保健利用情况)以及儿童哮喘结果的结果数据将在3：00通过结构化电话访谈收集， 注册后6、12、18和24个月。这项试验可以通过验证短信增强的医疗沟通干预的有效性来减少儿科健康差距，这种干预可以延伸到其他慢性病，并具有健康和政策影响。

DESCRIPTION (provided by applicant): Chronic diseases, such as asthma, disproportionately affect African American (AA) children. A key recommendation of the National Asthma Education and Prevention Program (NAEPP) Guidelines for the Diagnosis and Management of Asthma is partnership between healthcare providers and patients (and their parents, for children). Facilitating parents' open communication with providers regarding healthcare status and concerns can equip them to more effectively partner with their child's primary care provider (PCP). Thus, improving the health communication skills of African American (AA) parents could improve parent's adherence to treatment recommendations including utilization of the primary care for asthma care, and ultimately improve their child's asthma health outcomes. Our team recently completed a randomized controlled trial of an in- person health communication intervention that resulted in more partnerships with PCPs for asthma care and lower urgent care usage, but effects were not sustained past 2 months post-intervention. Mobile technology, such as Short Message Service (SMS, "text messaging"), is a low-cost means of extending the dosage and scope of this intervention and may be particularly useful among AAs, for whom the use of SMS is widespread. The proposed study involves a SMS-enhanced healthcare communication intervention (Text2Breathe) designed to equip urban, low-income AA parents with tools/techniques to empower parents to more effectively communicate with their children's PCP. 268 AA parents of children attending an emergency department asthma education clinic will be randomized to usual care or Text2Breathe. The Text2Breathe group will receive ongoing individualized text messages providing instruction about asthma care communication during the year- long intervention period. Outcome data on parental self-efficacy and outcome expectations, adherence to asthma care treatment recommendations (e.g., primary care utilization), and child asthma outcomes will be collected via structured telephone interviews at 3, 6, 12, 18, and 24 months post-enrollment. This trial can reduce pediatric health disparities by verifying the efficacy of a SMS-enhanced healthcare communication intervention that can extend to other chronic conditions and have health and policy implications.