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Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study.
Coller, Ryan J; Lerner, Carlos F; Berry, Jay G; Klitzner, Thomas S; Allshouse, Carolyn; Warner, Gemma; Nacht, Carrie L; Thompson, Lindsey R; Eickhoff, Jens; Ehlenbach, Mary L; Bonilla, Andrea J; Venegas, Melanie; Garrity, Brigid M; Casto, Elizabeth; Bowe, Terah; Chung, Paul J.
Afiliação
  • Coller RJ; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: rcoller@pediatrics.wisc.edu.
  • Lerner CF; Department of Biostatistics and Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Berry JG; Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Klitzner TS; Department of Biostatistics and Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Allshouse C; Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
  • Warner G; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Nacht CL; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Thompson LR; Department of Biostatistics and Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Eickhoff J; Family Voices of Minnesota, Stillwater, MN.
  • Ehlenbach ML; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Bonilla AJ; Department of Biostatistics and Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Venegas M; Department of Biostatistics and Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Garrity BM; Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Casto E; Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA.
  • Bowe T; Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
  • Chung PJ; Department of Health Systems Science, Kaiser Permanente School of Medicine, Los Angeles, CA; Departments of Pediatrics and Health Policy & Management, UCLA, RAND Health, Los Angeles, CA; RAND Corporation, Los Angeles, CA.
J Pediatr ; 230: 207-214.e1, 2021 03.
Article em En | MEDLINE | ID: mdl-33253733
OBJECTIVE: 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, Assessing Confidence at Times of Increased Vulnerability (ACTIV), to collect repeated measures of parent confidence. STUDY DESIGN: This prospective cohort study purposively sampled parent-child dyads (n = 75) in 1 of 3 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. RESULTS: 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 greater. 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. CONCLUSIONS: 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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Atitude / Telemedicina / Envio de Mensagens de Texto / Hospitalização Tipo de estudo: Clinical_trials / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Atitude / Telemedicina / Envio de Mensagens de Texto / Hospitalização Tipo de estudo: Clinical_trials / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de publicação: Estados Unidos