Text2Breathe: Enhance Parent Communication to Reduce Pediatric Asthma Disparities

Text2Breathe：加强家长沟通，减少小儿哮喘差异

• 批准号: 9065943
• 负责人: Tumaini Rucker Coker
• 金额: $ 37.66万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-10 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065943
• 关键词: 18 year old; Accident and Emergency department; Address; Adherence; Adult; Affect; African American; Asthma; Behavior; Caring; Cellular Phone; Child; Childhood; Childhood Asthma; Chronic; Chronic Disease; Clinic; Cognition; Communication; Data; Diabetes Mellitus; Diagnosis; Disadvantaged; District of Columbia; Education; Emergency Department-based Intervention; Emergency department visit; Enrollment; Ensure; Family; Foundations; Goals; Guidelines; Health; Health Communication; Health Personnel; Health Policy; Health behavior change; Healthcare; Immunization; Impairment; Instruction; Intervention; Intervention Trial; Knowledge; Low income; Mediating; Medical; Medical Education; Morbidity - disease rate; Outcome; Parents; Patients; Persons; Pharmaceutical Preparations; Prevalence; Prevention program; Preventive; Primary Health Care; Provider; Randomized; Randomized Controlled Trials; Recommendation; Reporting; Self Efficacy; Self Management; Services; Structure; Surveys; Symptoms; Techniques; Telephone Interviews; Text; Time; United States; base; behavior change; cost; design; disparity reduction; dosage; effective therapy; efficacy testing; empowered; empowerment; expectation; follow-up; health disparity; improved; inner city; mHealth; minority children; mobile computing; mortality; policy implication; post intervention; primary outcome; programs; response; routine provider; secondary outcome; skills; social cognitive theory; standard care; tool; treatment as usual; urgent care

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.

描述（由申请人提供）：哮喘等慢性病对非裔美国 (AA) 儿童的影响尤为严重。国家哮喘教育和预防计划 (NAEPP) 哮喘诊断和管理指南的一项重要建议是医疗保健提供者和患者（以及儿童的父母）之间的合作。促进家长与提供者就医疗保健状况和担忧进行公开沟通，可以使他们能够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）父母的健康沟通技巧可以提高父母对治疗建议的依从性，包括利用初级保健进行哮喘护理，并最终改善孩子的哮喘健康结果。我们的团队最近完成了一项关于现场健康沟通干预的随机对照试验，该试验导致与 PCP 建立更多的哮喘护理合作伙伴关系并减少紧急护理的使用，但效果在干预后 2 个月内并未持续。移动技术，例如短消息服务（SMS，“文本消息”），是扩大这种干预的剂量和范围的低成本手段，并且对于广泛使用 SMS 的 AA 来说可能特别有用。拟议的研究涉及短信增强型医疗保健沟通干预措施 (Text2Breathe)，旨在为城市低收入 AA 父母提供工具/技术，使父母能够更有效地与孩子的 PCP 沟通。 268 名前往急诊室哮喘教育诊所就诊的儿童的 AA 家长将被随机分配到常规护理或 Text2Breathe。 Text2Breathe 小组将持续收到个性化短信，提供为期一年的干预期间有关哮喘护理沟通的指导。有关父母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）以及儿童哮喘结果的结果数据将在 3 点通过结构化电话访谈收集。 注册后 6、12、18 和 24 个月。该试验可以通过验证短信增强型医疗保健沟通干预措施的有效性来减少儿科健康差异，该干预措施可以扩展到其他慢性病并具有健康和政策影响。