A Texting Intervention in Latino Families to Reduce ED Use: A Randomized Trial

Author:

DeCamp Lisa Ross12,Godage Sashini K.3,Valenzuela Araujo Doris4,Dominguez Cortez José1,Wu Linxuan2,Psoter Kevin J.2,Quintanilla Kassandra5,Rivera Rodríguez Tatiahna6,Polk Sarah12

Affiliation:

1. Center for Salud/Health and Opportunity for Latinos and

2. Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland;

3. Harvard Medical School, Harvard University, Boston, Massachusetts;

4. Oregon Health and Science University, Portland, Oregon;

5. Western Michigan Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan; and

6. Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois

Abstract

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 Día 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 Día (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.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference68 articles.

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3. Technical report–racial and ethnic disparities in the health and health care of children;Flores;Pediatrics,2010

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