General Pediatrician/HSR Researcher Los Angeles County Department of Public Health Los Angeles, California, United States
Background: Inequitable access to quality asthma care is a barrier to improving racially disparate asthma outcomes. Novel approaches to increase access to quality care are needed to reduce outcome disparities. Text messaging, a ubiquitous technology, can be used as an asynchronous telemedicine strategy to bypass transportation and other barriers to in-person care.
We hypothesize text messaging will be an acceptable and feasible strategy of routinely engaging underserved minority families of children with asthma cared for in safety net settings. Objective: We aim to (1) increase access to asthma care for underserved minority pediatric patients with asthma, (2) assess whether there is improvement in asthma control, and (3) determine the feasibility of a text message-based telemedicine model to augment asthma management. Design/Methods: This is a one-group pretest posttest design that targets parents of children (0-17 years) with asthma cared for at one of three county clinics in a large urban area. Parents will be sent 5 monthly asthma assessment surveys (using a validated asthma survey) via text message. The final survey will include questions related to feasibility of the intervention. Based on the responses received and the determined asthma severity/control, participants will receive automated simple feedback to manage their asthma.
Participants will receive weekly text message alerts that indicate when the risk of asthma attacks is high, based on local environmental conditions. Data collection will continue through October 2023. IRB approval was obtained.
Data Analysis Plan: Baseline sociodemographic characteristics including age, gender, and social vulnerability index, will be compared between respondents and non-respondents. Race and ethnicity, parental income and education levels, insurance type, and asthma control and severity will be determined among respondents. Change in asthma morbidity overtime will be assessed along with participants’ preference for management using a text message-based telemedicine model.
