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Randomized Controlled Trial of Acute Illness Educational Intervention in the Pediatric Emergency Department: Written
Bryn E Lepley1, David C Brousseau2, Meghan F May1
1From the Medical College of Wisconsin.
Insights
Parents in a pediatric emergency department preferred a written health book over a mobile health app. The book was used more, understood better, and found more useful than the app.
Area of Science:
- Digital Health
- Pediatric Emergency Medicine
- Health Literacy
Background:
- Mobile health (mHealth) applications offer potential for health education.
- Written materials are commonly used for patient education in pediatric emergency departments (EDs).
- Assessing the comparative effectiveness of digital versus print interventions is crucial for optimizing patient engagement.
Purpose of the Study:
- To evaluate the feasibility, demand, acceptability, and usefulness of an mHealth app compared to a written intervention.
- To compare parent preferences for digital versus print health information in a pediatric ED setting.
Main Methods:
- A randomized controlled trial involving parents of children aged 12 years or younger presenting to the ED.
- Participants were randomized to receive a low-literacy pediatric health book with video, an mHealth app, both, or a control intervention.
- Outcomes including demand, acceptability, and usefulness were assessed at 1-, 3-, and 6-month follow-ups.
Main Results:
- Only 57.1% of parents downloaded the mHealth app.
- Parents used the book significantly more than the app (73.0% vs 35.1%).
- The book was perceived as easier to understand and more useful than the app, with higher recommendation rates.
Conclusions:
- Parents demonstrated a clear preference for the written health book over the mHealth app.
- Written health information in the pediatric ED setting empowers parents and may reduce future nonurgent ED visits.
- Further research into effective health communication strategies for vulnerable populations is warranted.
Objectives:
The aim of this study was to determine the (1) feasibility, (2) demand, (3) acceptability, and (4) usefulness of a mobile health (mHealth) application (app) compared with a written intervention distributed in a pediatric emergency department (ED).
Methods:
This was a randomized controlled trial with parents of children 12 years or younger presenting to the ED for nonurgent complaints. Parents were randomized to receive a (1) low literacy pediatric health book with video, (2) pediatric mHealth app, (3) both 1 and 2, or (4) car-seat safety video and handout (control). Demand, acceptability, and usefulness were assessed at 1-, 3-, and 6-month follow-ups. Modified intention-to-treat analysis was completed for proportional data.
Results:
Ninety-eight parents completed randomization (83% approached). One or more follow-up was completed for 80.6% of parents. Only 57.1% downloaded the app. Parents used the app less than the book (35.1% vs 73.0%, P < 0.01), found the app to be harder to understand (26.0% vs 94.6%, P < 0.001) and less useful (37.8% vs 70.3%, P < 0.01), and were less likely to recommend the app to others (48.7% vs 100%, P < 0.01). No parent who received both book and app would prefer to have only the app; 88.9% of parents wanted either the book or both.
Conclusions:
There was low demand for an mHealth app with parents who prefer, accept, and use the book more. Giving written health information to vulnerable populations in a pediatric ED has the capacity to empower parents with knowledge to care for a child and potentially decrease future nonurgent ED use with translation into a larger study.
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