Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study

Area of Science:

• Pediatric Healthcare
• Digital Health Interventions
• Patient-Reported Outcomes

Background:

• Children with medical complexity (CMC) often face frequent hospitalizations.
• Parental confidence in managing their child's health at home is crucial for preventing hospitalizations.
• Existing methods for tracking parental confidence are limited in real-time data collection.

Purpose of the Study:

• To assess the association between parental confidence in preventing hospitalization and actual hospitalizations in CMC.
• To evaluate the feasibility and acceptability of the Assessing Confidence at Times of Increased Vulnerability (ACTIV) texting platform for repeated measurement of parental confidence.

Main Methods:

• A prospective cohort study involving 75 parent-child dyads from complex care programs.
• Parents received bi-weekly text messages over 3 months to rate their confidence (1-10) in avoiding hospitalization.
• Generalized estimating equations analyzed the association between confidence levels and subsequent hospitalizations within 14 days.

Main Results:

• A high texting response rate (95.6%) was observed.
• Low parental confidence (<5) was associated with a 4.02 times greater adjusted odds of hospitalization within 2 weeks.
• The ACTIV platform demonstrated high feasibility and acceptability, with minimal burden and strong likelihood of continued use.

Conclusions:

• Low parental confidence is a significant predictor of impending hospitalizations for CMC.
• The ACTIV texting platform is a feasible and acceptable tool for monitoring parental confidence in this population.
• Future research should explore real-time interventions triggered by low reported confidence.