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Video Tutorials to Empower Caregivers of Ill Children and Reduce Health Care Utilization: A Randomized Clinical Trial
Liv Borch-Johnsen1,2, Caroline Gren1, Stine Lund3,4
1Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark.
Insights
Video tutorials for caregivers of acutely ill children significantly boosted self-efficacy and reduced healthcare use. This empowers parents and may decrease hospital visits, improving care for sick children.
Area of Science:
- Pediatric Healthcare
- Health Informatics
- Caregiver Education
Background:
- Young children frequently experience illnesses, causing caregiver distress and leading to healthcare service utilization.
- Effective caregiver support is crucial for managing childhood illnesses and optimizing healthcare resource allocation.
Purpose of the Study:
- To evaluate the efficacy and safety of video tutorials in enhancing caregiver self-efficacy for managing acutely ill children.
- To determine if video tutorials reduce the need for medical helpline consultations and hospital assessments.
Main Methods:
- A randomized clinical trial involving 4686 caregivers and children (aged 0.5-11.9 years) who contacted an out-of-hours Medical Helpline.
- Intervention group received video tutorials on managing common childhood symptoms and seeking medical help; control group received standard telephone triage.
- Primary outcome was caregiver self-efficacy, with secondary outcomes including satisfaction, child status, and healthcare utilization over 72 hours.
Main Results:
- Caregivers receiving video tutorials reported significantly higher self-efficacy (80% vs 76%; P=.04).
- The intervention group had substantially fewer telephone triages during follow-up (887 vs 2374).
- Per-protocol analysis indicated fewer hospital assessments in the video tutorial group (27% vs 35%).
Conclusions:
- Video tutorials effectively and safely increase caregiver self-efficacy and reduce telephone triage usage.
- Providing video resources can empower caregivers, potentially leading to fewer hospital visits for acutely ill children.
- This approach highlights the potential of digital health information to improve caregiver confidence and streamline healthcare utilization.
Importance:
Young children often fall ill, leading to concern among their caregivers and urgent contact with health care services.
Objective:
To assess the effectiveness and safety of video tutorials to empower caregivers in caring for acutely ill children.
Design, Setting, And Participants:
Caregivers calling the out-of-hours Medical Helpline 1813 (MH1813), Emergency Medical Services Capital Region, Denmark, and their children aged 0.5 to 11.9 years were randomized to video tutorials (intervention) or telephone triage by a nurse or physician (control) from October 2020 to December 2021 and followed up for 72 hours blinded to the intervention. Data were analyzed from March to July 2022.
Intervention:
The intervention group had the call disconnected before telephone triage and received video tutorials on managing common symptoms in acutely ill children and when to seek medical help. Caregivers could subsequently call MH1813 for telephone triage.
Main Outcomes And Measures:
The primary outcome was caregivers' self-efficacy, reported in an electronic survey the following day. Secondary outcomes were satisfaction, child status, assessment by a general practitioner or physician at the hospital, telephone triage, and adverse events during the 72-hour follow-up period.
Results:
In total, 4686 caregivers and children were randomized to intervention (2307 participants) or control (2379 participants), with a median (IQR) child age of 2.3 (1.3-5.1) years and 53% male distribution in both groups (2493 participants). Significantly more caregivers in the intervention group reported high self-efficacy (80% vs 76%; crude odds ratio [OR], 1.30; 95% CI, 1.01-1.67; P = .04). The intervention group received fewer telephone triages during follow-up (887 vs 2374 in the control group). Intention-to-treat analysis showed no difference in secondary outcomes, but per-protocol subanalysis showed fewer hospital assessments when caregivers watched video tutorials (27% vs 35%; adjusted OR, 0.67; 95% CI, 0.55-0.82). Randomization to video tutorials did not increase adverse outcomes.
Conclusions And Relevance:
In this randomized clinical trial, offering caregivers video tutorials significantly and safely increased self-efficacy and reduced use of telephone triage. Children had fewer hospital assessments when caregivers watched videos. This suggests a future potential of health care information to empower caregivers and reduce health care utilization.
Trial Registration:
ClinicalTrials.gov Identifier: NCT04301206.
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