Primary Health Care Clinical Trial
Official title:
Salud al Día: Engaging Latino Parents in Pediatric Primary Care
Objective: To conduct a pilot randomized controlled trial comparing the effectiveness of a parent support intervention consisting of periodic text messages and educational support (video, collateral materials),and usual care on the healthcare engagement of limited English proficient (LEP) Latino parents during participants' child's first year and to examine its impact on healthcare utilization and primary care quality.
Lessons learned in organizational engagement reveal a critical need to increase healthcare
engagement among LEP Latino parents. LEP Latina mothers who were founding members of Latino
Family Advisory Board (LFAB) at the Johns Hopkins Bayview Medical Center identified the
health system knowledge that enabled participants to more effectively use the healthcare
system as one of the key benefits of board membership. The gains in knowledge, skills, and
confidence demonstrated in the LFAB evaluation mirror qualitative evaluation findings of
other ambulatory care advisory boards, and reflect the concept of patient activation. Patient
activation, a component of individual patient engagement, is defined as the patient's
willingness to manage their health and healthcare based on understanding one's role in the
care process and having the knowledge, skills, and confidence to do so. Interventions focused
on increasing activation, using both in-person and mHealth support, have demonstrated
efficacy and have led to improvement in health and healthcare quality. mHealth-based
interventions have the ability to reach larger populations at lower cost, with the potential
for increased tailoring and interactivity, especially as the use of cellular phones becomes
nearly universal, even among low-income populations. For example, Text4baby, a perinatal
health education program delivered through passive educational text messages, has
demonstrated success at reaching low-income Spanish-speaking parents with positive user
assessments.
A recent study of parent healthcare activation among low-income parents (conducted by PI:
DeCamp) demonstrated that parent activation among parents whose preferred healthcare language
was Spanish was significantly lower than that of parents whose preferred healthcare language
was English. These findings further support targeting increasing the healthcare engagement of
LEP Latino parents.
This novel intervention will integrate mobile health (mHealth) technology and culturally- and
linguistically-tailored interpersonal support to increase healthcare engagement of LEP Latino
parents and to enable participants to overcome barriers to effective healthcare access and
use. Investigators hypothesize that this intervention will measurably increase parent
healthcare engagement and that this will positively impact healthcare utilization, quality
and the patient/family experience. Increasing healthcare engagement of LEP Latino families
and demonstrating positive healthcare impact through a tailored, scalable intervention would
create a foundation for larger-scale impact on healthcare disparities for Latino children and
a model for increasing engagement of other vulnerable populations.
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