Texting Adolescents in Repeat DKA and Their Caregivers.

BACKGROUND: Text message interventions are feasible, preferable, and sometimes effective for youth with diabetes. However, few, if any studies, have examined the personalized use of text messages with youth repeatedly hospitalized for diabetic ketoacidosis (DKA) and their caregivers. This study characterizes the use of personalized text messages in Novel Interventions in Children's Healthcare (NICH). METHODS: Approximately 2 months of text messages sent to youth with repeat DKA and their caregivers were logged regarding the following text characteristics: (1) content, (2) intervention type, (3) timing, and (4) recipient characteristics. RESULTS: NICH interventionists sent 2.3 and 1.5 texts per day to patients and caregivers, respectively. Approximately 59% of outgoing texts occurred outside of typical business hours, and roughly 68% of texts contained some form of support and/or encouragement. The relation between type of intended intervention and day/time of text was significant, χ(2)(2, N = 5,808) = 266.93, P < .001. Interventionists were more likely to send behavioral intervention text messages outside of business hours, whereas they were more likely to send care coordination and case management text messages during business hours. CONCLUSIONS: To our knowledge, this is the first study to specifically categorize and describe the personalized use of text messages with youth repeatedly hospitalized for DKA and their caregivers. Findings indicate that a promising treatment program for these youth frequently used text interventions to deliver praise and encouragement to patients and caregivers alike, often outside of typical business hours, and tailored text content based on patient and caregiver characteristics.

Novel Interventions in Children's Healthcare for Youth Hospitalized for Chronic Pain.

The purpose of this study was to pilot the implementation of the Novel Interventions in Children's Healthcare (NICH) program for youth with chronic pain who utilized a disproportionate amount of health care. Three youth (2 males and 1 female, aged 11 to 15 years) participated. The intervention consisted of a combination of family-based problem-solving, care coordination, and case management, with the inclusion of technology-assisted treatment delivery (e.g., text messages, video chat) to reduce costs. Both objective (i.e., hospitalization records) and subjective (e.g., interventionist reports) outcomes were examined to assess changes over the course of treatment. Two of the three youth demonstrated reductions in the number of days hospitalized and associated costs. In addition, interventionist reports indicated improved quality of life for family and youth served. Although further research is needed, NICH appears to be a promising intervention for youth with chronic pain and high health care utilization and shows the potential to result in improved youth health and reduced monetary costs for families, providers, and the healthcare system.