Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Feb 5, 2024
Open Peer Review Period: Feb 12, 2024 - Apr 8, 2024
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer-Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Association Between Applying a Mobile Health Decision Aid and Education Application and Caregivers' Behavioral Change in the Management of Child Febrile Illnesses - Use of Antibiotics, Antipyretics, and the Healthcare System: A Single-Arm Prospective Pre-Post Intervention Study
ABSTRACT
Background:
Feverish illnesses are common among children, presenting a management challenge for caregivers. Despite evidence supporting beneficial immunological effects, the practical implementation of this knowledge is lacking and a prevailing negative attitude towards fever persists. The overuse of antipyretics and antibiotics in general pediatric practice, along with the associated risk of antimicrobial resistance, underscores critical considerations in healthcare.
Objective:
The goal of this study was to evaluate the mHealth intervention FeverFriend, a personalized decision aid mobile phone application connected with a knowledge base. The aim was to enhance health literacy to improve health literacy among caregivers of children with feverish illnesses and to teach fever management adherent to the NICE (2021) guideline. It was hypothesized, that the users following the app usage would administer less antipyretics, antibiotics, and seek less frequent consultations with doctors compared to their practices before using the app.
Methods:
This study had a single-arm, prospective, pre-post evaluation design. Eligible participants were caregivers of healthy children under 18 residing in Hungary. Entering the study, participants provided demographic, anthropometric information and responded to premeasurements related to the use of 1) antibiotics, 2) antipyretics, and the 3) healthcare system (visiting a doctor) due to feverish illnesses. The prospective intervention involved the use of the FeverFriend mHealth application, followed by post-measurements on the same three dimensions, among other feverish symptoms. We assessed sample coverage by examining basic caregiver-reported sociodemographic and anthropometric measures using chi-square test for independence. We captured within-patient change applying paired binary McNemar's tests for the three user-reported baseline and post-intervention outcome measures during the 35-month period analyzed.
Results:
Caregivers enrolled a total of 22.219 healthy children with average age 3 years 1 month (SD 3.28) demonstrating good coverage of the population on gender (female 48.22% (10.714/22.219; χ21=2.517, P=.64) and number of siblings (1.67, SD 0.88; χ24=11.45, P=.56). A total of 12.948 feverish illnesses were reported, of which 4.927 (38.05%, 4.927/12.948) were reviewed in detail providing post-measurements. The outcomes of the first illness reviews per each patient (n=1.934) were utilized to ensure consistent intervention exposure for all patients. Our results support the hypotheses: after completing the mHealth intervention, caregivers administered significantly less antipyretics (McNemar χ21=13.79), antibiotics (McNemar χ21=8.17) and consult less often (McNemar χ21=128.84) with doctors (all P values <.005).
Conclusions:
This study provides preliminary evidence that the FeverFriend mHealth intervention has the potential to reduce administration of antipyretics, antibiotics among children with feverish illnesses and users exhibited a decreased frequency of doctor visits compared to their practices before using the app. Future research should incorporate randomized trials to confirm causality and the multivariate analysis of the secondary outcome measures of the app on symptoms and parental confidence. Clinical Trial: ClinicalTrials.gov NCT04633603; https://clinicaltrials.gov/study/NCT04633603
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.