Matthew A. Broom

Feasibility and Perception of Using Text Messages as an Adjunct Therapy for Low-Income, Minority Mothers With Postpartum Depression

Background Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face. Objective Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression. Methods Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey. Results In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US

Text Messaging in Medical Education

777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%). Conclusions Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression.

Texting preferences in a Paediatric residency

Today’s medical students and residents are from the first generation of digital natives: those who grew up with cell phones, text messaging, and the Internet. They are comfortable with e-innovation,1 are increasingly disengaged from traditional teaching methods within medical schools and residency programs, and are quick to embrace new teaching technologies. Students instead stream lectures from home, use electronic devices to access medical journals online, and use “smart” phone applications during rounds. Adapting teaching methods within medical schools and residencies to connect with this generation of e-learners is challenging. Text messaging (short message service) offers a method of bridging the gap between traditional teaching styles and the educational styles of millennial learners because of its ease, familiarity, and asynchronous nature. Among adults aged 18 to 29 years, 94% own a cell phone, and of those, 97% send and receive text messages.2 Some residency programs even provide trainees with smart phones.3 The prevalence, acceptance, and low cost of text messaging make it particularly inviting as a potentially high-yield learning tool in medical education. Texting has already become a well-accepted way to communicate with and engage students in high school and undergraduate settings, with a variety of platforms available for teachers.4–6 Teachers may use text messages to remind students about assignments, to deliver rapid-fire surveys or quizzes during class, or to conduct course-wide discussions (either within or outside the standard classroom period).7 Texting platforms are unique in that they allow participants to ask questions or discuss topics via the comfort of anonymity, which may promote participation and enhance learning.8 This form of feedback direct from one’s mobile phone is popular. Texting that occurs directly between learner and teacher, although it may not afford anonymity to the student from the teacher, … Address correspondence to Matthew A. Broom, MD, Department of Pediatrics, Saint Louis University School of Medicine at SSM Cardinal Glennon Children’s Medical Center, 1465 S Grand Blvd, St Louis, MO 63104. E-mail: broomma{at}slu.edu

Brief, Rapid Response, Parenting Interventions Within Primary Care Settings.

Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question‐and‐answer (Q&A) texting format; and (2) pre‐/post‐paediatric in‐training exam (ITE) performance.

The Role of Maternal Knowledge of Child Development in Predicting Risk for Child Maltreatment

Opportunities created by the Patient Protection and Affordable Care Act along with the increased prevalence of pediatric behavioral and mental health concerns provide new challenges for pediatric health care providers. To address these matters, providers need to change the manner by which they provide health care to families. A novel approach is providing brief, rapid response, evidence-based parenting interventions within the pediatric primary care setting. Family-focused parenting programs support the American Academy of Pediatrics recommendations of improving mental health via supports in pediatric primary care to maximize the social and psychological well-being of families. A considerable body of research indicates that parenting interventions reduce the severity and frequency of disruptive behavior disorders in children and provide support to parent by bolstering parental resilience and improving overall family functioning. Providing these services within the pediatric primary care setting addresses the need for fully integrated health services that are family-centered and easily accessible.

Social Media: Social Intelligence Training Module

Child maltreatment is a serious pediatric concern that results in immediate physical and emotional injuries and also creates increased risk for other adverse outcomes across the life course, such as substance abuse, risky sexual behavior, obesity, mental illness, and criminal behavior. Child maltreatment is difficult to quantify as many cases are not reported, but nationally representative data suggest that at some point during childhood, 25.6% of children have experienced some degree of maltreatment. Pediatricians are mandated reporters of child abuse and neglect and will likely encounter patients at risk for maltreatment in their practice. Incomplete and often poor parental knowledge of child development is linked to unrealistic expectations of young children, leading to maltreatment. Increasingly child protection systems recognize parental knowledge of child development as a key protective factor against maltreatment. Parents with enough child development knowledge to understand the needs and limitations of their developing children are better prepared to provide a safe home environment. Poor parental knowledge of child development is especially problematic in specific subgroups. The overall risk of child maltreatment increases 3 to 4 times for children with developmental disabilities and is related to both child and parent factors. As a result, medically and/or developmentally complex children are at even greater risk of child maltreatment. Because 70% of reported child abuse deaths occur prior to age 3, understanding parents’ knowledge and perspective about the child development of very young children is important to prevent maltreatment early. This study seeks to contribute to the ability of pediatricians to offer anticipatory guidance to parents about developing appropriate expectations for and anticipating the needs of very young, developmentally disabled children. Methods

text4peds: a randomised text-messaging trial

Introduction Physicians’ posts on social media have the potential to impact the patient-physician relationship, interpersonal relationships at work, institutions’ reputations, and the publics trust in health care professionals. Empirical research, along with several very public cases of unprofessional behavior by physicians on social media, suggests that resident physicians are not always aware of the implications of their actions online. Residency programs are being charged with ways to model positive online presence. The goal of this project was to develop a social media training program that emphasized perspective taking and fostered appropriate social media use. Methods This training program involves an interactive lecture and discussion, with approximately 20 minutes of content, 20 minutes of small-group discussion, and 10 minutes of large-group discussion. We evaluated the effectiveness of this program by asking participants to complete presession and postsession surveys of social media knowledge, attitudes, and behaviors. Results Survey responses (N = 16) suggest that the social media training program was successful. Participants demonstrated an increase in knowledge of social media policies, ability to identify potentially inappropriate media interactions, ability to identify appropriate responses to such interactions, and understanding of how their actions on social media affect others. Discussion We believe that the social media module is an effective and useful tool for members of the medical community as the internet and social media continue to grow in popularity and lines between professional and personal realms are continually blurred. While the effectiveness of this program was established with first-year pediatric residents, the module material is applicable to a broader medical audience.

Educational Text Messages Decreased Emergency Department Utilization Among Infant Caregivers: A Randomized Trial

The use of cell phone text messaging in the medical field is of growing interest, but there are few data examining its value in medical education. The text4peds educational text‐messaging program was created for third‐year medical students preparing for the National Board of Medical Examiners (NBME) paediatric subject examination.

Text4Peds: Feasibility of an Educational Text-Messaging Program for Pediatrics Residents

OBJECTIVE To determine the feasibility and effectiveness of text messages as an educational tool to reduce the prevalence of nonurgent emergency department (ED) visits among a population with high levels of low health literacy. METHODS This prospective, randomized experiment conducted in a large, urban, academic pediatric primary care practice enrolled 231 caregivers of infants into 2 groups: enhanced standard of care materials at well-child visits through 6 months (n = 99 completing), and enhanced standard of care and 4 text messages a week through 6 months (n = 108 completing). Use of the ED and visit urgency were compared between groups via chart review at 1 year of age. RESULTS Of the 230 included in the analysis, 84.2% (n = 194 of 230) were racial or ethnic minorities, 69.7% (n = 142 of 204) reported yearly incomes of less than

A Program to Prevent Burnout, Depression, and Anxiety in First-Year Pediatric Residents

20,000 per year, and 70.4% (n = 142 of 204) were identified as having likely or probable limited health literacy. Participants who received text messages had fewer visits to the ED in their first year (2.14 visits in the control group to 1.47 visits in the intervention group who received text messages; P < .05). CONCLUSIONS Sending educational text messages to caregivers is effective in reducing the number of visits to the ED. Given the accessibility and small expense of sending text messages, these findings have direct implications on the cost of health care, in addition to improving continuity and quality of care for pediatric patients.