Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 3, 2019
Date Accepted: May 21, 2019
Willingness to Join a Smartphone-based Emergency Response Community: Evidence from a Field Study
ABSTRACT
Background:
Medical emergencies such as anaphylaxis may require immediate use of emergency medication. The low adherence of chronic patients (i.e., carrying anti-anaphylactic medication) and the potentially long response time of Emergency Medical Services (EMS) require alternative approaches in order to provide immediate first aid. A smartphone-based Emergency Response Community (ERC) was established for allergy patients that enables members to share their Automatic Adrenaline Injector (AAI) with other patients who don’t have their AAI at the onset of symptoms. The community is operated by a national EMS. In the first stage of the trial, children with food allergies and their parents were invited to join the community.
Objective:
To identify the factors that influence the willingness to join a smartphone-based Emergency Response Community for allergy patients at risk of anaphylaxis.
Methods:
The willingness to join an ERC was studied from different perspectives: the willingness of children who suffer from severe allergies to join an ERC, the willingness of their parents to join an ERC, the willingness of parents to enroll their children in an ERC, and the parents’ and children’s opinions about the minimum age to join an ERC. Several types of independent variables were used: demographics, medical data, adherence, parenting style, and children autonomy. A convenience sample of children and their parents who attended an annual meeting of a nonprofit organization for patients with food allergies, was used. Various statistical methods, cluster analyses, and classification trees were applied.
Results:
73 parents’ questionnaires and 23 children’s questionnaires were collected. Response rates were approximately 95%. Adherence was high (96% of children and 42% of parents had the AAI when asked). Willingness to join the community was high among parents (95%) and among children (78%). Willingness of parents to enroll their children was 49%. The minimum age to join an ERC was 12.27 years (STD 3.02) in the parents’ opinion and 13.15 years (STD = 3.44) in the children’s opinion.
Conclusions:
Parents’ willingness to join an ERC was negatively correlated with parents’ age, child’s age, and parents’ adherence. These correlations can be explained by the “free-rider effect”: parents who carried an AAI for their young child, but had low adherence, wanted to join the ERC in order to get an additional layer of response in an emergency. Children’s willingness to join the community was positively correlated with age and negatively correlated with the child’s emotional autonomy. Parents’ willingness to enroll their children in an ERC was positively correlated with child’s age and negatively correlated with parents’ adherence: again, can be explained by the aforementioned "free-rider effect". Parents’ and children’s opinions about the minimum age to join an ERC were negatively correlated with protective parenting style and positively correlated with monitoring parenting style. Clinical Trial: The research was approved by the Institutional Review Board of Bar-Ilan University and by the Research Committee of Magen David Adom.
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