WhatsApp Effective as Atopic Dermatitis Education Tool

Patients living with atopic dermatitis and the parents of pediatric patients living with the chronic inflammatory skin condition demonstrated knowledge gained and retained following a 7-day educational module delivered via WhatsApp that targeted Hispanic individuals. In 2003, this population was declared the largest minority group in the United States, according to the US Census Bureau.

“Barriers to health care access, such as communication and language proficiency, are one of many factors driving health disparities in diseases prevalent in the Hispanic community, one of which is atopic dermatitis,” the study authors wrote. “Interventions that are culturally competent, cost-effective, easily accessed, and available in the Spanish language can provide a solution to the traditional barriers to health access found in the Hispanic community.”

They published their findings in Journal of Clinical Medicine, following both the provision of the educational module and evaluation of its effectiveness via a health knowledge survey distributed before the program, after it concluded, and 1 month later. Each day covered a different topic: introduction to atopic dermatitis, up-to-date knowledge on causes, common triggers, pharmacological treatments, nonpharmacological treatments, dietary considerations, and stress reduction/psychological effects.

There was an overall 14% increase (P < .001) in health knowledge of atopic dermatitis seen among the program participants upon the education module’s conclusion, with the study investigators highlighting that WhatsApp is free and easy to access—qualities that help to remove barriers in terms of cost, convenience, cultural understanding, and Spanish language translation.

Most participants were aged 18 to 29 years and 30 to 39 years (34.5% each), female (85.5%), and Hispanic/Latino (83.6%); had university (47.3%) or high school (29.1%) as their highest level of education; and had an annual household income below $40,000 (69.2%).

Three groups overall were evaluated, with groups 1, 2, and 3 having 28, 17, and 10 participants each, respectively. The different sizes comprised a subanalysis that aimed to determine if group size had an impact on participation and outcomes.

Results of the 1-way analysis of variance, which was used to measure changes between the 3 survey distributions, show similar results in knowledge on the initial (P = .062) and final (P = .978) surveys. However, a significant difference was seen overall (P < .001), when the initial, final, and 1-month follow-up surveys were considered. Mean (SD) health knowledge scores rose from 26.51 (3.27) before the survey to 31.57 (3.22) after the survey, and this had not significantly changed by time of the 1-month follow-up, when the score was 30.46 (2.99).

Together, these findings represent a 14% overall increase in health knowledge, with a 1-month postintervention drop of 3.2%.

Additional analyses revealed the following findings:

• Higher yearly income was associated with higher baseline knowledge score, with those with a yearly income of $40,000 or less having 71.7% of questions correct vs 89.2% for those making $100,000 or more.
• Lower total level of education was linked to a higher health knowledge percent increase, with 17.6% seen for those with a middle school education vs 7.6% for those with postgraduate education.
• Children living with atopic dermatitis were frequently bullied.
• Adults living with atopic dermatitis were ostracized from their coworkers, friends, and family over fears the skin condition was contagious.
• There was a lack of exposure to atopic dermatitis education, even from medical providers.

“To our knowledge, this is the first study in the field of dermatology utilizing the WhatsApp virtual platform to administer an educational intervention,” the study authors concluded. “Participants found comfort in having the ability to discuss, support, and confide in other individuals that have lived through shared realities, something that a majority of participants have reported not having access to in their daily life.”

Going forward, the authors recommend investigations of other dermatological virtual interventions and to expand them to gauge quality-of-life measures (eg, sleep, mood, stress) and patient education based on incorrect answers from postintervention surveys.

Reference

Andrade LF, Bekhash MJ, Choragudi S, Gonzalez JM, Valdes R, Yosipovitch G. Impact of a digital atopic dermatitis educational intervention on Hispanic patients and family members. J Clin Med. Published online March 8, 2023. doi:10.3390/jcm12062130