Limitations
This study had certain limitations, including a low participation rate and low viewership of the video tutorials. The intervention group showed increased self-efficacy, but only a third watched the video tutorials. Caregivers in the intervention group who did not watch the video tutorials or made repeated triage calls may have sought advice on home management elsewhere.The low participation rate affects generalizability, although children of nonparticipating caregivers had the same hospital referral ratio, indicating similar symptom severity. Providing video tutorials alone as intervention assumed they could address caregivers’ worries. However, low participation and viewership suggest caregiver concerns hindered motivation to participate.Additionally, missing data on self-efficacy limited the analysis, and imputation was not feasible. Surveys carry social desirability bias, but randomization and neutral response options (eg, text message surveys) enable meaningful comparisons. However, the lack of participant blinding introduces response bias. Combining the 3 self-efficacy items into a dichotomized outcome also posed a limitation, and aggregating questions into an ordinal score or analyzing each question separately (given the questionnaire’s brevity) could have enhanced statistical power. Additionally, data were unavailable on parental age, parental socioeconomic status, and the number of siblings, which could impact health care utilization.Although promising for caregiver empowerment, this study does not reflect real-world conditions due to low participation rate, and the user base might differ from those who participated in the study. Further studies with different setups are needed to assess the effectiveness of video tutorials in empowering caregivers and reducing health care costs, as well as to assess other patient groups.