Effect of virtual education and follow-up on health literacy and resilience in family caregivers of pediatric hemodialysis patients: a randomized controlled trial.

BACKGROUND: Family caregivers of pediatric hemodialysis patients may face challenges in health literacy and resilience. This study evaluated the effect of a culturally tailored virtual education and follow-up program on these outcomes. METHODS: Sixty caregivers were randomly assigned to intervention (n = 30) and control (n = 30) groups using computer-generated randomization with allocation concealment. The intervention group received routine education plus 3 weeks of virtual training and follow-up via Eitaa, an interactive Iranian messaging application, including multimedia content and online interactive sessions; controls received routine education only. Health literacy and resilience were measured at baseline, immediately post-intervention, and 1 month later using the Health Literacy for Iranian Adults (HELIA) and Connor-Davidson Resilience Scale (CD-RISC). Non-parametric tests were applied due to non-normal data, and effect sizes (Cohen's d and Kendall's W) were reported. RESULTS: Fifty-five participants completed the study. Baseline characteristics were comparable. The intervention group showed significant improvements in health literacy (HELIA: baseline 36.7 ± 9.4, post-intervention 45.2 ± 8.5, 1-month 44.0 ± 9.0; Friedman P < .001; Cohen's d = 0.45) and resilience (CD-RISC: baseline 66.6 ± 11.0, post-intervention 78.3 ± 10.5, 1-month 76.5 ± 11.2; Friedman P < .001; Cohen's d = 0.55) compared with controls, who exhibited minimal changes. CONCLUSIONS: Culturally tailored virtual education with follow-up moderately improves health literacy and resilience among family caregivers of pediatric hemodialysis patients, supporting its integration into routine care. The use of Eitaa ensures feasibility and accessibility within Iran. TRIAL REGISTRATION: IRCT20240914063036N1. Registered on October 11, 2024.