A Randomized Controlled Trial of a Text Messaging Intervention to Promote Virologic Suppression and Retention in Care in an Urban Safety-Net HIV Clinic: The Connect4Care (C4C) Trial.

PubMed

Christopoulos, Katerina A; Riley, Elise D; Carrico, Adam W; Tulsky, Jacqueline; Moskowitz, Judith T; Dilworth, Samantha; Coffin, Lara S; Wilson, Leslie; Peretz, Jason Johnson; Hilton, Joan F

2018-02-21

Text messaging is a promising strategy to support HIV care engagement, but little is known about its efficacy in urban safety-net HIV clinic populations. We conducted a randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor retention or were new to clinic. Participants were randomized (stratified by new HIV diagnosis status) to receive one of the following for 12 months: 1) thrice-weekly intervention messages, plus texted primary care appointment reminders and a monthly text message requesting confirmation of study participation, or; 2) texted reminders and monthly messages alone. Viral load was assessed at 6 and 12 months. The primary outcome was virologic suppression (<200 copies/mL) at 12 months, estimated via repeated measures log-binomial regression, adjusted for new diagnosis status. The secondary outcome was retention in clinic care. Between August 2013-November 2015, 230 participants were randomized. Virologic suppression at 12 months was similar between intervention and control participants (48.8% vs. 45.8%), with negligible change from 6-month estimates, yielding RR 1.07 (95% CI: 0.82, 1.39). Suppression was higher in the newly diagnosed (78.3% vs. 45.3%). There were no intervention effects on the secondary outcome. Exploratory analyses suggested that patients with more responses to study text messages had better outcomes, regardless of arm. The C4C text messaging intervention did not significantly increase virologic suppression or retention in care. Response to text messages may be a useful way for providers to gauge risk for poor HIV outcomes. NCT01917994.

Young People’s Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior

PubMed Central

McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-01-01

Background The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. Objectives The aim of this paper is to explore young people’s views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. Methods We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. Results We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection on and sharing of messages with friends, family members, and partners, thus providing opportunities for education and discussion. For some recipients, the messages had increased their knowledge of how to correctly use condoms. Some described how the messages had increased their confidence and reduced stigma, enabling them to disclose infection to a partner and/or to do so sooner and more calmly. Discussing the messages with a partner reportedly enabled some women to negotiate condom use. Conclusion From the perspective of the recipients, the tone, frequency, and content of the text messaging-based sexual health intervention was acceptable and appropriate. Their accounts indicated that the intervention increased knowledge, confidence, and safer sex behaviors. A large-scale randomized controlled trial (RCT) is needed to assess effectiveness. PMID:27083784

Young People's Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior.

PubMed

French, Rebecca Sophia; McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-04-15

The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. The aim of this paper is to explore young people's views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection on and sharing of messages with friends, family members, and partners, thus providing opportunities for education and discussion. For some recipients, the messages had increased their knowledge of how to correctly use condoms. Some described how the messages had increased their confidence and reduced stigma, enabling them to disclose infection to a partner and/or to do so sooner and more calmly. Discussing the messages with a partner reportedly enabled some women to negotiate condom use. From the perspective of the recipients, the tone, frequency, and content of the text messaging-based sexual health intervention was acceptable and appropriate. Their accounts indicated that the intervention increased knowledge, confidence, and safer sex behaviors. A large-scale randomized controlled trial (RCT) is needed to assess effectiveness.

Development and Preliminary Pilot Testing of a Peer Support Text Messaging Intervention for HIV-Infected Black Men Who Have Sex with Men

PubMed Central

Senn, Theresa E.; Braksmajer, Amy; Coury-Doniger, Patricia; Urban, Marguerite A.; Rossi, Adam; Carey, Michael P.

2016-01-01

Background Black men who have sex with men (MSM) are disproportionately infected with HIV, and are less well retained along the HIV continuum of care. We report on the feasibility of a peer support text messaging intervention designed to increase retention in HIV care and HIV medication adherence among HIV-infected Black MSM. Methods Based on formative research, a cellphone app was developed to support a peer-based text messaging intervention. The app allowed the researchers to view text messages sent between mentors and mentees, but did not allow them to view other text messages sent by these phones. Three HIV-infected Black MSM were recruited to serve as volunteer peer mentors. They were trained in motivational techniques, peer support skills, and skills for improving appointment attendance and medication adherence. Mentees (N = 8) received the intervention for one month. Mentees completed a post-intervention survey and interview. Results The peer mentor text messaging intervention was feasible. Mentors delivered support in a nonjudgmental, motivational way. However, technical and other implementation problems arose. Some mentees desired more frequent contact with mentors, and mentors reported that other commitments made it difficult at times to be fully engaged. Both mentors and mentees desired more personalized contact (i.e., phone calls). Conclusions A text messaging peer mentor intervention was feasible. Additional research with a larger sample is needed to determine optimal ways to improve mentors’ engagement in the intervention, as well as to determine intervention acceptability and efficacy. In future studies, peer support phone calls could be incorporated. PMID:28079722

Texting your way to healthier eating? Effects of participating in a feedback intervention using text messaging on adolescents' fruit and vegetable intake.

PubMed

Pedersen, Susanne; Grønhøj, Alice; Thøgersen, John

2016-04-01

This study investigates the effects of a feedback intervention employing text messaging during 11 weeks on adolescents' behavior, self-efficacy and outcome expectations regarding fruit and vegetable intake. A pre- and post-survey was completed by 1488 adolescents school-wise randomly allocated to a control group and two experimental groups. Both experimental groups set weekly goals on fruit and vegetable intake, reported their consumption daily and subsequently received feedback on their performance via mobile text messaging (Short Message Service [SMS]). The second experimental group also received, in addition, a 45-min nutrition education session from a dietitian during school. The direct effects of the interventions were not significant. However, for adolescents participating in the SMS routines, there were significant effects of the level of engagement in the intervention, reflected in the number of sent text messages, on intervention outcomes. Participants sending more than half of the possible text messages significantly increased their fruit and vegetable intake. Participants sending between 10% and 50% of the possible text messages experienced a significant drop in self-efficacy and those sending less than 10% experienced a significant drop in outcome expectations. The findings suggest that participants' active engagement in an intervention is crucial to its success. Implications for health-promoting interventions are discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Text2Floss: the feasibility and acceptability of a text messaging intervention to improve oral health behavior and knowledge.

PubMed

Hashemian, Tony S; Kritz-Silverstein, Donna; Baker, Ryan

2015-01-01

Text messaging is useful for promoting numerous health-related behaviors. The Text2Floss Study examines the feasibility and utility of a 7-day text messaging intervention to improve oral health knowledge and behavior in mothers of young children. Mothers were recruited from a private practice and a community clinic. Of 156 mothers enrolled, 129 randomized into text (n = 60) and control groups (n = 69) completed the trial. Participants in the text group received text messages for 7 days, asking about flossing and presenting oral health information. Oral health behaviors and knowledge were surveyed pre- and post-intervention. At baseline, there were no differences between text and control group mothers in knowledge and behaviors (P > 0.10). Post-intervention, text group mothers flossed more (P = 0.01), had higher total (P = 0.0006) and specific (P < 0.05) knowledge, and tried to improve their child's oral health behaviors (P = 0.03) and decrease their soda and sugary snacks (P = 0.05) more than control mothers. Text messages were accepted and perceived as useful. Mothers receiving text messages improved their own oral health behaviors and knowledge as well as their behaviors regarding their children's oral health. Text messaging represents a viable method to improve oral health behaviors and knowledge. Its high acceptance may make it useful for preventing oral disease. © 2014 American Association of Public Health Dentistry.

Development and Preliminary Pilot Testing of a Peer Support Text Messaging Intervention for HIV-Infected Black Men Who Have Sex With Men.

PubMed

Senn, Theresa E; Braksmajer, Amy; Coury-Doniger, Patricia; Urban, Marguerite A; Rossi, Adam; Carey, Michael P

2017-02-01

Black men who have sex with men (MSM) are disproportionately infected with HIV and are less well retained along the HIV continuum of care. We report on the feasibility of a peer support text messaging intervention designed to increase retention in HIV care and HIV medication adherence among HIV-infected black men who have sex with men. Based on formative research, a cell phone app was developed to support a peer-based text messaging intervention. The app allowed the researchers to view text messages sent between mentors and mentees, but did not allow them to view other text messages sent by these phones. Three HIV-infected black men who have sex with men were recruited to serve as volunteer peer mentors. They were trained in motivational techniques, peer support skills, and skills for improving appointment attendance and medication adherence. Mentees (N = 8) received the intervention for 1 month. Mentees completed a postintervention survey and interview. The peer mentor text messaging intervention was feasible. Mentors delivered support in a nonjudgmental, motivational way. However, technical and other implementation problems arose. Some mentees desired more frequent contact with mentors, and mentors reported that other commitments made it difficult at times to be fully engaged. Both mentors and mentees desired more personalized contact (ie, phone calls). A text messaging peer mentor intervention was feasible. Additional research with a larger sample is needed to determine optimal ways to improve mentors' engagement in the intervention and to determine intervention acceptability and efficacy. In future studies, peer support phone calls could be incorporated.

Impact of an Educational Text Message Intervention on Adolescents' Knowledge and High-Risk Behaviors.

PubMed

Hickman, Nichole Erin; Schaar, Gina

2018-03-01

Health care providers need to develop improved methods of educating adolescents. This study was developed to evaluate adolescents' responses to and satisfaction with an educational text message intervention to promote healthy behaviors, reduce the incidence of unhealthy behaviors, and prevent high-risk behaviors. Adolescent participants received weekly text messages regarding high-risk sexual behaviors, healthy dietary habits, exercise, drug, or alcohol use, and social issues. Results indicate adolescents learned something new, made a behavioral change, and overall liked the delivery of educational information via text message. This indicates long-term continuation of a text message intervention is a viable means to deliver adolescent health information, thereby improving an adolescent's current and future health status.

Bilingual Text Messaging Translation: Translating Text Messages From English Into Spanish for the Text4Walking Program

PubMed Central

Sandi, Giselle; Ingram, Diana; Welch, Mary Jane; Ocampo, Edith V

2015-01-01

Background Hispanic adults in the United States are at particular risk for diabetes and inadequate blood pressure control. Physical activity improves these health problems; however Hispanic adults also have a low rate of recommended aerobic physical activity. To address improving physical inactivity, one area of rapidly growing technology that can be utilized is text messaging (short message service, SMS). A physical activity research team, Text4Walking, had previously developed an initial database of motivational physical activity text messages in English that could be used for physical activity text messaging interventions. However, the team needed to translate these existing English physical activity text messages into Spanish in order to have culturally meaningful and useful text messages for those adults within the Hispanic population who would prefer to receive text messages in Spanish. Objective The aim of this study was to translate a database of English motivational physical activity messages into Spanish and review these text messages with a group of Spanish speaking adults to inform the use of these text messages in an intervention study. Methods The consent form and study documents, including the existing English physical activity text messages, were translated from English into Spanish, and received translation certification as well as Institutional Review Board approval. The translated text messages were placed into PowerPoint, accompanied by a set of culturally appropriate photos depicting barriers to walking, as well as walking scenarios. At the focus group, eligibility criteria for this study included being an adult between 30 to 65 years old who spoke Spanish as their primary language. After a general group introduction, participants were placed into smaller groups of two or three. Each small group was asked to review a segment of the translated text messages for accuracy and meaningfulness. After the break out, the group was brought back together to review the text messages. Results A translation confirmation group met at a church site in an urban community with a large population of Hispanics. Spanish speaking adults (N=8), with a mean age of 40 (SD 6.3), participated in the study. Participants were engaged in the group and viewed the text messages as culturally appropriate. They also thought that text messages could motivate them to walk more. Twenty-two new text messages were added to the original database of 246 translated text messages. While the text messages were generally understood, specific word preferences were seen related to personal preference, dialect, and level of formality which resulted in minor revisions to four text messages. Conclusions The English text messages were successfully translated into Spanish by a bilingual research staff and reviewed by Hispanic participants in order to inform the use of these text messages for future intervention studies. These Spanish text messages were recently used in a Text4Walking intervention study. PMID:25947953

Adolescents just do not know what they want: a qualitative study to describe obese adolescents' experiences of text messaging to support behavior change maintenance post intervention.

PubMed

Smith, Kyla L; Kerr, Deborah A; Fenner, Ashley A; Straker, Leon M

2014-04-08

Adolescents are considered a hard to reach group and novel approaches are needed to encourage good health. Text messaging interventions have been reported as acceptable to adolescents but there is little evidence regarding the use of text messages with overweight and obese adolescents to support engagement or behavior change after the conclusion of a healthy lifestyle program. The intent of this study was to explore the opinions of overweight adolescents and their parents regarding the use of text messages as a support during the maintenance period following an intervention. This paper reports on the findings from focus groups conducted with adolescents (n=12) and parents (n=13) who had completed an eight-week intensive intervention known as Curtin University's Activity, Food and Attitudes Program (CAFAP). Focus groups were conducted three months post intensive intervention. Participants were asked about their experiences of the prior three-month maintenance phase during which adolescents had received tri-weekly text messages based on the self-determination theory and goal-setting theory. Participants were asked about the style and content of text messages used as well as how they used the text messages. Data were analyzed using content and thematic analyses. Two clear themes emerged from the focus groups relating to (1) what adolescents liked or thought they wanted in a text message to support behavior change, and (2) how they experienced or responded to text messages. Within the "like/want" theme, there were five sub-themes relating to the overall tone of the text, frequency, timing, reference to long-term goals, and inclusion of practical tips. Within the "response to text" theme, there were four sub-themes describing a lack of motivation, barriers to change, feelings of shame, and perceived unfavorable comparison with other adolescents. What adolescents said they wanted in text messages often conflicted with their actual experiences. Parent reports provided a useful secondary view of adolescent experience. The conflicting views described in this study suggest that overweight and obese adolescents may not know or have the ability to articulate how they would best be supported with text messages during a healthy lifestyle maintenance phase. Further, supporting both engagement and behavior change simultaneously with text messaging may not be possible. Intervention texts should be personalized as much as possible and minimize feelings of guilt and shame in overweight and obese adolescents. Future research with text messaging for overweight and obese adolescents should incorporate clear intervention aims and evaluation methods specifically related to adolescent engagement or behavior change. Australian New Zealand Clinical Trials Registry: ACTRN12611001187932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001187932.

Acceptability, Language, and Structure of Text Message-Based Behavioral Interventions for High-Risk Adolescent Females: A Qualitative Study

PubMed Central

Ranney, Megan L.; Choo, Esther K.; Cunningham, Rebecca M.; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J.; Morrow, Kathleen

2014-01-01

Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants’ needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. PMID:24559973

Text Messaging Interventions on Cancer Screening Rates: A Systematic Review.

PubMed

Uy, Catherine; Lopez, Jennifer; Trinh-Shevrin, Chau; Kwon, Simona C; Sherman, Scott E; Liang, Peter S

2017-08-24

Despite high-quality evidence demonstrating that screening reduces mortality from breast, cervical, colorectal, and lung cancers, a substantial portion of the population remains inadequately screened. There is a critical need to identify interventions that increase the uptake and adoption of evidence-based screening guidelines for preventable cancers at the community practice level. Text messaging (short message service, SMS) has been effective in promoting behavioral change in various clinical settings, but the overall impact and reach of text messaging interventions on cancer screening are unknown. The objective of this systematic review was to assess the effect of text messaging interventions on screening for breast, cervical, colorectal, and lung cancers. We searched multiple databases for studies published between the years 2000 and 2017, including PubMed, EMBASE, and the Cochrane Library, to identify controlled trials that measured the effect of text messaging on screening for breast, cervical, colorectal, or lung cancers. Study quality was evaluated using the Cochrane risk of bias tool. Our search yielded 2238 citations, of which 31 underwent full review and 9 met inclusion criteria. Five studies examined screening for breast cancer, one for cervical cancer, and three for colorectal cancer. No studies were found for lung cancer screening. Absolute screening rates for individuals who received text message interventions were 0.6% to 15.0% higher than for controls. Unadjusted relative screening rates for text message recipients were 4% to 63% higher compared with controls. Text messaging interventions appear to moderately increase screening rates for breast and cervical cancer and may have a small effect on colorectal cancer screening. Benefit was observed in various countries, including resource-poor and non-English-speaking populations. Given the paucity of data, additional research is needed to better quantify the effectiveness of this promising intervention. ©Catherine Uy, Jennifer Lopez, Chau Trinh-Shevrin, Simona C Kwon, Scott E Sherman, Peter S Liang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.08.2017.

Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

PubMed

Tofighi, Babak; Nicholson, Joseph M; McNeely, Jennifer; Muench, Frederick; Lee, Joshua D

2017-07-01

Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;36:477-491]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program.

PubMed

McCoy, Pamela; Leggett, Sophia; Bhuiyan, Azad; Brown, David; Frye, Patricia; Williams, Bryman

2017-03-29

African American adults are less likely to meet the recommended physical activity guidelines for aerobic and muscle-strengthening activity than Caucasian adults. The purpose of this study was to assess whether a text message intervention would increase physical activity in this population. This pilot study used a pre-/post-questionnaire non-randomized design. Participants in a faith-based weight loss competition who agreed to participate in the text messaging were assigned to the intervention group ( n = 52). Participants who declined to participate in the intervention, but agreed to participate in the study, were assigned to the control group ( n = 30). The text messages provided strategies for increasing physical activity and were based on constructs of the Health Belief Model and the Information-Motivation-Behavioral Skills Model. Chi square tests determined the intervention group participants increased exercise time by approximately eight percent ( p = 0.03), while the control group's exercise time remained constant. The intervention group increased walking and running. The control group increased running. Most participants indicated that the health text messages were effective. The results of this pilot study suggest that text messaging may be an effective method for providing options for motivating individuals to increase physical activity.

Text Messaging: An Intervention to Increase Physical Activity among African American Participants in a Faith-Based, Competitive Weight Loss Program

PubMed Central

McCoy, Pamela; Leggett, Sophia; Bhuiyan, Azad; Brown, David; Frye, Patricia; Williams, Bryman

2017-01-01

African American adults are less likely to meet the recommended physical activity guidelines for aerobic and muscle-strengthening activity than Caucasian adults. The purpose of this study was to assess whether a text message intervention would increase physical activity in this population. This pilot study used a pre-/post-questionnaire non-randomized design. Participants in a faith-based weight loss competition who agreed to participate in the text messaging were assigned to the intervention group (n = 52). Participants who declined to participate in the intervention, but agreed to participate in the study, were assigned to the control group (n = 30). The text messages provided strategies for increasing physical activity and were based on constructs of the Health Belief Model and the Information-Motivation-Behavioral Skills Model. Chi square tests determined the intervention group participants increased exercise time by approximately eight percent (p = 0.03), while the control group’s exercise time remained constant. The intervention group increased walking and running. The control group increased running. Most participants indicated that the health text messages were effective. The results of this pilot study suggest that text messaging may be an effective method for providing options for motivating individuals to increase physical activity. PMID:28353650

Using text messages to bridge the intention-behavior gap? A pilot study on the use of text message reminders to increase objectively assessed physical activity in daily life.

PubMed

Schwerdtfeger, Andreas R; Schmitz, Catalina; Warken, Matthias

2012-01-01

Sedentarism is a serious health concern in industrialized countries throughout the world. We examined whether a text message-based intervention, targeted at increasing daily levels of physical activity, would be more effective than a standard psychoeducational intervention and a control condition. Sixty-three individuals (43 women) with a mean age of 23.7 years participated in the study. They were randomly assigned to a psychoeducational standard intervention; an augmented intervention with additional short text messages sent to the mobile phones to remind participants of their action plans, and a control condition. Objectively assessed physical activity and self-efficacy were assessed pre- and post-intervention. Participants in the control condition showed a significant decline in physical activity from pre-assessment to post-assessment, whereas participants in both intervention arms exhibited a slight increase. Moreover, the augmented intervention resulted in a marginally significant increase in self-efficacy, whereas the standard intervention resulted in a significant decrease. The findings suggest that short text messages reminding individuals of their action plans are not more effective than an intervention without text messages, although there seems to be a beneficial effect on self-efficacy, which might facilitate behavior change in the long-term. Challenging aspects of the research design (e.g., reactivity of the assessment protocol) are discussed and suggestions for future research are highlighted.

Text Messaging as a Tool for Behavior Change in Disease Prevention and Management

PubMed Central

Cole-Lewis, Heather; Kershaw, Trace

2011-01-01

Mobile phone text messaging is a potentially powerful tool for behavior change because it is widely available, inexpensive, and instant. This systematic review provides an overview of behavior change interventions for disease management and prevention delivered through text messaging. Evidence on behavior change and clinical outcomes was compiled from randomized or quasi-experimental controlled trials of text message interventions published in peer-reviewed journals by June 2009. Only those interventions using text message as the primary mode of communication were included. Study quality was assessed by using a standardized measure. Seventeen articles representing 12 studies (5 disease prevention and 7 disease management) were included. Intervention length ranged from 3 months to 12 months, none had long-term follow-up, and message frequency varied. Of 9 sufficiently powered studies, 8 found evidence to support text messaging as a tool for behavior change. Effects exist across age, minority status, and nationality. Nine countries are represented in this review, but it is problematic that only one is a developing country, given potential benefits of such a widely accessible, relatively inexpensive tool for health behavior change. Methodological issues and gaps in the literature are highlighted, and recommendations for future studies are provided. PMID:20354039

Text messaging as a tool for behavior change in disease prevention and management.

PubMed

Cole-Lewis, Heather; Kershaw, Trace

2010-01-01

Mobile phone text messaging is a potentially powerful tool for behavior change because it is widely available, inexpensive, and instant. This systematic review provides an overview of behavior change interventions for disease management and prevention delivered through text messaging. Evidence on behavior change and clinical outcomes was compiled from randomized or quasi-experimental controlled trials of text message interventions published in peer-reviewed journals by June 2009. Only those interventions using text message as the primary mode of communication were included. Study quality was assessed by using a standardized measure. Seventeen articles representing 12 studies (5 disease prevention and 7 disease management) were included. Intervention length ranged from 3 months to 12 months, none had long-term follow-up, and message frequency varied. Of 9 sufficiently powered studies, 8 found evidence to support text messaging as a tool for behavior change. Effects exist across age, minority status, and nationality. Nine countries are represented in this review, but it is problematic that only one is a developing country, given potential benefits of such a widely accessible, relatively inexpensive tool for health behavior change. Methodological issues and gaps in the literature are highlighted, and recommendations for future studies are provided.

Physical activity text messaging interventions in adults: a systematic review.

PubMed

Buchholz, Susan Weber; Wilbur, JoEllen; Ingram, Diana; Fogg, Louis

2013-08-01

Physical inactivity is a leading health risk factor for mortality worldwide. Researchers are examining innovative techniques including the use of mobile technology to promote physical activity. One such technology, text messaging, is emerging internationally as a method to communicate with and motivate individuals to engage in healthy behaviors, including physical activity. Review the existing scientific literature on adult physical activity text messaging interventions. This systematic review examined research papers that addressed physical activity text messaging intervention studies in adults. Using multiple databases, the search strategy included published English language studies through October 1, 2011. An author-developed data collection tool was used independently by two reviewers to extract and examine the selected study variables. The initial search resulted in the identification of 200 publications. Eleven publications representing 10 studies were included in the final review. Studies were conducted in seven countries with over half the studies being randomized controlled trials. Participants of the studies were predominantly young to middle aged women. Physical activity data were mainly obtained by self-report although three studies used pedometers or accelerometers. Interventions ranged from only sending out text messages to combining text messages with educational materials, staff support, and/or Internet technology. Minimal information was given regarding development or number of text messages used. The median effect size for the studies was 0.50. To date, using text messaging as a method to promote physical activity has only been studied by a small group of researchers. Current physical activity text messaging literature is characterized by small sample sizes, heterogeneous but positive effect sizes, and a lack of specificity as to the development of the text messages used in these studies. Further research in this area is imperative to facilitate the expansion of mobile technology to promote physical activity. © 2013 Sigma Theta Tau International.

Technology-Enhanced Maintenance of Treatment Gains in Eating Disorders: Efficacy of an Intervention Delivered via Text Messaging

ERIC Educational Resources Information Center

Bauer, Stephanie; Okon, Eberhard; Meermann, Rolf; Kordy, Hans

2012-01-01

Objective: Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment. Method: The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on…

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol

PubMed Central

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-01-01

Introduction Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. Methods and analysis We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. Ethics and dissemination This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. Trial registration number NCT02585206. PMID:27029775

Combined Quitline Counseling and Text Messaging for Smoking Cessation: A Quasi-Experimental Evaluation.

PubMed

Boal, Ashley L; Abroms, Lorien C; Simmens, Samuel; Graham, Amanda L; Carpenter, Kelly M

2016-05-01

This study seeks to determine whether comprehensive quitline services combined with text messaging improve smoking cessation rates beyond those achieved by offering comprehensive quitline services alone. The study sample consisted of callers to the Alere Wellbeing, Inc, commercial quitline in 2012. A quasi-experimental design was implemented using propensity score matching to create the intervention and control groups. The intervention group consisted of those who were offered and accepted a text message intervention in addition to usual quitline services, while the control group consisted of those who were not offered the text message intervention. Analyses utilized baseline data collected at intake, program use data (eg, call history and text message use), and reports of smoking behaviors and program satisfaction collected 6 months after intake. Similar rates of 7-day abstinence were reported regardless of whether participants received combined multi-call quitline services plus text messaging (25.3%) or multi-call quitline services in isolation (25.5%), though those who received combined services reported higher treatment satisfaction (P < .05). Among those who received combined services, the number of text messages sent to the text message program predicted 7-day abstinence such that those who sent more text messages were less likely to report 7-day abstinence. Text messaging may not confer additional benefits over and above those received through multi-modal, multi-call quitline programs. Future research should investigate whether text messaging programs improve quit rates when combined with less intensive services such as single-call phone counseling. While the impact of quitline and text messaging services for smoking cessation have been examined in isolation, no study has explored the impact of combined services on smoking outcomes. This study examines the role of text messaging in combination with comprehensive quitline services including multi-call phone counseling, access to an interactive website and nicotine replacement therapy. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Implementation of Text-Messaging and Social Media Strategies in a Multilevel Childhood Obesity Prevention Intervention: Process Evaluation Results.

PubMed

Loh, Ivory H; Schwendler, Teresa; Trude, Angela C B; Anderson Steeves, Elizabeth T; Cheskin, Lawrence J; Lange, Sarah; Gittelsohn, Joel

2018-01-01

Social media and text messaging show promise as public health interventions, but little evaluation of implementation exists. The B'more Healthy Communities for Kids (BHCK) was a multilevel, multicomponent (wholesalers, food stores, recreation centers) childhood obesity prevention trial that included social media and text-messaging components. The BHCK was implemented in 28 low-income areas of Baltimore City, Maryland, in 2 waves. The texting intervention targeted 241 low-income African American caregivers (of 283), who received 3 texts/week reinforcing key messages, providing nutrition information, and weekly goals. Regular posting on social media platforms (Facebook, Instagram, Twitter) targeted community members and local stakeholders. High implementation standards were set a priori (57 for social media, 11 for texting), with low implementation defined as <50%, medium as 50% to 99%, high as ≥100% of the high standard for each measure. Reach, dose delivered, and fidelity were assessed via web-based analytic tools. Between waves, social media implementation improved from low-moderate to high reach, dose delivered, and fidelity. Text messaging increased from moderate to high in reach and dose delivered, fidelity decreased from high to moderate. Data were used to monitor and revise the BHCK intervention throughout implementation. Our model for evaluating text messaging-based and social media-based interventions may be applicable to other settings.

Using Text Message Surveys to Evaluate a Mobile Sexual Health Question-and-Answer Service.

PubMed

Willoughby, Jessica Fitts; L'Engle, Kelly Ladin; Jackson, Kennon; Brickman, Jared

2018-01-01

Text message programs for sexual health are becoming increasingly popular as practitioners aim to meet youth on media they use frequently. Two-way mobile health (mHealth) interventions allow for feedback solicitation from participants. This study explores the use of a text message survey to assess demographics and program feedback from users of an adolescent sexual health text message question-and-answer service. Development and feasibility of the short-message service survey are discussed. The text message survey achieved a 43.9% response rate, which is comparable to response rates of surveys conducted via other methods. When compared to respondents who used the service and completed an online in-school questionnaire, text survey respondents were more likely to be female and older. They also reported higher service satisfaction. Results have implications for text message service providers and researchers. This article examines a community application of a new intervention strategy and research methodology.

Text Messaging for Psychiatric Outpatients: Effect on Help-Seeking and Self-Harming Behaviors.

PubMed

Kodama, Toyohiko; Syouji, Hiroko; Takaki, Sachiko; Fujimoto, Hirokazu; Ishikawa, Shinichi; Fukutake, Masaaki; Taira, Masaru; Hashimoto, Takeshi

2016-04-01

A mobile phone intervention was developed and tested with 30 psychiatric outpatients with mental illness, who had high ideation for suicide. The intervention involved promoting help-seeking behaviors by sending text messages, including information about social welfare services and reminders about medical appointments, for 6 months. After the intervention period, the number of participants who used social services significantly increased, and more than 80% of participants reported that the text messaging service was helpful and useful. Compared to baseline, participants' self-harming behaviors decreased and the attending psychiatrists rated their suicide ideation as weaker. This is the first intervention study to promote psychiatric patients' help-seeking using text messaging, and although it was not a randomized controlled trial, this intervention has practical value and may lead to the prevention of suicide. Copyright 2016, SLACK Incorporated.

Text Messaging May Engage and Benefit Adults with Type 2 Diabetes Regardless of Health Literacy Status.

PubMed

Bergner, Erin M; Nelson, Lyndsay A; Rothman, Russell L; Mayberry, Lindsay

2017-10-01

Technology-delivered interventions have the potential to improve diabetes self-care and glycemic control among adults with type 2 diabetes (T2D). However, patients who do not engage with interventions may not reap benefits, and there is little evidence on how engagement with mobile health interventions varies by health literacy status. This study explored how patients with limited health literacy engaged with and experienced Rapid Education/Encouragement and Communications for Health (REACH), a text messaging intervention designed to support the self-care adherence of disadvantaged patients with T2D. We recruited adults with T2D from federally qualified health centers and used mixed methods to examine (1) associations between users' health literacy status and their prior mobile phone use and their engagement with REACH and (2) similarities and differences in users' self-reported benefits by health literacy status. Participants ( N = 55) completed a survey, including measures of health literacy and prior mobile phone use. For 2 weeks, participants experienced REACH, which included daily text messages promoting self-care and asking about medication adherence, and weekly text messages providing medication adherence feedback. After 2 weeks, participants completed a semi-structured telephone interview about their experiences. Participants with limited health literacy were less likely to have used cell phones to access the Internet (48% vs. 90%, p = .001) or email (36% vs. 87%, p < .001), but equally as likely to have used text messaging and to respond to REACH text messages ( p = .12 and p = .40, respectively) compared to participants with adequate health literacy. Participants responded to 93% of text messages on average and reported benefits of the intervention, including reminders and accountability, convenience and accessibility, and information and motivation. Participants with limited health literacy described a unique benefit of receiving social support from the intervention. Text messaging interventions may engage and benefit patients with T2D, regardless of health literacy status. Text messaging may have the potential to reduce T2D health disparities related to limited health literacy.

Text Messaging May Engage and Benefit Adults with Type 2 Diabetes Regardless of Health Literacy Status

PubMed Central

Bergner, Erin M.; Nelson, Lyndsay A.; Rothman, Russell L.; Mayberry, Lindsay

2017-01-01

Background Technology-delivered interventions have the potential to improve diabetes self-care and glycemic control among adults with type 2 diabetes (T2D). However, patients who do not engage with interventions may not reap benefits, and there is little evidence on how engagement with mobile health interventions varies by health literacy status. Objective This study explored how patients with limited health literacy engaged with and experienced Rapid Education/Encouragement and Communications for Health (REACH), a text messaging intervention designed to support the self-care adherence of disadvantaged patients with T2D. We recruited adults with T2D from federally qualified health centers and used mixed methods to examine (1) associations between users’ health literacy status and their prior mobile phone use and their engagement with REACH and (2) similarities and differences in users’ self-reported benefits by health literacy status. Methods Participants (N = 55) completed a survey, including measures of health literacy and prior mobile phone use. For 2 weeks, participants experienced REACH, which included daily text messages promoting self-care and asking about medication adherence, and weekly text messages providing medication adherence feedback. After 2 weeks, participants completed a semi-structured telephone interview about their experiences. Key Results Participants with limited health literacy were less likely to have used cell phones to access the Internet (48% vs. 90%, p = .001) or email (36% vs. 87%, p < .001), but equally as likely to have used text messaging and to respond to REACH text messages (p = .12 and p = .40, respectively) compared to participants with adequate health literacy. Participants responded to 93% of text messages on average and reported benefits of the intervention, including reminders and accountability, convenience and accessibility, and information and motivation. Participants with limited health literacy described a unique benefit of receiving social support from the intervention. Conclusions Text messaging interventions may engage and benefit patients with T2D, regardless of health literacy status. Text messaging may have the potential to reduce T2D health disparities related to limited health literacy. PMID:29214241

Adolescents Just Do Not Know What They Want: A Qualitative Study to Describe Obese Adolescents’ Experiences of Text Messaging to Support Behavior Change Maintenance Post Intervention

PubMed Central

Kerr, Deborah A; Fenner, Ashley A; Straker, Leon M

2014-01-01

Background Adolescents are considered a hard to reach group and novel approaches are needed to encourage good health. Text messaging interventions have been reported as acceptable to adolescents but there is little evidence regarding the use of text messages with overweight and obese adolescents to support engagement or behavior change after the conclusion of a healthy lifestyle program. Objective The intent of this study was to explore the opinions of overweight adolescents and their parents regarding the use of text messages as a support during the maintenance period following an intervention. Methods This paper reports on the findings from focus groups conducted with adolescents (n=12) and parents (n=13) who had completed an eight-week intensive intervention known as Curtin University’s Activity, Food and Attitudes Program (CAFAP). Focus groups were conducted three months post intensive intervention. Participants were asked about their experiences of the prior three-month maintenance phase during which adolescents had received tri-weekly text messages based on the self-determination theory and goal-setting theory. Participants were asked about the style and content of text messages used as well as how they used the text messages. Data were analyzed using content and thematic analyses. Results Two clear themes emerged from the focus groups relating to (1) what adolescents liked or thought they wanted in a text message to support behavior change, and (2) how they experienced or responded to text messages. Within the “like/want” theme, there were five sub-themes relating to the overall tone of the text, frequency, timing, reference to long-term goals, and inclusion of practical tips. Within the “response to text” theme, there were four sub-themes describing a lack of motivation, barriers to change, feelings of shame, and perceived unfavorable comparison with other adolescents. What adolescents said they wanted in text messages often conflicted with their actual experiences. Parent reports provided a useful secondary view of adolescent experience. Conclusions The conflicting views described in this study suggest that overweight and obese adolescents may not know or have the ability to articulate how they would best be supported with text messages during a healthy lifestyle maintenance phase. Further, supporting both engagement and behavior change simultaneously with text messaging may not be possible. Intervention texts should be personalized as much as possible and minimize feelings of guilt and shame in overweight and obese adolescents. Future research with text messaging for overweight and obese adolescents should incorporate clear intervention aims and evaluation methods specifically related to adolescent engagement or behavior change. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12611001187932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001187932 (Archived by WebCite at http://www.webcitation.org/6LGSbk8d9). PMID:24713407

The Role of Text Messaging in Cardiovascular Risk Factor Optimization.

PubMed

Klimis, Harry; Khan, Mohammad Ehsan; Kok, Cindy; Chow, Clara K

2017-01-01

Many cases of CVD may be avoidable through lowering behavioural risk factors such as smoking and physical inactivity. Mobile health (mHealth) provides a novel opportunity to deliver cardiovascular prevention programs in a format that is potentially scalable. Here, we provide an overview of text messaging-based mHealth interventions in cardiovascular prevention. Text messaging-based interventions appear effective on a range of behavioural risk factors and can effect change on multiple risk factors-e.g. smoking, weight, blood pressure-simultaneously. For many texting studies, there are challenges in interpretation as many texting interventions are part of larger complex interventions making it difficult to determine the benefits of the separate components. Whilst there is evidence for text messaging improving cardiovascular risk factor levels in the short-term, future studies are needed to examine the durability of these effects and whether they can be translated to improvements in clinical care and outcomes.

Development of a Theoretically Driven mHealth Text Messaging Application for Sustaining Recent Weight Loss.

PubMed

Shaw, Ryan J; Bosworth, Hayden B; Hess, Jeffrey C; Silva, Susan G; Lipkus, Isaac M; Davis, Linda L; Johnson, Constance M

2013-05-07

Mobile phone short message service (SMS) text messaging, has the potential to serve as an intervention medium to promote sustainability of weight loss that can be easily and affordably used by clinicians and consumers. To develop theoretically driven weight loss sustaining text messages and pilot an mHealth SMS text messaging intervention to promote sustaining recent weight loss in order to understand optimal frequency and timing of message delivery, and for feasibility and usability testing. Results from the pilot study were used to design and construct a patient privacy compliant automated SMS application to deliver weight loss sustaining messages. We first conducted a pilot study in which participants (N=16) received a daily SMS text message for one month following a structured weight loss program. Messages were developed from diet and exercise guidelines. Following the intervention, interviews were conducted and self-reported weight was collected via SMS text messaging. All participants (N=16) were capable of sending and receiving SMS text messages. During the phone interview at 1 month post-baseline and at 3 months post-baseline, 13/14 (93%) of participants who completed the study reported their weight via SMS. At 3 months post-baseline, 79% (11/14) participants sustained or continued to lose weight. Participants (13/14, 93%) were favorable toward the messages and the majority (10/14, 71%) felt they were useful in helping them sustain weight loss. All 14 participants who completed the interview thought SMS was a favorable communication medium and was useful to receive short relevant messages promptly and directly. All participants read the messages when they knew they arrived and most (11/14, 79%) read the messages at the time of delivery. All participants felt that at least one daily message is needed to sustain weight loss behaviors and that they should be delivered in the morning. Results were then used to develop the SMS text messaging application. Study results demonstrated the feasibility of developing weight loss SMS text messages, and the development of an mHealth SMS text messaging application. SMS text messaging was perceived as an appropriate and accepted tool to deliver health promotion content.

Use of text messaging for maternal and infant health: a systematic review of the literature.

PubMed

Poorman, Elisabeth; Gazmararian, Julie; Parker, Ruth M; Yang, Baiyu; Elon, Lisa

2015-05-01

Text messaging is an increasingly popular communication tool in health interventions, but has been little studied in maternal and infant health. This literature review evaluates studies of text messaging that may be applied to the promotion of maternal and infant health. Articles from peer-reviewed journals published before June 2012 were included if they were experimental or quasi-experimental studies of behaviors endorsed either by the American College of Obstetrics and Gynecology, the American Pediatrics Association, or the United States Preventive Services Task Force; included reproductive age women (12-50 years) or infants up to 2 years of age; and were available in English. Qualitative studies of text messaging specific to pregnant women were also included. Studies were compared and contrasted by key variables, including: design, time-period, study population, and results. Forty-eight articles were included, 30 of which were randomized controlled trials. Interventions vary greatly in effectiveness and soundness of methodology, but collectively indicate that there is a wide range of preventative behaviors that text message interventions can effectively promote, including smoking cessation, diabetes control, appointment reminders, medication adherence, weight loss, and vaccine uptake. Common methodological issues include not accounting for attention affect and not aligning text message content to measured outcomes. Those interventions that are based on an established theory of behavior change and use motivational as opposed to informational language are more likely to be successful. Building on the growing body of evidence for text message interventions reviewed here, as well as the growing popularity of text messaging as a medium, researchers should be able to use this technology to engage difficult to reach populations.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease.

PubMed

Park, Linda G; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002-2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease

PubMed Central

Park, Linda G.; Beatty, Alexis; Stafford, Zoey; Whooley, Mary A.

2016-01-01

Mobile health in the form of text messaging and mobile applications provides an innovative and effective approach to promote prevention and management of cardiovascular disease (CVD); however, the magnitude of these effects is unclear. Through a comprehensive search of databases from 2002–2016, we conducted a quantitative systematic review. The selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. A large majority of studies (22 of 28, 79%) demonstrated text messaging, mobile applications, and telemonitoring via mobile phones were effective in improving outcomes. Some key factors associated with successful interventions included personalized messages with tailored advice, greater engagement (2-way text messaging, higher frequency of messages), and use of multiple modalities. Overall, text messaging appears more effective than smartphone-based interventions. Incorporating principles of behavioral activation will help promote and sustain healthy lifestyle behaviors in patients with CVD that result in improved clinical outcomes. PMID:27001245

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial.

PubMed

Patterson, Paul Daniel; Moore, Charity G; Weaver, Matthew D; Buysse, Daniel J; Suffoletto, Brian P; Callaway, Clifton W; Yealy, Donald M

2014-06-21

Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'. The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Clinicaltrials.gov NCT02063737, Registered on 10 January 2014.

Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial

PubMed Central

2014-01-01

Background Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. Methods/Design We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes ‘alertness behaviors’. Discussion The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Trial Registration Clinicaltrials.gov NCT02063737, Registered on 10 January 2014 PMID:24952387

Text messaging reminders for influenza vaccine in primary care: a cluster randomised controlled trial (TXT4FLUJAB).

PubMed

Herrett, Emily; Williamson, Elizabeth; van Staa, Tjeerd; Ranopa, Michael; Free, Caroline; Chadborn, Tim; Goldacre, Ben; Smeeth, Liam

2016-02-19

(1) To develop methods for conducting cluster randomised trials of text messaging interventions utilising routine electronic health records at low cost; (2) to assess the effectiveness of text messaging influenza vaccine reminders in increasing vaccine uptake in patients with chronic conditions. Cluster randomised trial with general practices as clusters. English primary care. 156 general practices, who used text messaging software, who had not previously used text message influenza vaccination reminders. Eligible patients were aged 18-64 in 'at-risk' groups. Practices were randomly allocated to either an intervention or standard care arm in the 2013 influenza season (September to December). Practices in the intervention arm were asked to send a text message influenza vaccination reminder to their at-risk patients under 65. Practices in the standard care arm were asked to continue their influenza campaign as planned. Practices were not blinded. Analysis was performed blinded to practice allocation. Practice-level influenza vaccine uptake among at-risk patients aged 18-64 years. 77 practices were randomised to the intervention group (76 analysed, n at-risk patients=51,121), 79 to the standard care group (79 analysed, n at-risk patients=51,136). The text message increased absolute vaccine uptake by 2.62% (95% CI -0.09% to 5.33%), p=0.058, though this could have been due to chance. Within intervention clusters, a median 21.0% (IQR 10.2% to 47.0%) of eligible patients were sent a text message. The number needed to treat was 7.0 (95% CI -0.29 to 14.3). Patient follow-up using routine electronic health records is a low cost method of conducting cluster randomised trials. Text messaging reminders are likely to result in modest improvements in influenza vaccine uptake, but levels of patients being texted need to markedly increase if text messaging reminders are to have much effect. ISRCTN48840025. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Involving service users in intervention design: a participatory approach to developing a text-messaging intervention to reduce repetition of self-harm.

PubMed

Owens, Christabel; Farrand, Paul; Darvill, Ruth; Emmens, Tobit; Hewis, Elaine; Aitken, Peter

2011-09-01

OBJECTIVE To engage a group of people with relevant lived experience in the development of a text-messaging intervention to reduce repetition of self-harm. BACKGROUND Contact-based interventions, such as follow-up letters, postcards and telephone calls, have shown potential to reduce repetition of self-harm in those who present at Accident and Emergency departments. Text messaging offers a low-cost alternative that has not been tested. We set out to develop a text-based intervention. The process of intervention development is rarely reported and little is known about the impact of service user involvement on intervention design. METHOD We held a series of six participatory workshops and invited service users and clinicians to help us work out how to get the right message to the right person at the right time, and to simulate and test prototypes of an intervention. RESULTS Service users rejected both the idea of a generic, 'one size fits all' approach and that of 'audience segmentation', maintaining that text messages could be safe and effective only if individualized. This led us to abandon our original thinking and develop a way of supporting individuals to author their own self-efficacy messages and store them in a personal message bank for withdrawal at times of crisis. CONCLUSIONS This paper highlights both the challenge and the impact of involving consumers at the development stage. Working with those with lived experience requires openness, flexibility and a readiness to abandon or radically revise initial plans, and may have unexpected consequences for intervention design. © 2010 Blackwell Publishing Ltd.

Design Considerations in Developing a Text Messaging Program Aimed at Smoking Cessation

PubMed Central

Holtrop, Jodi Summers; Bağci Bosi, A Tülay; Emri, Salih

2012-01-01

Background Cell phone text messaging is gaining increasing recognition as an important tool that can be harnessed for prevention and intervention programs across a wide variety of health research applications. Despite the growing body of literature reporting positive outcomes, very little is available about the design decisions that scaffold the development of text messaging-based health interventions. What seems to be missing is documentation of the thought process of investigators in the initial stages of protocol and content development. This omission is of particular concern because many researchers seem to view text messaging as the intervention itself instead of simply a delivery mechanism. Certainly, aspects of this technology may increase participant engagement. Like other interventions, however, the content is a central driver of the behavior change. Objective To address this noted gap in the literature, we discuss the protocol decisions and content development for SMS Turkey (or Cebiniz birakin diyor in Turkish), a smoking cessation text messaging program for adult smokers in Turkey. Methods Content was developed in English and translated into Turkish. Efforts were made to ensure that the protocol and content were grounded in evidence-based smoking cessation theory, while also reflective of the cultural aspects of smoking and quitting in Turkey. Results Methodological considerations included whether to provide cell phones and whether to reimburse participants for texting costs; whether to include supplementary intervention resources (eg, personal contact); and whether to utilize unidirectional versus bidirectional messaging. Program design considerations included how messages were tailored to the quitting curve and one’s smoking status after one’s quit date, the number of messages participants received per day, and over what period of time the intervention lasted. Conclusion The content and methods of effective smoking cessation quitline programs were a useful guide in developing SMS Turkey. Proposed guidelines in developing text messaging-based behavior change programs are offered. PMID:22832182

A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking

PubMed Central

van Stolk-Cooke, Katherine; Kuerbis, Alexis; Stadler, Gertraud; Baumel, Amit; Shao, Sijing; McKay, James R.; Morgenstern, Jon

2017-01-01

Introduction Recent evidence suggests that text messaging may help to reduce problem drinking as an extension to in-person services, but very little is known about the effectiveness of remote messaging on problem drinking as a stand-alone intervention, or how different types of messages may improve drinking outcomes in those seeking to moderate their alcohol consumption. Methods We conducted an exploratory, single-blind randomized controlled pilot study comparing four different types of alcohol reduction-themed text messages sent daily to weekly drink self-tracking texts in order to determine their impact on drinking outcomes over a 12-week period in 152 participants (≈ 30 per group) seeking to reduce their drinking on the internet. Messaging interventions included: weekly drink self-tracking mobile assessment texts (MA), loss-framed texts (LF), gain-framed texts (GF), static tailored texts (ST), and adaptive tailored texts (TA). Poisson and least squares regressions were used to compare differences between each active messaging group and the MA control. Results When adjusting for baseline drinking, participants in all messaging groups except GF significantly reduced the number of drinks consumed per week and the number of heavy drinking days compared to MA. Only the TA and GF groups were significantly different from MA in reducing the number of drinking days. While the TA group yielded the largest effect sizes on all outcome measures, there were no significant differences between active messaging groups on any outcome measure. 79.6% of individuals enrolled in the study wanted to continue receiving messages for an additional 12 weeks at the end of the study. Discussion Results of this pilot study indicate that remote automated text messages delivered daily can help adult problem drinkers reduce drinking frequency and quantity significantly more than once-a-week self-tracking messages only, and that tailored adaptive texts yield the largest effect sizes across outcomes compared to MA. Larger samples are needed to understand differences between messaging interventions and to target their mechanisms of efficacy. PMID:28146560

The feasibility, patterns of use and acceptability of using mobile phone text-messaging to improve treatment adherence and post-treatment review of children with uncomplicated malaria in western Kenya.

PubMed

Otieno, Gabriel; Githinji, Sophie; Jones, Caroline; Snow, Robert W; Talisuna, Ambrose; Zurovac, Dejan

2014-02-03

Trials evaluating the impact of mobile phone text-messaging to support management of acute diseases, such as malaria, are urgently needed in Africa. There has been however a concern about the feasibility of interventions that rely on access to mobile phones among caregivers in rural areas. To assess the feasibility and inform development of an intervention to improve adherence to malaria medications and post-treatment review, mobile phone network, access, ownership and use among caregivers in western Kenya was assessed. A cross-sectional survey based on outpatient exit interviews was undertaken among caregivers of children with malaria at four trial facilities. The main outcomes were proportions of caregivers that have mobile signal at home; have access to mobile phones; are able to read; and use text-messaging. Willingness to receive text-message reminders was also explored. Descriptive analyses were performed. Of 400 interviewed caregivers, the majority were female (93.5%), mothers of the sick children (87.8%) and able to read (97.3%). Only 1.7% of caregivers were without any education. Nearly all (99.8%) reported access to a mobile signal at home. 93.0% (site range: 89-98%) had access to a mobile phone within their household while 73.8% (site range: 66-78%) possessed a personal phone. Among caregivers with mobile phone access, 93.6% (site range: 85-99%) used the phone to receive text-messages. Despite only 19% having electricity at home nearly all (99.7%) caregivers reported that they would be able to have permanent phone access to receive text-messages in the next 28 days. Willingness to receive text-message reminders was nearly universal (99.7%) with 41.7% of caregivers preferring texts in English, 32.3% in Kiswahili and 26.1% in Dholuo. Despite concerns that the feasibility of text-messaging interventions targeting caregivers may be compromised in rural high malaria risk areas in Kenya, very favourable conditions were found with respect to mobile network, access and ownership of phones, use of text-messaging and minimum literacy levels required for successful intervention delivery. Moreover, there was a high willingness of caregivers to receive text-message reminders. Impact evaluations of carefully tailored text-messaging interventions targeting caregivers of children with malaria are timely and justified.

HealthyhornsTXT: A Text-Messaging Program to Promote College Student Health and Wellness.

PubMed

Glowacki, Elizabeth M; Kirtz, Susan; Hughes Wagner, Jessica; Cance, Jessica Duncan; Barrera, Denise; Bernhardt, Jay M

2018-01-01

Text-messaging interventions positively affect health behaviors, but their use on college campuses has been limited. Text messaging serves as a relatively affordable way to communicate with large audiences and is one of the preferred modes of communication for young adults. This study examined the feasibility and acceptability of a campus-wide, health text-messaging program. The subscriber pool consisted of approximately 6,000 undergraduate students from a large, southern university. From that pool, 1,095 participants (64% female; 41% White) completed a posttest survey. Text messages covered a range of health topics and information about campus resources. Research was conducted from August through December 2015. Process data were collected throughout the semester; participants' attitudes were assessed via an online survey at the program's conclusion. Students demonstrated engagement with the messages throughout the semester as evidenced by replies to text-back keywords and clicks on website links embedded within messages. Messages about sleep, stress management, and hydration were considered most relevant. The majority of participants (61%) reported increased awareness regarding their health. Text-messaging interventions are a feasible strategy to improve college student health.

Increasing the response rate of text messaging data collection: a delayed randomized controlled trial

PubMed Central

Li, Ye; Wang, Wei; Wu, Qiong; van Velthoven, Michelle Helena; Chen, Li; Du, Xiaozhen; Zhang, Yanfeng; Rudan, Igor; Car, Josip

2015-01-01

Objective To test the effectiveness of multiple interventions on increasing the response rate of text messaging for longitudinal data collection. Methods Our cohort included 283 caregivers of children aged 6–12 months who were participating in an anemia program in rural China. Using text messages to collect data on anemia medication adherence, we conducted a delayed randomized controlled trial to test multiple interventions (an additional four reminders; a ¥5.0 (US$0.79) credit reward for replying; and a feedback text message). After a 6-week pilot study with week 7 as the baseline measurement, we randomly allocated all participants into two groups: group 1 (n = 142) and group 2 (n = 141). During weeks 8–11, we introduced the interventions to group 1, and in weeks 12–15 the intervention was introduced to both groups. We compared the response rates between groups and explored factors affecting the response rate. Results During weeks 8–11, the response rates in group 1 increased and were significantly higher than in group 2 (p<0.05). During weeks 12–15, the response rate increased significantly in group 2 (p>0.05) and slightly decreased in group 1. Younger participants or participants who had children with lower hemoglobin concentration were more likely to reply (p = 0.02). Sending four reminders on the second day contributed to only 286 (11.7%) extra text messages. Discussion Our study showed that multiple interventions were effective in increasing response rate of text messaging data collection in rural China. Conclusions Larger multi-site studies are needed to find the most effective way of using these interventions to allow usage of text messaging data collection for health research. PMID:25332355

A systematic review and meta-analysis of interventions for weight management using text messaging.

PubMed

Siopis, G; Chey, T; Allman-Farinelli, M

2015-02-01

Obesity prevalence continues to increase worldwide, with significant associated chronic disease and health cost implications. Among more recent innovations in health service provision is the use of text messaging for health behaviour change interventions including weight management. This review investigates the efficacy of weight management programmes incorporating text messaging. Medical and scientific databases were searched from January 1993 to October 2013. Eligibility criteria included randomised controlled trials (RCTs), pseudoRCTs and before and after studies of weight management, among healthy children and adults, that used text messaging and included a nutrition component. Data extraction and quality assessment followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and the Evidence Analysis Manual of the American Academy of Nutrition and Dietetics. From 512 manuscripts retrieved, 14 met the inclusion criteria (five manuscripts in children and nine in adults). Duration of interventions ranged from 1 to 24 months. Frequency of text messaging was from daily to fortnightly. Six studies in adults were included in a meta-analysis with mean body weight change as the primary outcome. The weighted mean change in body weight in intervention participants was -2.56 kg (95% confidence interval = -3.46 to -1.65) and in controls -0.37 kg (95% confidence interval = -1.22 to 0.48). The small body of evidence indicates that text messaging interventions can promote weight loss. However, lack of long-term results indicate that further efficacy studies are required. Future investigations should elucidate the determinants, such as intervention duration, text message frequency and level of interactivity that maximise the success and cost effectiveness of the delivery medium. © 2014 The British Dietetic Association Ltd.

Costs and cost-effectiveness of a mobile phone text-message reminder programmes to improve health workers' adherence to malaria guidelines in Kenya.

PubMed

Zurovac, Dejan; Larson, Bruce A; Sudoi, Raymond K; Snow, Robert W

2012-01-01

Simple interventions for improving health workers' adherence to malaria case-management guidelines are urgently required across Africa. A recent trial in Kenya showed that text-message reminders sent to health workers' mobile phones improved management of pediatric outpatients by 25 percentage points. In this paper we examine costs and cost-effectiveness of this intervention. We evaluate costs and cost-effectiveness in 2010 USD under three implementation scenarios: (1) as implemented under study conditions in study areas; (2) if the intervention was routinely implemented by the Ministry of Health (MoH) in the same areas; and (3) if the intervention was scaled up nationally. Under study conditions, intervention costs were 19,342 USD, of which 45% were for developing and pretesting text-messages, 12% for developing text-message distribution system, 29% for collecting health workers' phone numbers, and 13% were costs of sending text-messages and monitoring of the system. If the intervention was implemented in the same areas by the MoH, the costs would be 28% lower (13,920 USD) due to lower costs of collecting health workers' numbers. The cost of national scale-up would be 97,350 USD, and the majority of these costs (66%) would be for sending text-messages. The cost per additional child correctly managed was 0.50 USD under study conditions, 0.36 USD if implemented by the MoH in the same area, and estimated at only 0.03 USD if implemented nationally. Even if the effect size was only 5% or the cost on the national scale was 400% higher than estimated, the cost per additional child correctly managed would be only 0.16 USD. A simple text-messaging intervention improving health worker adherence to malaria guidelines is effective and inexpensive. Further research is justified to optimize delivery of the intervention and expand targets beyond children and malaria disease.

Daily text messaging for weight control among racial and ethnic minority women: randomized controlled pilot study.

PubMed

Steinberg, Dori M; Levine, Erica L; Askew, Sandy; Foley, Perry; Bennett, Gary G

2013-11-18

Daily self-monitoring of diet and physical activity behaviors is a strong predictor of weight loss success. Text messaging holds promise as a viable self-monitoring modality, particularly among racial/ethnic minority populations. This pilot study evaluated the feasibility of a text messaging intervention for weight loss among predominantly black women. Fifty obese women were randomized to either a 6-month intervention using a fully automated system that included daily text messages for self-monitoring tailored behavioral goals (eg, 10,000 steps per day, no sugary drinks) along with brief feedback and tips (n=26) or to an education control arm (n=24). Weight was objectively measured at baseline and at 6 months. Adherence was defined as the proportion of text messages received in response to self-monitoring prompts. The average daily text messaging adherence rate was 49% (SD 27.9) with 85% (22/26) texting self-monitored behavioral goals 2 or more days per week. Approximately 70% (16/23) strongly agreed that daily texting was easy and helpful and 76% (16/21) felt the frequency of texting was appropriate. At 6 months, the intervention arm lost a mean of 1.27 kg (SD 6.51), and the control arm gained a mean of 1.14 kg (SD 2.53; mean difference -2.41 kg, 95% CI -5.22 to 0.39; P=.09). There was a trend toward greater text messaging adherence being associated with greater percent weight loss (r=-.36; P=.08), but this did not reach statistical significance. There was no significant association between goal attainment and text messaging adherence and no significant predictors of adherence. Given the increasing penetration of mobile devices, text messaging may be a useful self-monitoring tool for weight control, particularly among populations most in need of intervention. Clinicaltrials.gov: NCT00939081; http://clinicaltrials.gov/show/NCT00939081 (Archived by WebCite at http://www.webcitation.org/6KiIIcnk1).

A Cognitive Behavioral Therapy-Based Text Messaging Intervention for Methamphetamine Dependence

PubMed Central

Keoleian, Victoria; Stalcup, S. Alex; Polcin, Douglas L.; Brown, Michelle; Galloway, Gantt

2013-01-01

Psychosocial treatments for methamphetamine dependence are of limited effectiveness. Thus, a significant need exists for add-on therapy for this substance user disorder. The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users. Text messaging has the potential to support patients in real-time, around the clock. We convened 2 meetings of an expert panel, held 3 focus groups in current and former users, and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully-automated, cognitive behavioral therapy-based text messaging intervention. We then conducted a randomized, crossover pre-test in 5 users seeking treatment. Participants’ ratings of ease of use and functionality of the system were high. During the pre-test we performed real-time assessments via text messaging on daily methamphetamine use, craving levels, and the perceived usefulness of messages; 79% of scheduled assessments were collected. The odds of messages being rated as “very” or “extremely” useful were 6.6 times [95% CI: 2.2, 19.4] higher in the active vs. placebo periods. The intervention is now ready for testing in randomized clinical trials. PMID:24592670

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol.

PubMed

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-03-30

Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. NCT02585206. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Texting Teens in Transition: The Use of Text Messages in Clinical Intervention Research

PubMed Central

Nicholas, David B

2014-01-01

Background The rapidly growing population of young adults living with congenital heart disease (CHD), currently challenging ill-prepared cardiac care systems, presents a novel population in which to consider the use of mHealth. This methodological study was part of a larger study that tested the effectiveness of a clinic-based nursing intervention to prepare teens for transfer from pediatric to adult cardiology care. The intervention included creation of a MyHealth Passport and subsequently SMS (short message service) text messages between the intervention nurse and study participant. Objective Our aim was to determine (1) the preference of teens with CHD to be contacted via text message following the nursing intervention, (2) the effectiveness of texting to collect data regarding the use of MyHealth Passport after participation in the intervention, (3) the nature of the texting interaction, and (4) the risks and benefits of texting. Methods Participants were recruited through the intervention study (n=24) by either choosing to receive information from the study coordinator through text message, or texting a question to the study nurses. Inclusion criteria were age 15-17 years, diagnosed with moderate or complex heart disease, and currently being followed by the Division of Cardiology at Stollery Children’s Hospital. Exclusion criteria were heart transplantation and/or less than a 6th grade reading and comprehension ability. Text message transcripts were analyzed by qualitative inductive content analysis. Results Two-thirds of teens (16/24, 67%) chose text messaging as their preferred contact, making them eligible for the study. Texting was effective in collecting information regarding the MyHealth Passport; all but one teen had their MyHealth Passport on them, and many reported carrying it with them wherever they went. All teens reported showing their MyHealth Passport to at least one person. Seven themes were identified in the texting transcripts: mixing formal and informal language, the passive teen, interaction with health care providers, texting teens in transition, texting as a mechanism to initiate other forms of communication, affirmation, and the nurse as an educator. Benefits of texting were identified as flexibility, ability to respond over time, information presented in byte-sized amounts, and information directly related to patient questions. Risks of texting were identified as the possibility that interactions may not be in-depth, distraction of teen and researcher, and invasiveness. Conclusions Text messaging was useful in collecting data regarding the use of the MyHealth Passport. Text messaging resulted in conversations with the teens that were sometimes in-depth and meaningful, especially when combined with other communication modalities. Using text messaging in a manner resulting in full conversations with the patients requires more study and may benefit from protocols and the use of solid theoretical foundations that would standardize the interaction so that more conclusions could be drawn. PMID:25379624

Texting teens in transition: the use of text messages in clinical intervention research.

PubMed

Rempel, Gwen R; Ballantyne, Ross T; Magill-Evans, Joyce; Nicholas, David B; Mackie, Andrew S

2014-11-06

The rapidly growing population of young adults living with congenital heart disease (CHD), currently challenging ill-prepared cardiac care systems, presents a novel population in which to consider the use of mHealth. This methodological study was part of a larger study that tested the effectiveness of a clinic-based nursing intervention to prepare teens for transfer from pediatric to adult cardiology care. The intervention included creation of a MyHealth Passport and subsequently SMS (short message service) text messages between the intervention nurse and study participant. Our aim was to determine (1) the preference of teens with CHD to be contacted via text message following the nursing intervention, (2) the effectiveness of texting to collect data regarding the use of MyHealth Passport after participation in the intervention, (3) the nature of the texting interaction, and (4) the risks and benefits of texting. Participants were recruited through the intervention study (n=24) by either choosing to receive information from the study coordinator through text message, or texting a question to the study nurses. Inclusion criteria were age 15-17 years, diagnosed with moderate or complex heart disease, and currently being followed by the Division of Cardiology at Stollery Children's Hospital. Exclusion criteria were heart transplantation and/or less than a 6th grade reading and comprehension ability. Text message transcripts were analyzed by qualitative inductive content analysis. Two-thirds of teens (16/24, 67%) chose text messaging as their preferred contact, making them eligible for the study. Texting was effective in collecting information regarding the MyHealth Passport; all but one teen had their MyHealth Passport on them, and many reported carrying it with them wherever they went. All teens reported showing their MyHealth Passport to at least one person. Seven themes were identified in the texting transcripts: mixing formal and informal language, the passive teen, interaction with health care providers, texting teens in transition, texting as a mechanism to initiate other forms of communication, affirmation, and the nurse as an educator. Benefits of texting were identified as flexibility, ability to respond over time, information presented in byte-sized amounts, and information directly related to patient questions. Risks of texting were identified as the possibility that interactions may not be in-depth, distraction of teen and researcher, and invasiveness. Text messaging was useful in collecting data regarding the use of the MyHealth Passport. Text messaging resulted in conversations with the teens that were sometimes in-depth and meaningful, especially when combined with other communication modalities. Using text messaging in a manner resulting in full conversations with the patients requires more study and may benefit from protocols and the use of solid theoretical foundations that would standardize the interaction so that more conclusions could be drawn.

Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis.

PubMed

Thakkar, Jay; Kurup, Rahul; Laba, Tracey-Lea; Santo, Karla; Thiagalingam, Aravinda; Rodgers, Anthony; Woodward, Mark; Redfern, Julie; Chow, Clara K

2016-03-01

Adherence to long-term therapies in chronic disease is poor. Traditional interventions to improve adherence are complex and not widely effective. Mobile telephone text messaging may be a scalable means to support medication adherence. To conduct a meta-analysis of randomized clinical trials to assess the effect of mobile telephone text messaging on medication adherence in chronic disease. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL (from database inception to January 15, 2015), as well as reference lists of the articles identified. The data were analyzed in March 2015. Randomized clinical trials evaluating a mobile telephone text message intervention to promote medication adherence in adults with chronic disease. Two authors independently extracted information on study characteristics, text message characteristics, and outcome measures as per the predefined protocol. Odds ratios and pooled data were calculated using random-effects models. Risk of bias and study quality were assessed as per Cochrane guidelines. Disagreement was resolved by consensus. Sixteen randomized clinical trials were included, with 5 of 16 using personalization, 8 of 16 using 2-way communication, and 8 of 16 using a daily text message frequency. The median intervention duration was 12 weeks, and self-report was the most commonly used method to assess medication adherence. In the pooled analysis of 2742 patients (median age, 39 years and 50.3% [1380 of 2742] female), text messaging significantly improved medication adherence (odds ratio, 2.11; 95% CI, 1.52-2.93; P < .001). The effect was not sensitive to study characteristics (intervention duration or type of disease) or text message characteristics (personalization, 2-way communication, or daily text message frequency). In a sensitivity analysis, our findings remained robust to change in inclusion criteria based on study quality (odds ratio, 1.67; 95% CI, 1.21-2.29; P = .002). There was moderate heterogeneity (I2 = 62%) across clinical trials. After adjustment for publication bias, the point estimate was reduced but remained positive for an intervention effect (odds ratio, 1.68; 95% CI, 1.18-2.39). Mobile phone text messaging approximately doubles the odds of medication adherence. This increase translates into adherence rates improving from 50% (assuming this baseline rate in patients with chronic disease) to 67.8%, or an absolute increase of 17.8%. While promising, these results should be interpreted with caution given the short duration of trials and reliance on self-reported medication adherence measures. Future studies need to determine the features of text message interventions that improve success, as well as appropriate patient populations, sustained effects, and influences on clinical outcomes.

Development and Usability of REACH: A Tailored Theory-Based Text Messaging Intervention for Disadvantaged Adults With Type 2 Diabetes.

PubMed

Nelson, Lyndsay A; Mayberry, Lindsay S; Wallston, Kenneth; Kripalani, Sunil; Bergner, Erin M; Osborn, Chandra Y

2016-09-08

Among adults with type 2 diabetes mellitus (T2DM), adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations. To develop Rapid Education/Encouragement And Communications for Health (REACH), a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with T2DM, based on the Information-Motivation-Behavioral skills model. We then tested REACH's usability to make improvements before evaluating its effects. We developed REACH's content and functionality using an empirical and theory-based approach, findings from a previously pilot-tested intervention, and the expertise of our interdisciplinary research team. We recruited 36 adults with T2DM from Federally Qualified Health Centers to participate in 1 of 3 rounds of usability testing. For 2 weeks, participants received daily text messages assessing and promoting self-care, including tailored messages addressing users' unique barriers to adherence, and weekly text messages with adherence feedback. We analyzed quantitative and qualitative user feedback and system-collected data to improve REACH. Participants were, on average, 52.4 (SD 9.5) years old, 56% (20/36) female, 63% (22/35) were a racial or ethnic minority, and 67% (22/33) had an income less than US $35,000. About half were taking insulin, and average hemoglobin A1c level was 8.2% (SD 2.2%). We identified issues (eg, user concerns with message phrasing, technical restrictions with responding to assessment messages) and made improvements between testing rounds. Overall, participants favorably rated the ease of understanding (mean 9.6, SD 0.7) and helpfulness (mean 9.3, SD 1.4) of self-care promoting text messages on a scale of 1-10, responded to 96% of assessment text messages, and rated the helpfulness of feedback text messages 8.5 (SD 2.7) on a scale of 1-10. User feedback led to refining our study enrollment process so that users understood the flexibility in message timing and that computers, not people, send the messages. Furthermore, research assistants' feedback on the enrollment process helped improve participants' engagement with study procedures. Testing technology-delivered interventions with disadvantaged adults revealed preferences and concerns unique to this population. Through iterative testing and multiple data sources, we identified and responded to users' intervention preferences, technical issues, and shortcomings in our research procedures.

A feasibility study of short message service text messaging as a surveillance tool for alcohol consumption and vehicle for interventions in university students

PubMed Central

2013-01-01

Background Practitioners who come into contact with the intoxicated, such as those in unscheduled care, often have limited resources to provide structured interventions. There is therefore a need for cost-effective alcohol interventions requiring minimal input. This study assesses the barriers, acceptability and validity of text messaging to collect daily alcohol consumption data and explores the feasibility of a text-delivered intervention in an exploratory randomised controlled trial. Methods Study I. Participants (n = 82) completed the initial online screening survey and those eligible were asked each day, for 157 days via text message, to reply with the number of alcohol units consumed the previous day. Analyses compared standard measures of hazardous consumption with self-report alcohol use. Attrition and sampling biases were examined. Study I included secondary exploratory analyses using data from 70 participants to determine associations between events (including Christmas and other celebratory occasions) and consumption. Study I further included the thematic analysis of semi-structured interview data and assessed the feasibility of and barriers to surveillance and interventions delivered through text messaging. Developing findings from Study I, Study II developed an exploratory randomised control trial that delivered a single message on monthly alcohol expenditure in order to assess effect size and test generalisability. Results Self-report alcohol consumption data was significantly associated with FAST and AUDIT scores. Attrition from the study was not associated with greater alcohol use. Greater alcohol use was observed on Fridays, Saturdays and Wednesdays as were notable celebratory events. Interview data indicated that text messaging was acceptable to participants and preferred over email and web-based methods. The exploratory randomised controlled trial suggested that a simple text delivered intervention might be effective in eliciting a reduction in alcohol consumption in a future trial. Conclusions The ubiquity of mobile telephones and the acceptability of text messaging suggests that this approach can be developed as a surveillance tool to collect high frequency consumption data to identify periods of vulnerability and that it can offer a platform through which targeted interventions can be delivered. PMID:24160674

Motivational Text Message Intervention for Eating Disorders: A Single-Case Alternating Treatment Design Using Ecological Momentary Assessment.

PubMed

Shingleton, Rebecca M; Pratt, Elizabeth M; Gorman, Bernard; Barlow, David H; Palfai, Tibor P; Thompson-Brenner, Heather

2016-05-01

This study tested a motivational text message treatment adjunct for individuals with eating disorders (EDs) who exhibited high dietary restraint/restriction. A replicated single-case alternating treatment design was used to examine (a) the feasibility of combining a brief motivational interview with subsequent text messages and (b) the influence of the text messages on eating behaviors and motivation to change in individuals with EDs (N=12). The protocol was 8weeks and the text messages were adjunctive to cognitive-behavioral therapy. The intervention was well accepted (mean rating=7/10) and feasible within the context of monetary compensation (mean daily monitoring compliance =91%). Text messages did not impact behavioral outcomes: dietary restraint and kilocalorie intake. They had mixed effects on motivation to change dietary restraint, measured by the Readiness and Motivation Questionnaire (RMQ). When receiving text messages, RMQ precontemplation scores (desire to restrict) significantly increased, indicating decreased motivation; however, action scores (effort toward reducing dietary restraint) significantly increased, indicating increased motivation. These effects were moderated by weight status. Underweight individuals (n=4; body mass index [BMI]<19.0) reported increased ambivalence-that is, an increased desire to restrict and increased action toward reducing restriction-in response to the text messages. Normal weight participants (n=8; BMI>19.0) reported only increased action toward reducing restriction in response to the text messages. These data demonstrate text messages are a potentially feasible and acceptable treatment adjunct and may be effective at increasing motivation to change for normal weight individuals, while their influence on underweight patients is more complex. These findings provide a foundation for future research in technology-based motivational interventions for EDs and offer preliminary evidence for using these methods among normal weight individuals. Copyright © 2016. Published by Elsevier Ltd.

Text Messaging Intervention for Teens and Young Adults With Diabetes

PubMed Central

Cousineau, Tara; Franko, Debra L.; Schultz, Alan T.; Trant, Meredith; Rodgers, Rachel; Laffel, Lori M. B.

2014-01-01

Adolescents and young adults use text messaging as their primary mode of communication, thus providing an opportunity to use this mode of communication for mobile health (mHealth) interventions. Youth with diabetes are an important group for these mHealth initiatives, as diabetes management requires an enormous amount of daily effort and this population has difficulty achieving optimal diabetes management. Goal setting and self-efficacy are 2 factors in the management of diabetes. We examined the feasibility of a healthy lifestyle text messaging program targeting self-efficacy and goal setting among adolescents and young adults with diabetes. Participants, ages 16-21, were assigned to either a text messaging group, which received daily motivational messages about nutrition and physical activity, or a control group, which received paper-based information about healthy lifestyle. Both groups set goals for nutrition and physical activity and completed a measure of self-efficacy. Participants’ mean age was 18.7 ± 1.6 years old, with diabetes duration of 10.0 ± 4.6 years, and A1c of 8.7 ± 1.7%. The text messaging intervention was rated highly and proved to be acceptable to participants. Self-efficacy, glycemic control, and body mass index did not change over the course of the short, 1-month pilot study. Positive, daily, motivational text messages may be effective in increasing motivation for small goal changes in the areas of nutrition and physical activity. These interventions may be used in the future in youth with diabetes to improve diabetes care. Utilizing more targeted text messages is an area for future research. PMID:25172879

Text messaging intervention for teens and young adults with diabetes.

PubMed

Markowitz, Jessica T; Cousineau, Tara; Franko, Debra L; Schultz, Alan T; Trant, Meredith; Rodgers, Rachel; Laffel, Lori M B

2014-09-01

Adolescents and young adults use text messaging as their primary mode of communication, thus providing an opportunity to use this mode of communication for mobile health (mHealth) interventions. Youth with diabetes are an important group for these mHealth initiatives, as diabetes management requires an enormous amount of daily effort and this population has difficulty achieving optimal diabetes management. Goal setting and self-efficacy are 2 factors in the management of diabetes. We examined the feasibility of a healthy lifestyle text messaging program targeting self-efficacy and goal setting among adolescents and young adults with diabetes. Participants, ages 16-21, were assigned to either a text messaging group, which received daily motivational messages about nutrition and physical activity, or a control group, which received paper-based information about healthy lifestyle. Both groups set goals for nutrition and physical activity and completed a measure of self-efficacy. Participants' mean age was 18.7 ± 1.6 years old, with diabetes duration of 10.0 ± 4.6 years, and A1c of 8.7 ± 1.7%. The text messaging intervention was rated highly and proved to be acceptable to participants. Self-efficacy, glycemic control, and body mass index did not change over the course of the short, 1-month pilot study. Positive, daily, motivational text messages may be effective in increasing motivation for small goal changes in the areas of nutrition and physical activity. These interventions may be used in the future in youth with diabetes to improve diabetes care. Utilizing more targeted text messages is an area for future research. © 2014 Diabetes Technology Society.

Efficacy of a web- and text messaging-based intervention to reduce problem drinking in young people: study protocol of a cluster-randomised controlled trial.

PubMed

Haug, Severin; Kowatsch, Tobias; Castro, Raquel Paz; Filler, Andreas; Schaub, Michael P

2014-08-07

Problem drinking, particularly risky single-occasion drinking is widespread among adolescents and young adults in most Western countries. Mobile phone text messaging allows a proactive and cost-effective delivery of short messages at any time and place and allows the delivery of individualised information at times when young people typically drink alcohol. The main objective of the planned study is to test the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people with heterogeneous educational level. A two-arm cluster-randomised controlled trial with one follow-up assessment after 6 months will be conducted to test the efficacy of the intervention in comparison to assessment only. The fully-automated intervention program will provide an online feedback based on the social norms approach as well as individually tailored mobile phone text messages to stimulate (1) positive outcome expectations to drink within low-risk limits, (2) self-efficacy to resist alcohol and (3) planning processes to translate intentions to resist alcohol into action. Program participants will receive up to two weekly text messages over a time period of 3 months. Study participants will be 934 students from approximately 93 upper secondary and vocational schools in Switzerland. Main outcome criterion will be risky single-occasion drinking in the past 30 days preceding the follow-up assessment. This is the first study testing the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people. Given that this intervention approach proves to be effective, it could be easily implemented in various settings, and it could reach large numbers of young people in a cost-effective way. Current Controlled Trials ISRCTN59944705.

Short message service (SMS) text messaging as an intervention medium for weight loss: A literature review.

PubMed

Shaw, Ryan; Bosworth, Hayden

2012-12-01

Nearly 68% of American adults are obese or overweight. Mobile devices such as mobile phones have emerged as a mode of intervention delivery to help people improve their health, particularly in relation to weight loss. This literature review examines the relationship between the use of short message service (SMS) text messaging as an intervention medium and weight loss. Results from this literature review (n = 14) suggest that SMS as an intervention tool for weight loss is still in its infancy. Initial results are promising but continued investigation is needed. We offer several recommendations for future research.

Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster-Randomized Trial in Ghana.

PubMed

Rokicki, Slawa; Cohen, Jessica; Salomon, Joshua A; Fink, Günther

2017-02-01

To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Designing a Text Messaging Intervention to Improve Physical Activity Behavior Among Low-Income Latino Patients With Diabetes: A Discrete-Choice Experiment, Los Angeles, 2014-2015.

PubMed

Ramirez, Magaly; Wu, Shinyi; Beale, Elizabeth

2016-12-22

Automated text messaging can deliver self-management education to activate self-care behaviors among people with diabetes. We demonstrated how a discrete-choice experiment was used to determine the features of a text-messaging intervention that are important to urban, low-income Latino patients with diabetes and that could support improvement in their physical activity behavior. In a discrete-choice experiment from December 2014 through August 2015 we conducted a survey to elicit information on patient preferences for 5 features of a text-messaging intervention. We described 2 hypothetical interventions and in 7 pairwise comparisons asked respondents to indicate which they preferred. Respondents (n = 125) were recruited in person from a diabetes management program of a safety-net ambulatory care clinic in Los Angeles; clinicians referred patients to the research assistant after routine clinic visits. Data were analyzed by using conditional logistic regression. We found 2 intervention features that were considered by the survey respondents to be important: 1) the frequency of text messaging and 2) physical activity behavior-change education (the former being more important than the latter). Physical activity goal setting, feedback on physical activity performance, and social support were not significantly important. A discrete-choice experiment is a feasible way to elicit information on patient preferences for a text-messaging intervention designed to support behavior change. However, discrepancies may exist between patients' stated preferences and their actual behavior. Future research should validate and expand our findings.

The efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China.

PubMed

Liao, Yanhui; Wu, Qiuxia; Tang, Jinsong; Zhang, Fengyu; Wang, Xuyi; Qi, Chang; He, Haoyu; Long, Jiang; Kelly, Brian C; Cohen, Joanna

2016-08-19

Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of "the efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China". The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions ('Happy Quit') will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that 'Happy Quit' will be an effective, feasible and affordable smoking cessation program in China. In this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19-34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to 'Happy Quit', comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day. The results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public health significance of other interventions, such as mental health interventions. NCT02693626 (Registration data April 11, 2016).

A text message intervention for alcohol risk reduction among community college students: TMAP.

PubMed

Bock, Beth C; Barnett, Nancy P; Thind, Herpreet; Rosen, Rochelle; Walaska, Kristen; Traficante, Regina; Foster, Robert; Deutsch, Chris; Fava, Joseph L; Scott-Sheldon, Lori A J

2016-12-01

Students at community colleges comprise nearly half of all U.S. college students and show higher risk of heavy drinking and related consequences compared to students at 4-year colleges, but no alcohol safety programs currently target this population. To examine the feasibility, acceptability, and preliminary efficacy of an alcohol risk-reduction program delivered through text messaging designed for community college (CC) students. Heavy drinking adult CC students (N=60) were enrolled and randomly assigned to the six-week active intervention (Text Message Alcohol Program: TMAP) or a control condition of general motivational (not alcohol related) text messages. TMAP text messages consisted of alcohol facts, strategies to limit alcohol use and related risks, and motivational messages. Assessments were conducted at baseline, week 6 (end of treatment) and week 12 (follow up). Most participants (87%) completed all follow up assessments. Intervention messages received an average rating of 6.8 (SD=1.5) on a 10-point scale. At week six, TMAP participants were less likely than controls to report heavy drinking and negative alcohol consequences. The TMAP group also showed significant increases in self-efficacy to resist drinking in high risk situations between baseline and week six, with no such increase among controls. Results were maintained through the week 12 follow up. The TMAP alcohol risk reduction program was feasible and highly acceptable indicated by high retention rates through the final follow up assessment and good ratings for the text message content. Reductions in multiple outcomes provide positive indications of intervention efficacy. Copyright © 2016. Published by Elsevier Ltd.

The Effectiveness of Mobile Phone Text Messaging in Improving Medication Adherence for Patients with Chronic Diseases: A Systematic Review.

PubMed

Ershad Sarabi, Roghayeh; Sadoughi, Farahnaz; Jamshidi Orak, Roohangiz; Bahaadinbeigy, Kambiz

2016-05-01

Medication non-adherence is a commonly observed problem in the self-administration of treatment, regardless of the disease type. Text messaging reminders, as electronic reminders, provide an opportunity to improve medication adherence. In this study, we aimed to provide evidence addressing the question of whether text message reminders were effective in improving patients' adherence to medication. We carried out a systematic literature search, using the five electronic bibliographic databases: PubMed, Embase, PsycINFO, CINAHL, and the Cochrane central register of controlled trials. Studies were included on the basis of whether they examined the benefits and effects of short-message service (SMS) interventions on medication adherence. The results of this systematic review indicated that text messaging interventions have improved patients' medication adherence rate (85%, 29.34). Included in the review, those who had problems with adherence, or those whom text messaging was most helpful had HIV, asthma, diabetes, schizophrenia and heart disease (73.5%). The period of intervention varied from 1 week to 14 months. The most common study design was randomized controlled trials (RCTs) (66%) carried out in the developed countries. This study demonstrated the potential of mobile phone text messaging for medication non-adherence problem solving.

Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study.

PubMed

Lau, Yan Kwan; Cassidy, Tali; Hacking, Damian; Brittain, Kirsty; Haricharan, Hanne Jensen; Heap, Marion

2014-08-21

Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa's high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy. Participants recruited were pregnant women attending a primary health care facility in Cape Town. A controlled clinical trial was carried out where the intervention group (n = 102) received text messages staggered according to the week of pregnancy at the time of recruitment. The control group (n = 104) received no text messages. These text messages contained antenatal health information, and were delivered in English, Xhosa or Afrikaans, according to the preference of each participant. A baseline knowledge questionnaire with nine questions was administered prior to the intervention. The same questionnaire was used with added health-related behaviour questions for the intervention group at exit. A modified intention-to-treat analysis was done. To compare the control and intervention group's knowledge, Fisher's exact tests and two-sample t-tests tests were carried out for binary and continuous outcomes, respectively. A focus group of seven participants from the intervention group was then conducted to gain more insight into how the text messages were perceived. There was substantial loss to follow-up during the study with only 57% of the participants retained at exit. No statistically significant difference was detected between the control and intervention group in any of the nine knowledge questions at exit (all p > 0.05). Responses from the focus group indicated that the text messages acted as a welcome reminder and a source of positive motivation, and were perceived as extended care from the health care provider. While the intervention failed to improve antenatal health knowledge, evidence from self-reported behaviour and the focus group suggests that text messages have the potential to motivate change in health-seeking behaviour. One should be mindful of loss to follow-up when rolling out mobile health interventions in developing country settings. Pan African Clinical Trials Registry PACTR201406000841188. Registered 3 June 2014.

TextTB: A Mixed Method Pilot Study Evaluating Acceptance, Feasibility, and Exploring Initial Efficacy of a Text Messaging Intervention to Support TB Treatment Adherence

PubMed Central

Pearce, Patricia F.; Chirico, Cristina; Etchevarria, Mirta; Cardinale, Daniel; Rubinstein, Fernando

2013-01-01

Objective. To assess a text messaging intervention to promote tuberculosis (TB) treatment adherence. Methods. A mixed-methods pilot study was conducted within a public pulmonary-specialized hospital in Argentina. Patients newly diagnosed with TB who were 18 or older, and had mobile phone access were recruited and randomized to usual care plus either medication calendar (n = 19) or text messaging intervention (n = 18) for the first two months of treatment. Primary outcomes were feasibility and acceptability; secondary outcomes explored initial efficacy. Results. Feasibility was evidenced by high access to mobile phones, familiarity with texting, most phones limited to basic features, a low rate of participant refusal, and many describing suboptimal TB understanding. Acceptability was evidenced by participants indicating feeling cared for, supported, responsible for their treatment, and many self-reporting adherence without a reminder. Participants in the texting group self-reported adherence on average 77% of the days whereas only 53% in calendar group returned diaries. Exploring initial efficacy, microscopy testing was low and treatment outcomes were similar in both groups. Conclusion. The texting intervention was well accepted and feasible with greater reporting of adherence using text messaging than the diary. Further evaluation of the texting intervention is warranted. PMID:24455238

Effectiveness of Intuitive Eating Intervention through Text Messaging among College Students

ERIC Educational Resources Information Center

Loughran, Tessa J.; Harpel, Tammy; Vollmer, Rachel; Schumacher, Julie

2018-01-01

This study examined the effects of an intuitive eating (IE) text messaging intervention on the IE habits, perceived stress, and perceived self-efficacy of college students in comparison to an electronically emailed handout with the same information. Undergraduate students at a Midwestern university (n = 300) completed a pre-intervention survey…

The Effects of Text Message Content on the Use of an Internet-Based Physical Activity Intervention in Hong Kong Chinese Adolescents.

PubMed

Lau, Erica Y; Lau, Patrick W C; Cai, Bo; Archer, Edward

2015-01-01

This study examined the effects of text message content (generic vs. culturally tailored) on the login rate of an Internet physical activity program in Hong Kong Chinese adolescent school children. A convenience sample of 252 Hong Kong secondary school adolescents (51% female, 49% male; M age = 13.17 years, SD = 1.28 years) were assigned to one of 3 treatments for 8 weeks. The control group consisted of an Internet physical activity program. The Internet plus generic text message group consisted of the same Internet physical activity program and included daily generic text messages. The Internet plus culturally tailored text message group consisted of the Internet physical activity program and included daily culturally tailored text messages. Zero-inflated Poisson mixed models showed that the overall effect of the treatment group on the login rates varied significantly across individuals. The login rates over time were significantly higher in the Internet plus culturally tailored text message group than the control group (β = 46.06, 95% CI 13.60, 156.02; p = .002) and the Internet plus generic text message group (β = 15.80, 95% CI 4.81, 51.9; p = .021) after adjusting for covariates. These findings suggest that culturally tailored text messages may be more advantageous than generic text messages on improving adolescents' website login rate, but effects varied significantly across individuals. Our results support the inclusion of culturally tailored messaging in future online physical activity interventions.

Daily Text Messaging for Weight Control Among Racial and Ethnic Minority Women: Randomized Controlled Pilot Study

PubMed Central

Levine, Erica L; Askew, Sandy; Foley, Perry; Bennett, Gary G

2013-01-01

Background Daily self-monitoring of diet and physical activity behaviors is a strong predictor of weight loss success. Text messaging holds promise as a viable self-monitoring modality, particularly among racial/ethnic minority populations. Objective This pilot study evaluated the feasibility of a text messaging intervention for weight loss among predominantly black women. Methods Fifty obese women were randomized to either a 6-month intervention using a fully automated system that included daily text messages for self-monitoring tailored behavioral goals (eg, 10,000 steps per day, no sugary drinks) along with brief feedback and tips (n=26) or to an education control arm (n=24). Weight was objectively measured at baseline and at 6 months. Adherence was defined as the proportion of text messages received in response to self-monitoring prompts. Results The average daily text messaging adherence rate was 49% (SD 27.9) with 85% (22/26) texting self-monitored behavioral goals 2 or more days per week. Approximately 70% (16/23) strongly agreed that daily texting was easy and helpful and 76% (16/21) felt the frequency of texting was appropriate. At 6 months, the intervention arm lost a mean of 1.27 kg (SD 6.51), and the control arm gained a mean of 1.14 kg (SD 2.53; mean difference –2.41 kg, 95% CI –5.22 to 0.39; P=.09). There was a trend toward greater text messaging adherence being associated with greater percent weight loss (r=–.36; P=.08), but this did not reach statistical significance. There was no significant association between goal attainment and text messaging adherence and no significant predictors of adherence. Conclusions Given the increasing penetration of mobile devices, text messaging may be a useful self-monitoring tool for weight control, particularly among populations most in need of intervention. Trial Registration Clinicaltrials.gov: NCT00939081; http://clinicaltrials.gov/show/NCT00939081 (Archived by WebCite at http://www.webcitation.org/6KiIIcnk1). PMID:24246427

A Depression Prevention Intervention for Adolescents in the Emergency Department.

PubMed

Ranney, Megan L; Freeman, Joshua R; Connell, Gerianne; Spirito, Anthony; Boyer, Edward; Walton, Maureen; Guthrie, Kate Morrow; Cunningham, Rebecca M

2016-10-01

To evaluate acceptability and feasibility of a theoretically based two-part (brief in-person + 8-week automated text message) depression prevention program, "intervention for DepressiOn and Violence prevention in the Emergency department" (iDOVE), for high-risk adolescents. English-speaking emergency department (ED) patients (age 13-17, any chief complaint) were sequentially approached for consent on a convenience sample of shifts and screened for inclusion based on current depressive symptoms and past-year violence. After consent, baseline assessments were obtained; all participants were enrolled in the two-part intervention (brief in-ED + 8-week two-way text messaging). At 8 weeks, quantitative and qualitative follow-up assessments were obtained. Measures included feasibility, acceptability, and preliminary data on efficacy. Qualitative data were transcribed verbatim, double coded, and interpreted using thematic analysis. Quantitative results were analyzed descriptively and with paired t tests. As planned, 16 participants (eight each gender) were recruited (75% of those who were eligible; 66% nonwhite, 63% low income, mean age 15.4). The intervention had high feasibility and acceptability: 93.8% completed 8-week follow-up; 80% of daily text messages received responses; 31% of participants requested ≥1 "on-demand" text message. In-person and text message portions were rated as good/excellent by 87%. Qualitatively, participants articulated: (1) iDOVE was welcome and helpful, if unexpected in the ED; (2) the daily text message mood assessment was "most important"; (3) content was "uplifting"; and (4) balancing intervention "relatability" and automation was challenging. Participants' mean ΔBDI-2 (Beck Depression Inventory) from baseline to 8-week follow-up was -4.9, (p = .02). This automated preventive text message intervention is acceptable and feasible. Qualitative data emphasize the importance of creating positive, relevant, and interactive digital health tools for adolescents. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Engagement with a Text-Messaging Intervention Improves Adherence in Adolescents with Type 1 Diabetes: Brief Report.

PubMed

Zhang, Shuodan; Hamburger, Emily; Kahanda, Sachini; Lyttle, Morgan; Williams, Rodayne; Jaser, Sarah S

2018-05-01

Adherence to diabetes management is a challenge for adolescents with type 1 diabetes (T1D). Positive psychology interventions have improved adherence to treatment recommendations in adults with chronic health conditions but have not been widely tested in pediatric populations. We hypothesized that higher engagement with a text-messaging intervention to promote positive affect would increase the effects on diabetes management among adolescents with T1D. Adolescents with T1D (n = 48) and their caregivers were randomized to either an attention control condition or a novel positive psychology intervention delivered through personalized automated text messaging. We examined rates of engagement (percent response to text messages) in relation to demographic factors, and we explored the effect of engagement in relation to adherence and glycemic control. Adolescent engagement was good (mean response rate of 76%) over the 8-week intervention. Engagement was related to adolescents' gender, race, baseline glycemic control, and blood glucose monitoring, but not to treatment type (pump vs. injection), diabetes duration, age, or household income. There was a significant effect of level of engagement on better caregiver-reported adherence, but adolescents' engagement was not related to self-reported adherence or glycemic control. These results indicate feasibility and initial efficacy of using automated text-messaging to deliver an intervention aimed at promoting adherence in adolescents with T1D.

Development and Usability of REACH: A Tailored Theory-Based Text Messaging Intervention for Disadvantaged Adults With Type 2 Diabetes

PubMed Central

Nelson, Lyndsay A; Mayberry, Lindsay S; Wallston, Kenneth; Kripalani, Sunil; Bergner, Erin M

2016-01-01

Background Among adults with type 2 diabetes mellitus (T2DM), adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations. Objective To develop Rapid Education/Encouragement And Communications for Health (REACH), a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with T2DM, based on the Information-Motivation-Behavioral skills model. We then tested REACH’s usability to make improvements before evaluating its effects. Methods We developed REACH’s content and functionality using an empirical and theory-based approach, findings from a previously pilot-tested intervention, and the expertise of our interdisciplinary research team. We recruited 36 adults with T2DM from Federally Qualified Health Centers to participate in 1 of 3 rounds of usability testing. For 2 weeks, participants received daily text messages assessing and promoting self-care, including tailored messages addressing users’ unique barriers to adherence, and weekly text messages with adherence feedback. We analyzed quantitative and qualitative user feedback and system-collected data to improve REACH. Results Participants were, on average, 52.4 (SD 9.5) years old, 56% (20/36) female, 63% (22/35) were a racial or ethnic minority, and 67% (22/33) had an income less than US $35,000. About half were taking insulin, and average hemoglobin A1c level was 8.2% (SD 2.2%). We identified issues (eg, user concerns with message phrasing, technical restrictions with responding to assessment messages) and made improvements between testing rounds. Overall, participants favorably rated the ease of understanding (mean 9.6, SD 0.7) and helpfulness (mean 9.3, SD 1.4) of self-care promoting text messages on a scale of 1-10, responded to 96% of assessment text messages, and rated the helpfulness of feedback text messages 8.5 (SD 2.7) on a scale of 1-10. User feedback led to refining our study enrollment process so that users understood the flexibility in message timing and that computers, not people, send the messages. Furthermore, research assistants’ feedback on the enrollment process helped improve participants’ engagement with study procedures. Conclusions Testing technology-delivered interventions with disadvantaged adults revealed preferences and concerns unique to this population. Through iterative testing and multiple data sources, we identified and responded to users’ intervention preferences, technical issues, and shortcomings in our research procedures. PMID:27609738

Internet and Mobile Phone Text Messaging Intervention for College Smokers

ERIC Educational Resources Information Center

Riley, William; Obermayer, Jami; Jean-Mary, Jersino

2008-01-01

Objective: The authors developed a smoking cessation program using mobile phone text messaging to provide tailored and stage-specific messages to college smokers. Participants and Methods: The authors recruited 31 daily smokers who desired to quit from a college campus and asked them to use an Internet and mobile phone text messaging program to…

Mobile phone messaging reminders for attendance at healthcare appointments.

PubMed

Car, Josip; Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Atun, Rifat

2012-07-11

Missed appointments are a major cause of inefficiency in healthcare delivery, with substantial monetary costs for the health system, leading to delays in diagnosis and appropriate treatment. Patients' forgetfulness is one of the main reasons for missed appointments, and reminders may help alleviate this problem. Modes of communicating reminders for appointments to patients include face-to-face communication, postal messages, calls to landlines or mobile phones, and mobile phone messaging. Mobile phone messaging applications such as Short Message Service (SMS) and Multimedia Message Service (MMS) could provide an important, inexpensive delivery medium for reminders for healthcare appointments. To assess the effects of mobile phone messaging reminders for attendance at healthcare appointments. Secondary objectives include assessment of patients' and healthcare providers' evaluation of the intervention; costs; and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009). We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We included studies assessing mobile phone messaging as reminders for healthcare appointments. We only included studies in which it was possible to assess effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third author. Primary outcomes of interest were rate of attendance at healthcare appointments. We also considered health outcomes as a result of the intervention, patients' and providers' evaluation of the intervention, perceptions of safety, costs, and potential harms or adverse effects. As the intervention characteristics and outcome measures were similar across included studies, we conducted a meta-analysis to estimate an overall effect size. We included four randomised controlled trials involving 3547 participants. Three studies with moderate quality evidence showed that mobile text message reminders improved the rate of attendance at healthcare appointments compared to no reminders (risk ratio (RR) 1.10 (95% confidence interval (CI) 1.03 to 1.17)). One low quality study reported that mobile text message reminders with postal reminders, compared to postal reminders, improved rate of attendance at healthcare appointments (RR 1.10 (95% CI 1.02 to 1.19)). However, two studies with moderate quality of evidence showed that mobile phone text message reminders and phone call reminders had a similar impact on healthcare attendance (RR 0.99 (95% CI 0.95 to 1.03). The costs per attendance of mobile phone text message reminders were shown to be lower compared to phone call reminders. None of the included studies reported outcomes related to harms or adverse effects of the intervention, nor health outcomes or user perception of safety related to the intervention. There is moderate quality evidence that mobile phone text message reminders are more effective than no reminders, and low quality evidence that text message reminders with postal reminders are more effective than postal reminders alone. Further, according to the moderate quality evidence we found, mobile phone text message reminders are as effective as phone call reminders. Overall, there is limited evidence on the effects of mobile phone text message reminders for appointment attendance, and further high-quality research is required to draw more robust conclusions.

Effects of a sleep hygiene text message intervention on sleep in college students.

PubMed

Gipson, Christine S; Chilton, Jenifer M; Dickerson, Suzanne S; Alfred, Danita; Haas, Barbara K

2018-04-13

To test the effectiveness of a text-message intervention to promote sleep hygiene to improve sleep in young adult college students. A convenience sample of undergraduate students from one Southwestern university (n = 96), 18-26 years old, recruited in August 2015. A 2-group pretest-posttest experimental design assigned participants to receive biweekly text messages about sleep hygiene or healthy behaviors for 6 weeks. Survey questions addressed sleep knowledge, sleep hygiene, self-efficacy for sleep hygiene, and sleep quality at baseline and posttest. Though not significant, sleep quality, sleep hygiene, and sleep knowledge improved in both groups. Self-efficacy for sleep hygiene is a modifiable factor that may serve to improve sleep quality. Sleep quality improved in both groups. Text messaging is a feasible approach to delivering an intervention to promote healthy behaviors among young adults.

A Matter of Urgency: Reducing Clinical Text Message Interruptions During Educational Sessions.

PubMed

Mendel, Arielle; Lott, Anthony; Lo, Lisha; Wu, Robert

2018-04-25

Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. This was a quality improvement project conducted at an academic hospital network. Measurements and interventions took place on 8 general internal medicine inpatient teaching teams. Interventions included (1) refining the clinical communication process in collaboration with nursing leadership; (2) disseminating guidelines with posters at nursing stations; (3) introducing a noninterrupting option for message senders; (4) audit and feedback of messages; (5) adding an alert for message senders advising if a message would interrupt educational sessions; and (6) training and support to nurses and residents. Interruptions (text messages, phone calls, emails) received by institution-supplied team smartphones were tracked during educational hours using statistical process control charts. A 1-month record of text message content was analyzed for urgency at baseline and following the interventions. The interruption frequency decreased from a mean of 0.92 (95% CI, 0.88 to 0.97) to 0.59 (95% CI, 0.51 to0.67) messages per team per educational hour from January 2014 to December 2016. The proportion of nonurgent educational interruptions decreased from 223/273 (82%) messages over one month to 123/182 (68%; P < .01). Creation of communication guidelines and modification of text message interface with feedback from end-users were associated with a reduction in nonurgent educational interruptions. Continuous audit and feedback may be necessary to minimize nonurgent messages that disrupt educational sessions. © 2018 Society of Hospital Medicine.

Text messaging data collection for monitoring an infant feeding intervention program in rural China: feasibility study.

PubMed

Li, Ye; Wang, Wei; van Velthoven, Michelle Helena; Chen, Li; Car, Josip; Rudan, Igor; Zhang, Yanfeng; Wu, Qiong; Du, Xiaozhen; Scherpbier, Robert W

2013-12-04

An effective data collection method is crucial for high quality monitoring of health interventions. The traditional face-to-face data collection method is labor intensive, expensive, and time consuming. With the rapid increase of mobile phone subscribers, text messaging has the potential to be used for evaluation of population health interventions in rural China. The objective of this study was to explore the feasibility of using text messaging as a data collection tool to monitor an infant feeding intervention program. Participants were caregivers of children aged 0 to 23 months in rural China who participated in an infant feeding health education program. We used the test-retest method. First, we collected data with a text messaging survey and then with a face-to-face survey for 2 periods of 3 days. We compared the response rate, data agreement, costs, and participants' acceptability of the two methods. Also, we interviewed participants to explore their reasons for not responding to the text messages and the reasons for disagreement in the two methods. In addition, we evaluated the most appropriate time during the day for sending text messages. We included 258 participants; 99 (38.4%) participated in the text messaging survey and 177 (68.6%) in the face-to-face survey. Compared with the face-to-face survey, the text messaging survey had much lower response rates to at least one question (38.4% vs 68.6%) and to all 7 questions (27.9% vs 67.4%) with moderate data agreement (most kappa values between .5 and .75, the intraclass correlation coefficients between .53 to .72). Participants who took part in both surveys gave the same acceptability rating for both methods (median 4.0 for both on a 5-point scale, 1=disliked very much and 5=liked very much). The costs per questionnaire for the text messaging method were much lower than the costs for the face-to-face method: ¥19.7 (US $3.13) versus ¥33.9 (US $5.39) for all questionnaires, and ¥27.1 (US $4.31) versus ¥34.4 (US $5.47) for completed questionnaires. The main reasons for not replying were that participants did not receive text messages, they were too busy to reply, or they did not see text messages in time. The main reasons for disagreement in responses were that participants forgot their answers in the text messaging survey and that they changed their minds. We found that participants were more likely to reply to text messages immediately during 2 time periods: 8 AM to 3 PM and 8 PM to 9 PM. The text messaging method had reasonable data agreement and low cost, but a low response rate. Further research is needed to evaluate effectiveness of measures that can increase the response rate, especially in collecting longitudinal data by text messaging.

Text Messaging Data Collection for Monitoring an Infant Feeding Intervention Program in Rural China: Feasibility Study

PubMed Central

van Velthoven, Michelle Helena; Chen, Li; Car, Josip; Rudan, Igor; Wu, Qiong; Du, Xiaozhen; Scherpbier, Robert W

2013-01-01

Background An effective data collection method is crucial for high quality monitoring of health interventions. The traditional face-to-face data collection method is labor intensive, expensive, and time consuming. With the rapid increase of mobile phone subscribers, text messaging has the potential to be used for evaluation of population health interventions in rural China. Objective The objective of this study was to explore the feasibility of using text messaging as a data collection tool to monitor an infant feeding intervention program. Methods Participants were caregivers of children aged 0 to 23 months in rural China who participated in an infant feeding health education program. We used the test-retest method. First, we collected data with a text messaging survey and then with a face-to-face survey for 2 periods of 3 days. We compared the response rate, data agreement, costs, and participants’ acceptability of the two methods. Also, we interviewed participants to explore their reasons for not responding to the text messages and the reasons for disagreement in the two methods. In addition, we evaluated the most appropriate time during the day for sending text messages. Results We included 258 participants; 99 (38.4%) participated in the text messaging survey and 177 (68.6%) in the face-to-face survey. Compared with the face-to-face survey, the text messaging survey had much lower response rates to at least one question (38.4% vs 68.6%) and to all 7 questions (27.9% vs 67.4%) with moderate data agreement (most kappa values between .5 and .75, the intraclass correlation coefficients between .53 to .72). Participants who took part in both surveys gave the same acceptability rating for both methods (median 4.0 for both on a 5-point scale, 1=disliked very much and 5=liked very much). The costs per questionnaire for the text messaging method were much lower than the costs for the face-to-face method: ¥19.7 (US $3.13) versus ¥33.9 (US $5.39) for all questionnaires, and ¥27.1 (US $4.31) versus ¥34.4 (US $5.47) for completed questionnaires. The main reasons for not replying were that participants did not receive text messages, they were too busy to reply, or they did not see text messages in time. The main reasons for disagreement in responses were that participants forgot their answers in the text messaging survey and that they changed their minds. We found that participants were more likely to reply to text messages immediately during 2 time periods: 8 AM to 3 PM and 8 PM to 9 PM. Conclusions The text messaging method had reasonable data agreement and low cost, but a low response rate. Further research is needed to evaluate effectiveness of measures that can increase the response rate, especially in collecting longitudinal data by text messaging. PMID:24305514

Can wireless text messaging improve adherence to preventive activities? Results of a randomised controlled trial.

PubMed

Cocosila, Mihail; Archer, Norm; Haynes, R Brian; Yuan, Yufei

2009-04-01

To determine the effectiveness of cell phone wireless text messaging for improving adherence to a healthy behaviour. A randomised, unblinded, controlled trial was conducted with 102 subjects, 18 years or older, each having a cell phone and willing to take 1 vitamin C pill per day for 1 month for preventive reasons. Intervention group participants received text messaging reminders and were asked to acknowledge receiving their messages after taking the vitamins, whereas control group subjects had no text messaging activity. Self-reported adherence and the number of participant text messages acknowledging vitamins taken. Both groups reported an increased adherence after the trial: by 246% for the intervention group and by 131% for the control group. There was a non-significant difference between the two groups at endpoint: an average difference of 0.8 between the number of pills missed in the last week of the trial (2.5 out of 7 in the intervention and 3.3 out of 7 in the control group) with a power of 0.54. The study revealed a significant correlation (coefficient=-0.352, sig.=0.01) between the average number of text messaging acknowledgements sent by the intervention group participants and the number of pills they reported missed during the last week of the trial. This was a small randomised controlled trial with inconclusive but encouraging results. It suggests a new approach in addressing insufficient adherence in outpatient conditions and shows that the use of information technology tools for compliance warrants further research.

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment

PubMed Central

Gonzales, Rachel; Douglas Anglin, M.; Glik, Deborah C.

2014-01-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12–24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems. PMID:24038196

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment.

PubMed

Gonzales, Rachel; Douglas Anglin, M; Glik, Deborah C

2014-02-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12-24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems.

Developing content for a mHealth intervention to promote postpartum retention in prevention of mother-to-child HIV transmission programs and early infant diagnosis of HIV: a qualitative study.

PubMed

Odeny, Thomas A; Newman, Maya; Bukusi, Elizabeth A; McClelland, R Scott; Cohen, Craig R; Camlin, Carol S

2014-01-01

Maternal attendance at postnatal clinic visits and timely diagnosis of infant HIV infection are important steps for prevention of mother-to-child transmission (PMTCT) of HIV. We aimed to use theory-informed methods to develop text messages targeted at facilitating these steps. We conducted five focus group discussions with health workers and women attending antenatal, postnatal, and PMTCT clinics to explore aspects of women's engagement in postnatal HIV care and infant testing. Discussion topics were informed by constructs of the Health Belief Model (HBM) and prior empirical research. Qualitative data were coded and analyzed according to the construct of the HBM to which they related. Themes were extracted and used to draft intervention messages. We carried out two stages of further messaging development: messages were presented in a follow-up focus group in order to develop optimal phrasing in local languages. We then further refined the messages, pretested them in individual cognitive interviews with selected health workers, and finalized the messages for the intervention. Findings indicated that brief, personalized, caring, polite, encouraging, and educational text messages would facilitate women bringing their children to clinic after delivery, suggesting that text messages may serve as an important "cue to action." Participants emphasized that messages should not mention HIV due to fear of HIV testing and disclosure. Participants also noted that text messages could capitalize on women's motivation to attend clinic for childhood immunizations. Applying a multi-stage content development approach to crafting text messages--informed by behavioral theory--resulted in message content that was consistent across different focus groups. This approach could help answer "why" and "how" text messaging may be a useful tool to support maternal and child health. We are evaluating the effect of these messages on improving postpartum PMTCT retention and infant HIV testing in a randomized trial.

Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial.

PubMed

Stockwell, Melissa S; Westhoff, Carolyn; Kharbanda, Elyse Olshen; Vargas, Celibell Y; Camargo, Stewin; Vawdrey, David K; Castaño, Paula M

2014-02-01

We evaluated the impact of influenza vaccine text message reminders in a low-income obstetric population. We conducted a randomized controlled trial that enrolled 1187 obstetric patients from 5 community-based clinics in New York City. The intervention group received 5 weekly text messages regarding influenza vaccination starting mid-September 2011 and 2 text message appointment reminders. Both groups received standard automated telephone appointment reminders. The prespecified endpoints were receipt of either pre- or postpartum influenza vaccination calculated cumulatively at the end of each month (September-December 2011). After adjusting for gestational age and number of clinic visits, women who received the intervention were 30% more likely to be vaccinated as of December 2011 (adjusted odds ratio [AOR] = 1.30; 95% confidence interval [CI] = 1.003, 1.69 end of September: AOR = 1.34; 95% CI = 0.98, 1.85; October: AOR = 1.35; 95% CI = 1.05, 1.75; November: AOR = 1.27; 95% CI = 0.98, 1.65). The subgroup of women early in the third trimester at randomization showed the greatest intervention effect (December 31: 61.9% intervention vs 49.0% control; AOR = 1.88; 95% CI = 1.12, 3.15). In this low-income obstetric population, text messaging was associated with increased influenza vaccination, especially in those who received messages early in their third trimester.

Designing Patient-Centered Text Messaging Interventions for Increasing Physical Activity Among Participants With Type 2 Diabetes: Qualitative Results From the Text to Move Intervention.

PubMed

Horner, Gabrielle N; Agboola, Stephen; Jethwani, Kamal; Tan-McGrory, Aswita; Lopez, Lenny

2017-04-24

Type 2 diabetes mellitus (T2DM) is a disease affecting approximately 29.1 million people in the United States, and an additional 86 million adults have prediabetes. Diabetes self-management education, a complex health intervention composed of 7 behaviors, is effective at improving self-care behaviors and glycemic control. Studies have employed text messages for education, reminders, and motivational messaging that can serve as "cues to action," aiming to improve glucose monitoring, self-care behaviors, appointment attendance, and medication adherence. The Text to Move (TTM) study was a 6-month 2-parallel group randomized controlled trial of individuals with T2DM to increase physical activity, measured by a pedometer. The intervention arm received text messages twice daily for 6 months that were tailored to the participant's stage of behavior change as defined by the transtheoretical model of behavior change. We assessed participants' attitudes regarding their experience with text messaging, focusing on perceived barriers and facilitators, through two focus groups and telephone interviews. All interviews were audiorecorded, transcribed verbatim, coded, and analyzed using a grounded theory approach. The response rate was 67% (31/46 participants). The average age was 51.4 years and 61% (19/31 participants) were male. The majority of individuals were English speakers and married, had completed at least 12th grade and approximately half of the participants were employed full-time. Overall, participants were satisfied with the TTM program and recalled the text messages as educational, informational, and motivational. Program involvement increased the sense of connection with their health care center. The wearing of pedometers and daily step count information served as motivational reminders and created a sense of accountability through the sentinel effect. However, there was frustration concerning the automation of the text message program, including the repetitiveness, predictability of text time delivery, and lack of customization and interactivity of text message content. Participants recommended personalization of texting frequency as well as more contact time with personnel for a stronger sense of support, including greater surveillance and feedback based on their own results and comparison to other participants. Participants in a theory-based text messaging intervention identified key facilitators and barriers to program efficacy that should be incorporated into future texting interventions to optimize participant satisfaction and outcomes. Clinicaltrials.gov NCT01569243; http://clinicaltrials.gov/ct2/show/NCT01569243 (Archived by Webcite at http://www.webcitation.org/6pfH6yXag). ©Gabrielle N Horner, Stephen Agboola, Kamal Jethwani, Aswita Tan-McGrory, Lenny Lopez. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.04.2017.

A Research Protocol to Test the Effectiveness of Text Messaging and Reminder Calls to Increase Service Use Referrals in a Community Engagement Program.

PubMed

Varma, Deepthi Satheesa; Hart, Mark; McIntyre, Denise Sonya; Kwiatkowski, Evan; Cottler, Linda Bauer

2016-06-28

Mobile phoned-based interventions have been increasingly used in clinical populations to improve health and health care delivery. The literature has shown that mobile phone-based text messages (short message service, SMS) are instantaneous, cost effective, and have less chance of being misplaced. Studies using mobile phone based-text messages have reported text messages as effective reminders that have resulted in increased appointment attendance, adherence to treatment, and better self-management. There have been no reports of adverse events when using text messaging in terms of misreading or misinterpreting data, transmitting inaccurate data, losing verbal or nonverbal communication cues, privacy issues, or failure or delay in message delivery. However, the literature has cited a need for personalized messages that are more responsive to individual needs. In addition, there has been a dearth of information on the use of reminders in nonclinical populations. The goal of this study is to assess the effectiveness of adding reminders in the form of text messaging versus reminder calls versus text messages and reminder calls to increase use of service referrals provided through community outreach. A total of 300 participants will be recruited for the study. Each participant will be randomized to one of three arms: a group that receives only reminder calls (CALLSONLY); a group that receives only text message reminders (TEXTONLY); and a group that receives both reminder calls and text messages (CALLS+TEXT). All groups will receive their reminder intervention on the 15th and 45th day after baseline when they receive medical and social service referrals from the community health workers (CHWs). A standard script will be used to administer the call and text reminders and a 15-item telephone-based satisfaction survey will be administered to assess the participant satisfaction with the process of receiving periodic reminders. The study is in the recruitment and follow-up phase. The authors anticipate completion of recruitment, interventions, and data entry by July 2016. Preliminary results are expected to be available by September 2016. This study will provide an opportunity to test the effectiveness of mobile-based interventions on nonclinical, community-recruited populations. In particular, such a protocol would increase the effectiveness of a community-based engagement program by instating a formal reminder system for all program members who receive social and/or medical service referrals during outreach in the community. Findings from this study would guide the development and implementation of reminder protocols for community-based engagement programs nationwide.

Mobile Delivery of Treatment for Alcohol Use Disorders

PubMed Central

Quanbeck, Andrew; Chih, Ming-Yuan; Isham, Andrew; Johnson, Roberta; Gustafson, David

2014-01-01

Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based systems engage the user using video games. Although many commercial applications for treatment of AUDs exist, few (if any) have empirical evidence of effectiveness. The available evidence suggests that although texting-based applications may have beneficial effects, they are probably insufficient as interventions for AUDs. Comprehensive recovery management systems have the strongest theoretical base and have yielded the strongest and longest-lasting effects, but challenges remain, including cost, understanding which features account for effects, and keeping up with technological advances. PMID:26259005

Texting to Reduce Alcohol Misuse (TRAM): main findings from a randomized controlled trial of a text message intervention to reduce binge drinking among disadvantaged men.

PubMed

Crombie, Iain K; Irvine, Linda; Williams, Brian; Sniehotta, Falko F; Petrie, Dennis; Jones, Claire; Norrie, John; Evans, Josie M M; Emslie, Carol; Rice, Peter M; Slane, Peter W; Humphris, Gerry; Ricketts, Ian W; Melson, Ambrose J; Donnan, Peter T; Hapca, Simona M; McKenzie, Andrew; Achison, Marcus

2018-06-01

To test the effectiveness of a theoretically based text-message intervention to reduce binge drinking among socially disadvantaged men. A multi-centre parallel group, pragmatic, individually randomized controlled trial. Community-based study conducted in four regions of Scotland. A total of 825 men aged 25-44 years recruited from socially disadvantaged areas who had two or more episodes of binge drinking (> 8 UK units on a single occasion) in the preceding 28 days: 411 men were randomized to the intervention and 414 to the control. A series of 112 interactive text messages was delivered by mobile phone during a 12-week period. The intervention was structured around the Health Action Process Approach, a comprehensive model which allows integration of a range of evidence-based behaviour change techniques. The control group received 89 texts on general health, with no mention of alcohol or use of behaviour change techniques. The primary outcome measure was the proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) at 12 months post-intervention. The proportion of men consuming > 8 units on three or more occasions (in the previous 28 days) was 41.5% in the intervention group and 47.8% in the control group. Formal analysis showed that there was no evidence that the intervention was effective [odds ratio (OR) = 0.79, 95% confidence interval (CI) = 0.57-1.08; absolute reduction 5.7%, 95% CI = -13.3 to 1.9]. The Bayes factor for this outcome was 1.3, confirming that the results were inconclusive. The retention was high and similar in intervention (84.9%) and control (86.5%) groups. Most men in the intervention group engaged with the text messages: almost all (92%) replied to text messages and 67% replied more than 10 times. A theoretically based text-messaging intervention aimed at reducing binge drinking in disadvantaged men was not found to reduce prevalence of binge drinking at 12-month follow-up. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Consumer understanding of calorie labeling: a healthy monday e-mail and text message intervention.

PubMed

Abel, Michelle L; Lee, Katherine; Loglisci, Ralph; Righter, Allison; Hipper, Thomas J; Cheskin, Lawrence J

2015-03-01

To assess caloric knowledge of participants and determine if an e-mail and/or text message intervention could increase knowledge of recommended daily caloric intake. Randomized, control trial. Johns Hopkins Hospital Cobblestone Café. The 246 participants reported eating at the Café at least twice/week. Participants randomized to control, e-mail, or text condition. The text and e-mail conditions received a message on four consecutive Mondays stating the recommended daily caloric intake. Knowledge of the government reference value of 2,000 calories. Intention-to-treat analysis was conducted. Multivariate logistic regression examined the effectiveness of text and e-mail messaging for improving knowledge of the government calorie reference value. Baseline awareness of the daily calorie reference value in study population was low. Participants in the text message condition were twice as likely to know the government calorie reference value compared to controls (p = .047, odds ratio = 2.2, 95% confidence interval [1.01, 4.73]). No significant differences were found for the e-mail condition (p = .5). Many people do not know the daily recommended caloric intake. Public education on the government calorie reference value is necessary for menu-labeling interventions to be more effective. Weekly text messaging can serve as an effective modality for delivering calorie information and nutrition education. © 2014 Society for Public Health Education.

Smartphone text message service to foster hand hygiene compliance in health care workers.

PubMed

Kerbaj, Jad; Toure, Youssoupha; Soto Aladro, Alberto; Boudjema, Sophia; Giorgi, Roch; Dufour, Jean Charles; Brouqui, Philippe

2017-03-01

Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence. The study is a historical comparison proof-of-concept study. Eighteen health care workers were monitored during 12 months by a radiofrequency identification system. Afterward we sent 2 types of text messages, congratulation or encouragement, and we studied the evolution of hand hygiene adherence. We recorded 15,723 hand hygiene opportunities, 8,973 before intervention and 6,750 during and after the intervention. Using a multilevel logistic regression analysis, we found a significant increase in hand hygiene adherence during the intervention (odds ratio, 1.68) compared with the historical period. Despite limitations due to the type of study, a text message encouraging personnel to be more vigilant is effective in increasing hand hygiene adherence in health care workers. Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Correlates of Healthy Lifestyle Beliefs and Behaviors in Parents of Overweight or Obese Preschool Children Before and After a Cognitive Behavioral Therapy Intervention With Text Messaging.

PubMed

Militello, Lisa K; Melnyk, Bernadette Mazurek; Hekler, Eric; Small, Leigh; Jacobson, Diana

2016-01-01

Significant gaps exist in the published literature regarding the treatment of overweight/obesity in preschool-aged children, especially in primary care settings. Parental influence plays an important factor in the development of healthy behaviors in children, yet there is no consensus about why some behavior change intervention strategies for parents of young children are more influential and effective than others. The purpose of this secondary data analysis was to assess correlations among the study variables (healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors) in parents of overweight/obese preschool children. A second aim explored if the parent's level of cognitive beliefs and perceived difficulty of engaging in healthy lifestyle behaviors correlated with text messaging cognitive behavioral support. Fifteen preschool-parent dyads from primary care clinics completed a 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the intervention content, and Fogg's Behavior Model guided the implementation. The intervention was delivered using a combination of face-to-face clinic visits and ecological momentary interventions using text messaging. Supported are the interconnected relationships among the study variables, that is, parental healthy lifestyle beliefs, thoughts, and behaviors. At baseline, parental healthy lifestyle belief scores significantly correlated with perceived difficulty (rs = 0.598, p < .05) and healthy lifestyle behaviors (rs = 0.545, p < .05). These associations strengthened after the intervention. Furthermore, as parental healthy lifestyle beliefs increased and perceived difficulty lessened, their response rate and subsequent feedback lessened to the static text messaging support. Findings from this study support the interconnections between parents' thoughts, feelings, and actions toward healthy lifestyles. As parental beliefs became stronger through cognitive behavioral skills building and tailored text messaging, the need for general support via text messaging lessened, warranting additional research. Published by Elsevier Inc.

Adolescent Female Text Messaging Preferences to Prevent Pregnancy After an Emergency Department Visit: A Qualitative Analysis.

PubMed

Chernick, Lauren Stephanie; Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S

2016-09-29

Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were "brief," "professional," and "nonaccusatory." Respondents favored texts with links to websites, repeated information regarding places to receive "confidential" care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to maintain "surprise." No participant feared that text messages would violate her privacy. Adolescent female patients at high pregnancy risk are interested in ED-based pregnancy prevention provided by texting. Understanding preferences for the content, frequency, and timing of messages can guide in designing future interventions in the ED.

Proof of Concept of a Mobile Health Short Message Service Text Message Intervention That Promotes Adherence to Oral Anticancer Agent Medications: A Randomized Controlled Trial.

PubMed

Spoelstra, Sandra L; Given, Charles W; Sikorskii, Alla; Coursaris, Constantinos K; Majumder, Atreyee; DeKoekkoek, Tracy; Schueller, Monica; Given, Barbara A

2016-06-01

This multisite, randomized controlled trial assigned 75 adult cancer patients prescribed an oral anticancer agent to either an experimental group that received daily text messages for adherence for 21 days plus usual care or a control group that received usual care. Measures were administered at baseline, weekly (Weeks 1-8), and at exit (Week 9). A satisfaction survey was conducted following the intervention. Acceptability, feasibility, and satisfaction were examined. Primary outcomes were adherence and symptoms. Secondary outcomes were depressive symptoms, self-efficacy, cognition, physical function, and social support. Mixed or general linear models were used for the analyses comparing trial groups. Effect sizes (ES) were estimated to gauge clinical significance. Regarding acceptability, 57.2% (83 of 145) of eligible patients consented, 88% (n = 37 of 42) receiving text messages read them most or all of the time, and 90% (n = 38) were satisfied. The differences between experimental and control groups' ES were 0.29 for adherence, 0.21 for symptom severity, and 0.21 for symptom interference, and differences were not statistically significant. Furthermore, perceived social support was higher (p = 0.04; ES = 0.54) in the experimental group. Proof of concept and preliminary efficacy of a mobile health intervention using text messages to promote adherence for patients prescribed oral anticancer agents were demonstrated. Patients accepted and had high satisfaction with the intervention, and adherence improved after the intervention. Text messages show promise. Additional research is needed prior to use in practice.

Effectiveness of extended contact interventions for weight management delivered via text messaging: a systematic review and meta-analysis.

PubMed

Job, J R; Fjeldsoe, B S; Eakin, E G; Reeves, M M

2018-04-01

Extended contact interventions provide support for continued weight management (weight loss/prevention of weight regain) following a weight loss intervention. Text messages offer a medium for delivery in a potentially cost-effective, broad-reach manner. This study aims to examine (i) the effectiveness of extended contact, text message interventions for adults in supporting weight management, and (ii) which intervention characteristics are common to those that are effective. A systematic database search (to 19 September 2016) was conducted. Meta-analyses were performed to quantify the average weight changes (kg) during the extended contact intervention, net of control (if a control group was present) and within-group. Seven studies were eligible for inclusion. The pooled effect of the extended contact intervention compared with control (n = 3 studies) was -0.82 kg (95% confidence interval -1.43, -0.21), while the pooled within-group weight loss (n = 6 studies) during the extended contact interventions was -2.16 kg (95% confidence interval -3.40, -0.91). Interventions considered 'effective' (n = 4) were more likely to be >12 weeks duration, compared with interventions considered 'ineffective' (n = 3). Evidence from the small number of studies reviewed suggests that extended contact, text message-delivered interventions are effective. Further research is required to elucidate effective intervention components and the longer-term impact on weight, diet and physical activity behaviour. © 2017 World Obesity Federation.

Fatigue mitigation with SleepTrackTXT2 in air medical emergency care systems: study protocol for a randomized controlled trial.

PubMed

Patterson, P Daniel; Moore, Charity G; Guyette, Frank X; Doman, Jack M; Sequeira, Denisse; Werman, Howard A; Swanson, Doug; Hostler, David; Lynch, Joshua; Russo, Lindsey; Hines, Linda; Swecker, Karen; Runyon, Michael S; Buysse, Daniel J

2017-06-05

Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians. We will conduct a multi-site randomized trial with a sample of adult EMS clinicians recruited from four air medical EMS systems located in the midwest, northeastern, and southern USA. Participants will be allocated to one of two possible arms for a 4-month (120-day) study period. The intervention arm will involve text-message assessments of sleepiness, fatigue, and difficulty concentrating at the beginning, every 4 hours during, and at the end of scheduled shifts. Participants reporting high levels of sleepiness, fatigue, or difficulty with concentration will receive one of nine randomly selected intervention messages to promote behavior change during shift work to improve alertness. Intervention participants will receive a text-message report on Friday of each week that shows their sleep debt over the previous 7 days followed by a text message to promote paying back sleep debt recovery when feasible. Participants in the control group receive text messages that only include assessments. Both arms will receive text-message assessments of perceived recovery since last shift, sleepiness, fatigue, or difficulty with concentration at noon (1200 hours) on days between scheduled shifts (off-duty days). We have two aims for this study: (1) to determine the short-term impact of the enhanced SleepTrackTXT2 intervention on air medical clinician fatigue reported in real time during and at the end of shift work, and (2) to determine the long-term impact of the SleepTrackTXT2 intervention on sleep quality and sleep health indicators including hours of sleep and recovery between shift work. The SleepTrackTXT2 trial may provide evidence of real-world effectiveness that would support widespread expansion of fatigue mitigation interventions in emergency care clinician shift workers. The trial may specifically support use of real-time assessments and interventions delivered via mobile technology such as text messaging. ClinicalTrials.gov, NCT02783027 . Registered on 23 May 2016.

Randomised controlled trial of a text messaging intervention for reducing processed meat consumption: The mediating roles of anticipated regret and intention.

PubMed

Carfora, V; Caso, D; Conner, M

2017-10-01

The present study aimed to extend the literature on text messaging interventions involved in promoting healthy eating behaviours. The theoretical framework was the Theory of Planned Behaviour (TPB). A randomized controlled trial was used to test the impact of daily text messages compared to no message (groups) for reducing processed meat consumption (PMC) over a 2 week period, testing the sequential mediation role of anticipated regret and intention on the relationship between groups and PMC reduction. PMC and TPB variables were assessed both at Time 1 and Time 2. Participants were Italian undergraduates (at Time 1 N = 124) randomly allocated to control and message condition groups. Undergraduates in the message condition group received a daily SMS, which focused on anticipated regret and urged them to self-monitor PMC. Participants in the control group did not receive any message. Those who completed all measures at both time points were included in the analyses (N = 112). Findings showed that a daily messaging intervention, controlling for participants' past behaviour, reduced self-reported consumption of PMC. Mediation analyses indicated partial serial mediation via anticipated regret and intentions. The current study provided support for the efficacy of a daily messaging intervention targeting anticipated regret and encouraging self-monitoring in decreasing PMC. Outcomes showed the important mediating role of anticipated regret and intentions for reducing PMC. Copyright © 2017 Elsevier Ltd. All rights reserved.

Phone-Based Interventions in Adolescent Psychiatry: A Perspective and Proof of Concept Pilot Study With a Focus on Depression and Autism

PubMed Central

Feltes, Jordan Robert; Tzeng, William Shun; Lu, Zoe Yunzhu; Pan, Michael; Zhao, Nan; Talkin, Rebecca; Javaherian, Kavon; Glowinski, Anne; Ross, Will

2017-01-01

Background Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed. Objective The aim of this paper was to explore the utility of text message interventions in adolescent psychiatry and describe a user feedback-driven iterative design process for text message systems. Methods We developed automated text message interventions using a platform for both depression (EpxDepression) and autism spectrum disorder (ASD; EpxAutism) and conducted 2 pilot studies for each intervention (N=3 and N=6, respectively). The interventions were prescribed by and accessible to the patients’ healthcare providers. EpxDepression and EpxAutism utilized an automated system to triage patients into 1 of 3 risk categories based on their text responses and alerted providers directly via phone and an online interface when patients met provider-specified risk criteria. Rapid text-based feedback from participants and interviews with providers allowed for quick iterative cycles to improve interventions. Results Patients using EpxDepression had high weekly response rates (100% over 2 to 4 months), but exhibited message fatigue with daily prompts with mean (SD) overall response rates of 66.3% (21.6%) and 64.7% (8.2%) for mood and sleep questionnaires, respectively. In contrast, parents using EpxAutism displayed both high weekly and overall response rates (100% and 85%, respectively, over 1 to 4 months) that did not decay significantly with time. Monthly participant feedback surveys for EpxDepression (7 surveys) and EpxAutism (18 surveys) preliminarily indicated that for both interventions, daily messages constituted the “perfect amount” of contact and that EpxAutism, but not EpxDepression, improved patient communication with providers. Notably, EpxDepression detected thoughts of self-harm in patients before their case managers or caregivers were aware of such ideation. Conclusions Text-message interventions in adolescent psychiatry can provide a cost-effective and engaging method to track symptoms, behavior, and ideation over time. Following the collection of pilot data and feedback from providers and patients, larger studies are already underway to validate the clinical utility of EpxDepression and EpxAutism. Trial Registration Clinicaltrials.gov NCT03002311; https://clinicaltrials.gov/ct2/show/NCT03002311 (Archived by WebCite at http://www.webcitation.org/6qQtlCIS0) PMID:28623183

Automated Behavioral Text Messaging and Face-to-Face Intervention for Parents of Overweight or Obese Preschool Children: Results From a Pilot Study.

PubMed

Militello, Lisa; Melnyk, Bernadette Mazurek; Hekler, Eric B; Small, Leigh; Jacobson, Diana

2016-03-14

Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period. The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting. Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the TEXT2COPE intervention content and Fogg's Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention's relevance to the family's needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation. Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week. Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.

Texting Your Way to Healthier Eating? Effects of Participating in a Feedback Intervention Using Text Messaging on Adolescents' Fruit and Vegetable Intake

ERIC Educational Resources Information Center

Pedersen, Susanne; Grønhøj, Alice; Thøgersen, John

2016-01-01

This study investigates the effects of a feedback intervention employing text messaging during 11 weeks on adolescents' behavior, self-efficacy and outcome expectations regarding fruit and vegetable intake. A pre- and post-survey was completed by 1488 adolescents school-wise randomly allocated to a control group and two experimental groups. Both…

Text messaging improves preoperative exercise in patients undergoing bariatric surgery.

PubMed

Lemanu, Daniel P; Singh, Primal P; Shao, Robert Y; Pollock, Terina T; MacCormick, Andrew D; Arroll, Bruce; Hill, Andrew G

2018-06-25

To investigate whether a text message intervention improves adherence to preoperative exercise advice prior to laparoscopic sleeve gastrectomy (LSG). A single-blinded parallel design 1:1 ratio randomized controlled trial was performed in patients undergoing LSG as a single-stage bariatric procedure for morbid obesity. The intervention group received preoperative daily text messages. The primary outcome was adherence to preoperative exercise advice as assessed by the number of participants partaking in ≥450 metabolic equivalent minutes (METmin -1 ) exercise activity per week preoperatively. Eighty-eight patients were included in the analysis with 44 allocated to each arm. Adherence and exercise activity increased significantly from baseline in the exposure group (EG) but not in the control group (CG). Adherence was significantly higher in the EG at the end of the intervention period compared to the CG. Despite increased exercise activity, there was no improvement in 6-min walk test or surgical recovery. A daily text message intervention improved adherence to preoperative exercise advice, but this did not correlate with improved surgical recovery. © 2018 Royal Australasian College of Surgeons.

Post-acute crisis text messaging outreach for suicide prevention: a pilot study.

PubMed

Berrouiguet, Sofian; Gravey, Michel; Le Galudec, Mickaël; Alavi, Zarrin; Walter, Michel

2014-07-30

Several post-suicide prevention strategies such as sending postcards or making phone calls have been used to keep in contact with suicide attempters. The continuity of care has been beneficial to the prevention of post-acute suicidal behaviors. The aim of the study was to evaluate the technical feasibility and acceptability of text messaging outreach in post-acute suicide attempters. Eighteen post-suicidal patients were included in a prospective, monocentric, open-label, 2 months pilot study. The text messages were sent from the intranet program that we specially developed for the study. Technical feasibility of this text message intervention was evaluated by the analysis of text message reports. Acceptability of such intervention was evaluated by a standardized phone interview. Our study showed that receiving text messages sent from an intranet program after a suicide attempt is technically possible. This post-crisis outreach program was accepted by the patients who found it to have a positive preventive impact. Text messaging outreach offers several advantages such as lower cost, and easier utilization compared to current post-acute care strategies. We suggest further randomized controlled trials in a large sample of suicidal patients to assess the efficacy of this novel outreach tool for prevention of post-acute suicide. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Text to Quit China: An mHealth Smoking Cessation Trial.

PubMed

Augustson, Erik; Engelgau, Michael M; Zhang, Shu; Cai, Ying; Cher, Willie; Li, Richun; Jiang, Yuan; Lynch, Krystal; Bromberg, Julie E

2017-05-01

To assess the feasibility, acceptability, and efficacy of a text message-based smoking cessation intervention in China. Study design was a randomized control trial with a 6-month follow-up assessment of smoking status. Zhejiang, Heilongjiang, and Shaanxi provinces in China provided the study setting. A total of 8000 adult smokers in China who used Nokia Life Tools and participated in phase 2 (smoking education via text message) of the study were included. The high-frequency text contact (HFTC) group received one to three messages daily containing smoking cessation advice, encouragement, and health education information. The low-frequency text contact (LFTC) group received one weekly message with smoking health effects information. Our primary outcome was smoking status at 0, 1, 3, and 6 months after intervention. Secondary outcomes include participant perceptions of the HFTC intervention, and factors associated with smoking cessation among HFTC participants. Descriptive and χ 2 analyses were conducted to assess smoking status and acceptability. Factors associated with quitting were assessed using multiple logistic regression analyses. Quit rates were high in both the HFTC and LFTC groups (HFTC: 0 month, 27.9%; 1 month, 30.5%; 3 months, 26.7%; and 6 months, 27.7%; LFTC: 0 month, 26.7%; 1 month, 30.4%; 3 months, 28.1%; and 6 months, 27.7%), with no significant difference between the two groups in an intent-to-treat analysis. Attitudes toward the HFTC intervention were largely positive. Our findings suggest that a text message-based smoking cessation intervention can be successfully delivered in China and is acceptable to Chinese smokers, but further research is needed to assess the potential impact of this type of intervention.

Text message reminders to promote human papillomavirus vaccination.

PubMed

Kharbanda, Elyse Olshen; Stockwell, Melissa S; Fox, Harrison W; Andres, Raquel; Lara, Marcos; Rickert, Vaughn I

2011-03-21

To implement and evaluate text message reminders for the second (HPV2) and third (HPV3) vaccine doses. Site-based intervention. Nine pediatric sites (5 academic and 4 private) located in New York City. Parents of adolescents 9-20 years who received HPV1 or HPV2 during the intervention period, January-June 2009. Parents who enrolled received up to three weekly text message reminders that their daughter was due for her next vaccine dose. On-time receipt of the next vaccine dose, within one month of its due date. During the intervention period, of 765 eligible HPV vaccine events, 434 enrollment instructions were distributed to parents (56.7% of doses). Parents of 124 adolescent girls (28.6% of those handed instructions) activated text message reminders. Comparing children of parents who enrolled versus those who did not, on-time receipt of next HPV vaccine dose occurred among 51.6% (95% CI 42.8-60.4%) versus 35.0% (95% CI 29.6-40.2%) of adolescents (p=.001). Similarly, among a historical cohort of adolescents, receiving HPV1 or HPV2 in the six months prior to the intervention period, on-time receipt of next vaccine dose was noted for 38.1% (95% CI 35.2-41.0%) (p=.003). Increases in receipt of next vaccine dose among intervention subjects were sustained at 4 months following the vaccine due date. Using a logistic regression model, after controlling for insurance and site of care, intervention subjects were significantly more likely than either control population to receive their next HPV vaccine dose on-time. Among those choosing to enroll, text message reminders were an effective intervention to increase on-time receipt of HPV2 or HPV3. Copyright © 2011 Elsevier Ltd. All rights reserved.

Preliminary findings describing participant experience with iSTEP, an mHealth intervention to increase physical activity and improve neurocognitive function in people living with HIV

PubMed Central

Henry, Brook L.; Moore, David J.

2016-01-01

We assessed the feasibility and acceptability of using text messages to monitor and encourage physical activity in the first 21 participants enrolled in an ongoing randomized controlled trial evaluating a 16-week Short Message Service/Multimedia Message Service (SMS/MMS) intervention (iSTEP) designed to increase moderate physical activity and improve neurocognition in persons with HIV-associated neurocognitive disorders (HAND; iSTEP, n = 11; control group, n = 10). Data were collected during the intervention and from interviews conducted at the 16-week post-intervention visits. Text message response rates for both iSTEP and control participants were high (89% and 85%, respectively). Pedometer self-monitoring, step count goals, and milestone achievement texts were reported to facilitate physical activity. All iSTEP participants (100%) and 70% of control participants indicated that they would recommend the study to other people living with HIV. The results indicate that it is feasible to administer an SMS/MMS physical activity intervention to persons with HAND. PMID:26847379

Health care providers' perspectives on a weekly text-messaging intervention to engage HIV-positive persons in care (WelTel BC1).

PubMed

Murray, Melanie C M; O'Shaughnessy, Sara; Smillie, Kirsten; Van Borek, Natasha; Graham, Rebecca; Maan, Evelyn J; van der Kop, Mia L; Friesen, Karen; Albert, Arianne; Levine, Sarah; Pick, Neora; Ogilvie, Gina; Money, Deborah; Lester, Richard

2015-10-01

Though evidence shows that Mobile health (mHealth) interventions can improve adherence and viral load in HIV-positive persons, few have studied the health care providers' (HCP) perspective. We conducted a prospective mixed methods pilot study using the WelTel intervention wherein HIV-positive participants (n = 25) received weekly interactive text messages for 6 months. Text message response rate and topic data were collected to illustrate the HCP experience. The aim of this study is to explore intervention acceptability and feasibility from the HCP perspective through a baseline focus group and end of study interviews with HCP impacted by the intervention. Interview data were thematically coded using the Technology Acceptance Model. HCPs identified that the WelTel intervention engaged patients in building relationships, while organizing and streamlining existing mHealth efforts and dealing with privacy issues. HCPs recognized that although workload would augment initially, intervention benefits were many, and went beyond simply improving HIV viral load.

Text messaging approach improves weight loss in patients with nonalcoholic fatty liver disease: A randomized study.

PubMed

Axley, Page; Kodali, Sudha; Kuo, Yong-Fang; Ravi, Sujan; Seay, Toni; Parikh, Nina M; Singal, Ashwani K

2018-05-01

Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common liver disease. The only effective treatment is 7%-10% weight loss. Mobile technology is increasingly used in weight management. This study was performed to evaluate the effects of text messaging intervention on weight loss in patients with NAFLD. Thirty well-defined NAFLD patients (mean age 52 years, 67% females, mean BMI 38) were randomized 1:1 to control group: counselling on healthy diet and exercise, or intervention group: text messages in addition to healthy life style counselling. NAFLD text messaging program sent weekly messages for 22 weeks on healthy life style education. Primary outcome was change in weight. Secondary outcomes were changes in liver enzymes and lipid profile. Intervention group lost an average of 6.9 lbs. (P = .03) compared to gain of 1.8 lbs. in the control group (P = .45). Intervention group also showed a decrease in ALT level (-12.5 IU/L, P = .035) and improvement in serum triglycerides (-28 mg/dL, P = .048). There were no changes in the control group on serum ALT level (-6.1 IU/L, P = .46) and on serum triglycerides (-20.3 mg/dL P = .27). Using one-way analysis of variance, change in outcomes in intervention group compared to control group was significant for weight (P = .02) and BMI (P = .02). Text messaging on healthy life style is associated with reduction in weight in NAFLD patients. Larger studies are suggested to examine benefits on liver histology, and assess long-term impact of this approach in patients with NAFLD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Motivating Smoking Cessation Text Messages: Perspectives from Pregnant Smokers.

PubMed

Schindler-Ruwisch, Jennifer M; Leavitt, Leah E; Macherelli, Laura E; Turner, Monique M; Abroms, Lorien C

2018-06-01

The purpose of this research is to analyze cessation text-messages written by pregnant smokers to elucidate the target population's preferred content and message attributes. To achieve this goal, the objectives of this study are three-fold; to qualitatively code messages written by pregnant smokers for frame, type of appeal, and intended target. Study participants were recruited as part of a larger trial of pregnant smokers who were enrolled in a text-messaging program or control group and surveyed 1 month post-enrollment. Each participant was asked to write a brief message to another pregnant smoker and two independent coders qualitatively analyzed responses. User generated messages (N = 51) were equally loss and gain framed, and the most common appeals were: fear, guilt, cognitive, hope and empathy, in order of most to least frequent. The target of the majority of the messages was the baby. Allowing pregnant smokers to write cessation text-messages for other pregnant women can provide relevant insight into intervention content. Specifically, pregnant smokers appear to equally promote gain and loss frames, but may prefer messages that include components of fear and guilt related to the impact of smoking on their baby. Additional research is needed to systematically uncover perspectives of pregnant smokers to ensure interventions are optimally effective.

A Text Message Delivered Smoking Cessation Intervention: The Initial Trial of TXT-2-Quit: Randomized Controlled Trial

PubMed Central

2013-01-01

Background Mobile technology offers the potential to deliver health-related interventions to individuals who would not otherwise present for in-person treatment. Text messaging (short message service, SMS), being the most ubiquitous form of mobile communication, is a promising method for reaching the most individuals. Objective The goal of the present study was to evaluate the feasibility and preliminary efficacy of a smoking cessation intervention program delivered through text messaging. Methods Adult participants (N=60, age range 18-52 years) took part in a single individual smoking cessation counseling session, and were then randomly assigned to receive either daily non-smoking related text messages (control condition) or the TXT-2-Quit (TXT) intervention. TXT consisted of automated smoking cessation messages tailored to individual’s stage of smoking cessation, specialized messages provided on-demand based on user requests for additional support, and a peer-to-peer social support network. Generalized estimating equation analysis was used to assess the primary outcome (7-day point-prevalence abstinence) using a 2 (treatment groups)×3 (time points) repeated measures design across three time points: 8 weeks, 3 months, and 6 months. Results Smoking cessation results showed an overall significant group difference in 7-day point prevalence abstinence across all follow-up time points. Individuals given the TXT intervention, with higher odds of 7-day point prevalence abstinence for the TXT group compared to the Mojo group (OR=4.52, 95% CI=1.24, 16.53). However, individual comparisons at each time point did not show significant between-group differences, likely due to reduced statistical power. Intervention feasibility was greatly improved by switching from traditional face-to-face recruitment methods (4.7% yield) to an online/remote strategy (41.7% yield). Conclusions Although this study was designed to develop and provide initial testing of the TXT-2-Quit system, these initial findings provide promising evidence that a text-based intervention can be successfully implemented with a diverse group of adult smokers. Trial Registration ClinicalTrials.gov: NCT01166464; http://clinicaltrials.gov/ct2/show/NCT01166464 (Archived by WebCite at http://www.webcitation.org/6IOE8XdE0). PMID:25098502

Mobile phone text messaging interventions for HIV and other chronic diseases: an overview of systematic reviews and framework for evidence transfer.

PubMed

Mbuagbaw, Lawrence; Mursleen, Sara; Lytvyn, Lyubov; Smieja, Marek; Dolovich, Lisa; Thabane, Lehana

2015-01-22

Strong international commitment and the widespread use of antiretroviral therapy have led to higher longevity for people living with human immune deficiency virus (HIV). Text messaging interventions have been shown to improve health outcomes in people living with HIV. The objectives of this overview were to: map the state of the evidence of text messaging interventions, identify knowledge gaps, and develop a framework for the transfer of evidence to other chronic diseases. We conducted a systematic review of systematic reviews on text messaging interventions to improve health or health related outcomes. We conducted a comprehensive search of PubMed, EMBASE (Exerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, Web of Science (WoS) and the Cochrane Library on the 17th April 2014. Screening, data extraction and assessment of methodological quality were done in duplicate. Our findings were used to develop a conceptual framework for transfer. Our search identified 135 potential systematic reviews of which nine were included, reporting on 37 source studies, conducted in 19 different countries. Seven of nine (77.7%) of these reviews were high quality. There was some evidence for text messaging as a tool to improve adherence to antiretroviral therapy. Text messages also improved attendance at appointments and behaviour change outcomes. The findings were inconclusive for self-management of illness, treatment of tuberculosis and communicating results of medical investigations. The geographical distribution of text messaging research was limited to specific regions of the world. Prominent knowledge gaps included the absence of data on long term outcomes, patient satisfaction, and economic evaluations. The included reviews also identified methodological limitations in many of the primary studies. Global evidence supports the use of text messaging as a tool to improve adherence to medication and attendance at scheduled appointments. Given the similarities between HIV and other chronic diseases (long-term medications, life-long care, strong link to behaviour and the need for home-based support) evidence from HIV may be transferred to these diseases using our proposed framework by integration of HIV and chronic disease services or direct transfer.

User preferences for a text message-based smoking cessation intervention.

PubMed

Bock, Beth C; Heron, Kristin E; Jennings, Ernestine G; Magee, Joshua C; Morrow, Kathleen M

2013-04-01

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants (N = 21, M age = 25.6 years, age range = 20-33 years) were current or recently quit smokers (M cigarettes/day = 12.8) who used text messaging. Participants completed questionnaires and participated in a 2-hour focus group. Focus groups were conducted using an a priori semistructured interview guide to promote discussion of the content and functionality of the intervention. Major themes from analysis of the focus groups included support for the acceptability of a text-based cessation program, suggestions for a more technologically broad-based program, and adjustments to the program structure. Participants recommended including social networking functions, user control of program output through an online profile, and text message features to promote interaction with the system. Interestingly, many participants suggested the program should begin on individuals' identified quit day, challenging the procedures used in most cessation programs, which begin by preparing participants for a future quit date. Overall, younger adult smokers appear to be interested in participating in a smoking cessation program that uses text messages and web-based elements. Qualitative feedback regarding the perceived optimal features and structure of a technology-based intervention challenged traditional methods of implementing smoking cessation interventions and will inform the development of future programs.

78 FR 2678 - Proposed Collection; Comment Request (60-Day FRN): The National Cancer Institute (NCI...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... text message smoking cessation intervention designed for young adult smokers ages 18-29. The SmokefreeTXT program is a component of a larger series of eHealth/mHealth tobacco cessation intervention... using the bidirectional aspect of text- messaging service and a series of web-based surveys. All web...

Mobile Assessment and Treatment for Schizophrenia (MATS): A Pilot Trial of An Interactive Text-Messaging Intervention for Medication Adherence, Socialization, and Auditory Hallucinations

PubMed Central

Granholm, Eric; Ben-Zeev, Dror; Bradshaw, Kristen R.; Holden, Jason L.

2012-01-01

Mobile Assessment and Treatment for Schizophrenia (MATS) employs ambulatory monitoring methods and cognitive behavioral therapy interventions to assess and improve outcomes in consumers with schizophrenia through mobile phone text messaging. Three MATS interventions were developed to target medication adherence, socialization, and auditory hallucinations. Participants received up to 840 text messages over a 12-week intervention period. Fifty-five consumers with schizophrenia or schizoaffective disorder were enrolled, but 13 consumers with more severe negative symptoms, lower functioning, and lower premorbid IQ did not complete the intervention, despite repeated prompting and training. For completers, the average valid response rate for 216 outcome assessment questions over the 12-week period was 86%, and 86% of phones were returned undamaged. Medication adherence improved significantly, but only for individuals who were living independently. Number of social interactions increased significantly and a significant reduction in severity of hallucinations was found. In addition, the probability of endorsing attitudes that could interfere with improvement in these outcomes was also significantly reduced in MATS. Lab-based assessments of more general symptoms and functioning did not change significantly. This pilot study demonstrated that low-intensity text-messaging interventions like MATS are feasible and effective interventions to improve several important outcomes, especially for higher functioning consumers with schizophrenia. PMID:22080492

Effects of text messaging in addition to emails on physical activity among university and college employees in the UK.

PubMed

Suggs, Suzanne; Blake, Holly; Bardus, Marco; Lloyd, Scott

2013-04-01

To test the effects of adding text messages to weekly email communications on recipients' total physical activity (leisure-time; workplace; domestic and garden; and active transportation) in employees of universities and colleges in the UK. A randomised trial with two study groups (email only or email plus text messaging for 12 weeks) was implemented at five workplaces. Data were collected at baseline, immediately after, and four weeks after the intervention. Intervention effects on physical activity were evaluated using latent growth modelling. Total physical activity decreased over time in both groups but the decrease was non-significant. The only significant difference between groups was found for workplace physical activity, with the group receiving emails and text messages having a linear decrease of 2.81 Metabolic Equivalent h/week (β = -0.31, p = 0.035) compared to the email only group. Sending employees two additional text messages resulted in less physical activity. Further investigation is needed to understand whether text messaging may play a beneficial role in promoting physical activity in workplace settings. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes

PubMed Central

Franklin, Victoria Louise; Greene, Alexandra; Waller, Annalu; Greene, Stephen Alan

2008-01-01

Background Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team. “Sweet Talk” is a novel intervention designed to support patients between clinic visits using text messages sent to a mobile phone. Scheduled messages are tailored to patient profiles and diabetes self-management goals, and generic messages include topical “newsletters” and anonymized tips from other participants. The system also allows patients to submit data and questions to the diabetes care team. Objectives The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to understand its utility to this user group. Methods Subjects were 64 young people with diabetes who were participating in the intervention arms of a randomized controlled trial. All text messages submitted to Sweet Talk during a 12-month period were recorded. Messaging patterns and content were analyzed using mixed quantitative and qualitative methods. Results Patients submitted 1180 messages during the observation period (mean 18.4, median 6). Messaging frequency ranged widely between participants (0-240) with a subset of 5 high users contributing 52% of the total. Patients’ clinical and sociodemographic characteristics were not associated with total messaging frequency, although girls sent significantly more messages unrelated to diabetes than did boys (P = .002). The content of patients’ messages fell into 8 main categories: blood glucose readings, diabetes questions, diabetes information, personal health administration, social messages, technical messages, message errors, and message responses. Unprompted submission of blood glucose values was the most frequent incoming message type (35% of total). Responses to requests for personal experiences and tips generated 40% of all the incoming messages, while topical news items also generated good responses. Patients also used the service to ask questions, submit information about their self-management, and order supplies. No patients nominated supporters to receive text messages about their self-management goals. Another option that was not used was the birthday reminder service. Conclusions Automated, scheduled text messaging successfully engaged young people with diabetes. While the system was primarily designed to provide “push” support to patients, submission of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers. Responses to the newsletters and submission of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community. Although participants submitted relatively few messages, positive responses to the system suggest that most derived passive support from reading the messages. The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups, and the results of this study may help to inform the design of future text message support interventions. PMID:18653444

Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial.

PubMed

Berrouiguet, Sofian; Larsen, Mark Erik; Mesmeur, Catherine; Gravey, Michel; Billot, Romain; Walter, Michel; Lemey, Christophe; Lenca, Philippe

2018-01-10

Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up. SIAM is a 2-year, multicenter randomized controlled trial conducted by the Brest University Hospital, France. Participants in the intervention group receive SIAM text messages 48 hours after discharge, then at day 8 and day 15, and months 1, 2, 3, 4, 5, and 6. The study includes participants aged 18 years or older, who have attended a participating hospital for an SA, and have been discharged from the emergency department (ED) or a psychiatric unit (PU) for a stay of less than 7 days. Eligible participants are randomized between the SIAM intervention messages and a control group. In this study, we present three cases from the ongoing SIAM study that demonstrate the capability of a mobile-based brief contact intervention for triggering patient-initiated contact with a crisis support team at various time points throughout the mobile-based follow-up period. Out of the 244 patients recruited in the SIAM randomized controlled trial, three cases were selected to illustrate the impact of mHealth on suicide risk management. Participants initiated contact with the emergency crisis support service after receiving text messages up to 6 months following discharge from the hospital. Contact was initiated immediately following receipt of a text message or up to 6 days following a message. This text message-based brief contact intervention has demonstrated the potential to reconnect suicidal individuals with crisis support services while they are experiencing suicidal ideation as well as in a period after receiving messages. As follow-up phone calls over an extended period of time may not be feasible, this intervention has the potential to offer simple technological support for individuals following discharge from the ED. ClinicalTrials.gov NCT02106949; https://clinicaltrials.gov/ct2/show/NCT02106949 (Archived by WebCite at http://www.webcitation.org/6wMtAFL49). ©Sofian Berrouiguet, Mark Erik Larsen, Catherine Mesmeur, Michel Gravey, Romain Billot, Michel Walter, HUGOPSY Network, Christophe Lemey, Philippe Lenca. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 10.01.2018.

Leveraging Text Messaging and Mobile Technology to Support Pediatric Obesity-Related Behavior Change: A Qualitative Study Using Parent Focus Groups and Interviews

PubMed Central

Dryden, Eileen M; Horan, Christine M; Price, Sarah; Marshall, Richard; Hacker, Karen; Finkelstein, Jonathan A; Taveras, Elsie M

2013-01-01

Background Text messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children. Objective Our aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change. Methods We conducted focus groups and follow-up interviews with parents of overweight and obese children, aged 6-12 years, seen for “well-child” care in eastern Massachusetts. A professional moderator used a semistructured discussion guide and sample text messages to catalyze group discussions. Seven participants then received 3 weeks of text messages before a follow-up one-on-one telephone interview. All focus groups and interviews were recorded and transcribed verbatim. Using a framework analysis approach, we systematically coded and analyzed group and interview data to identify salient and convergent themes. Results We reached thematic saturation after five focus groups and seven follow-up interviews with a total of 31 parents of diverse race/ethnicity and education levels. Parents were generally enthusiastic about receiving text messages to support healthy behaviors for their children and preferred them to paper or email communication because they are brief and difficult to ignore. Participants anticipated high responsiveness to messaging endorsed by their child’s doctor and indicated they would appreciate messages 2-3 times/week or more as long as content remains relevant. Suggestions for maintaining message relevance included providing specific strategies for implementation and personalizing information. Most felt the negative features of text messaging (eg, limited message size) could be overcome by providing links within messages to other media including email or websites. Conclusions Text messaging is a promising medium for supporting pediatric obesity-related behavior change. Parent perspectives could assist in the design of text-based interventions. Trial Registration Clinicaltrials.gov NCT01565161; http://clinicaltrials.gov/show/NCT01565161 (Archived by WebCite at http://www.webcitation.org/6LSaqFyPP). PMID:24317406

Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: a qualitative study using parent focus groups and interviews.

PubMed

Sharifi, Mona; Dryden, Eileen M; Horan, Christine M; Price, Sarah; Marshall, Richard; Hacker, Karen; Finkelstein, Jonathan A; Taveras, Elsie M

2013-12-06

Text messaging (short message service, SMS) is a widely accessible and potentially cost-effective medium for encouraging behavior change. Few studies have examined text messaging interventions to influence child health behaviors or explored parental perceptions of mobile technologies to support behavior change among children. Our aim was to examine parental acceptability and preferences for text messaging to support pediatric obesity-related behavior change. We conducted focus groups and follow-up interviews with parents of overweight and obese children, aged 6-12 years, seen for "well-child" care in eastern Massachusetts. A professional moderator used a semistructured discussion guide and sample text messages to catalyze group discussions. Seven participants then received 3 weeks of text messages before a follow-up one-on-one telephone interview. All focus groups and interviews were recorded and transcribed verbatim. Using a framework analysis approach, we systematically coded and analyzed group and interview data to identify salient and convergent themes. We reached thematic saturation after five focus groups and seven follow-up interviews with a total of 31 parents of diverse race/ethnicity and education levels. Parents were generally enthusiastic about receiving text messages to support healthy behaviors for their children and preferred them to paper or email communication because they are brief and difficult to ignore. Participants anticipated high responsiveness to messaging endorsed by their child's doctor and indicated they would appreciate messages 2-3 times/week or more as long as content remains relevant. Suggestions for maintaining message relevance included providing specific strategies for implementation and personalizing information. Most felt the negative features of text messaging (eg, limited message size) could be overcome by providing links within messages to other media including email or websites. Text messaging is a promising medium for supporting pediatric obesity-related behavior change. Parent perspectives could assist in the design of text-based interventions. Clinicaltrials.gov NCT01565161; http://clinicaltrials.gov/show/NCT01565161 (Archived by WebCite at http://www.webcitation.org/6LSaqFyPP).

Adolescent Female Text Messaging Preferences to Prevent Pregnancy After an Emergency Department Visit: A Qualitative Analysis

PubMed Central

Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S

2016-01-01

Background Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. Objective The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. Methods We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Results Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were “brief,” “professional,” and “nonaccusatory.” Respondents favored texts with links to websites, repeated information regarding places to receive “confidential” care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to maintain “surprise.” No participant feared that text messages would violate her privacy. Conclusions Adolescent female patients at high pregnancy risk are interested in ED-based pregnancy prevention provided by texting. Understanding preferences for the content, frequency, and timing of messages can guide in designing future interventions in the ED. PMID:27687855

Can skin cancer prevention and early detection be improved via mobile phone text messaging? A randomised, attention control trial.

PubMed

Youl, Philippa H; Soyer, H Peter; Baade, Peter D; Marshall, Alison L; Finch, Linda; Janda, Monika

2015-02-01

To test the impact of a theory-based, SMS (text message)-delivered behavioural intervention (Healthy Text) targeting sun protection or skin self-examination behaviours compared to attention control. Overall, 546 participants aged 18-42 years were randomised using a computer-generated number list to the skin self-examination (N=176), sun protection (N=187), or attention control (N=183) text messages group. Each group received 21 text messages about their assigned topic over 12 months (12 weekly messages for 3 months, then monthly messages for the next 9 months). Data were collected via telephone survey at baseline, 3, and 12 months across Queensland from January 2012 to August 2013. One year after baseline, the sun protection (mean change 0.12; P=0.030) and skin self-examination groups (mean change 0.12; P=0.035) had significantly greater improvement in their sun protection habits (SPH) index compared to the attention control group (reference mean change 0.02). The increase in the proportion of participants who reported any skin self-examination from baseline to 12 months was significantly greater in the skin self-examination intervention group (103/163; 63%; P<0.001) than the sun protection (83/173; 48%) or attention control (65/165; 36%) groups. There was no significant effect of the intervention for participants' self-reported whole-body skin self-examination, sun tanning, or sunburn behaviours. The Healthy Text intervention was effective in inducing significant improvements in sun protection and any type of skin self-examination behaviours. The Australian and New Zealand Clinical Trials register (ACTRN12612000577819). Cancer Australia 1011999. Copyright © 2014 Elsevier Inc. All rights reserved.

Three controlled trials of interventions to increase recruitment to a randomized controlled trial of mobile phone based smoking cessation support.

PubMed

Free, Caroline; Hoile, Elizabeth; Robertson, Steven; Knight, Rosemary

2010-06-01

Recruitment is a major challenge for trials but there is little evidence regarding interventions to increase trial recruitment. We report three controlled trials of interventions to increase recruitment to the Txt2stop trial. To evaluate: Trial 1. The impact on registrations of a text message regarding an online registration facility; Trial 2. The impact on randomizations of sending pound5 with a covering letter to those eligible to join the trial; Trial 3. The impact on randomizations of text messages containing quotes from existing participants. Single blind controlled trials with allocation concealment. Trial 1: A text message regarding our new online registration facility; Trial 2: A letter with pound5 enclosed; Trial 3: A series of four text messages containing quotes from participants. The control group in each trial received standard Txt2stop procedures. Trial 1: 3.6% (17/470) of the intervention group and 1.1% (5/467) of the control group registered for the trial, risk difference 2.5% (95% CI 0.6-4.5). 0% (0/ 470) of the intervention group and 0.2% (1/467) of the control group registered successfully online, risk difference -0.2 (95% CI -0.6-0.2); Trial 2: 4.5% (11/246) of the intervention group and 0.4% (1/245) of the control group were randomized into the Txt2stop trial, risk difference 4.0% (95% CI 1.4-6.7); Trial 3: 3.5% (14/405) of the intervention group and 0% (0/406) of the control group were randomized into the Txt2stop trial, risk difference 3.5 (95% CI 1.7-5.2). There were no baseline data available for trial 1. Allocation of participant IDs in trials 2 and 3 were systematic. Sending a text message about an online registration facility increased registrations to Txt2stop, but did not increase online registrations. Sending a pound5 reimbursement for participants' time and sending text messages containing quotes from existing participants increased randomizations into the Txt2stop trial. Clinical Trials 2010; 7: 265-273. http://ctj.sagepub.com.

Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging

PubMed Central

Cornelius, Judith B.; St Lawrence, Janet S.

2013-01-01

PURPOSE This study assessed African American adolescents’ receptivity to an HIV-prevention curriculum enhanced by text messaging. DESIGN AND METHODS Two focus groups were conducted with 14 African American adolescents regarding how an HIV-prevention curriculum could be enhanced for text messaging delivery. RESULTS The adolescents were receptive to the idea of text messaging HIV-prevention information but wanted to receive a maximum of three messages per day during the hours of 4:00–6:00 p.m. PRACTICE IMPLICATIONS By taking the findings of this study, nurses, other healthcare providers, and community-based organizations can adapt evidence-based interventions for text messaging delivery to individuals at high risk for HIV infection. PMID:19356206

A Newsletter/Text Message Intervention Promoting Beverage-Related Parenting Practices: Pilot Test Results.

PubMed

Zahid, Arwa; Reicks, Marla

2018-06-01

Positive beverage parenting practices may reduce sugar-sweetened beverage consumption by children and prevent potential health problems. An online newsletter/text message intervention was conducted with parents of children 6 to 12 years to improve beverage parenting practices. Newsletters and text messages were sent weekly over a 4-week period providing gain-framed messages encouraging parenting practices including role modeling and controlling home beverage availability. Pre-post surveys included measures of home availability of beverages and parent beverage intake as an indication of parenting practices. Parents were primarily White, well-educated, and female. About one third lived in rural areas. Results from 100 parents with pre-post data from baseline to 4 weeks showed decreased reported home availability of regular soda pop (p = .008), decreased parent intake of sweetened beverages (p = .004), and decreased parent-reported child intake of regular soft drinks (p = .001), and sweetened juice drink beverages (p < .0001). Most parents (82%) reported reading all three newsletters and indicated that the information provided was relevant (93%). A brief newsletter/text message intervention may be a positive and convenient approach to promote positive beverage parenting practices.

A pilot test of a tailored mobile and web-based diabetes messaging system for adolescents.

PubMed

Mulvaney, Shelagh A; Anders, Shilo; Smith, Annie K; Pittel, Eric J; Johnson, Kevin B

2012-03-01

We conducted a pilot trial of a new mobile and web-based intervention to improve diabetes adherence. The text messaging system was designed to motivate and remind adolescents about diabetes self-care tasks. Text messages were tailored according to individually-reported barriers to diabetes self-care. A total of 23 adolescents with type 1 diabetes used the system for a period of three months. On average, they received 10 text messages per week (range 8-12). A matched historical control group from the same clinic was used for comparison. After three months, system users rated the content, usability and experiences with the system, which were very favourable. Comparison of the intervention and control groups indicated a significant interaction between group and time. Both groups had similar HbA(1c) levels at baseline. After three months, the mean HbA(1c) level in the intervention group was unchanged (8.8%), but the mean level in the control group was significantly higher (9.9%), P = 0.006. The results demonstrate the feasibility of the messaging system, user acceptance and a promising effect on glycaemic control. Integrating this type of messaging system with online educational programming could prove to be beneficial.

A Mobile Health Strategy to Support Adherence to Antiretroviral Preexposure Prophylaxis.

PubMed

Fuchs, Jonathan D; Stojanovski, Kristefer; Vittinghoff, Eric; McMahan, Vanessa M; Hosek, Sybill G; Amico, K Rivet; Kouyate, Aminta; Gilmore, Hailey J; Buchbinder, Susan P; Lester, Richard T; Grant, Robert M; Liu, Albert Y

2018-03-01

Preexposure prophylaxis is a highly protective HIV prevention strategy, yet nonadherence can significantly reduce its effectiveness. We conducted a mixed methods evaluation of a mobile health intervention (iText) that utilized weekly bidirectional text or e-mail support messages to encourage preexposure prophylaxis (PrEP) adherence among participants in the multi-site iPrEx open-label extension study. A convenience sample of PrEP users from the San Francisco and Chicago sites participated in a 12-week pilot study. Fifty-six men who have sex with men were enrolled; a quarter of them were less than 30 years of age, 13% were black/African American, 11% were Latino, and most (88%) completed some college. Two-thirds opted for text message delivery. Of the 667 messages sent, only 1 individual requested support; initial nonresponse was observed in 22% and was higher among e-mail compared to text message recipients. Poststudy, a majority of participants would recommend the intervention to others, especially during PrEP initiation. Moreover, younger participants and men of color were more likely to report that they would use the iText strategy if it were available to them. Several participants commented that while they were aware that the messages were automated, they felt supported and encouraged that "someone was always there." Study staff reported that the intervention is feasible to administer and can be incorporated readily into clinic flow. A pre-post intervention regression discontinuity analysis using clinic-based pill counts showed a 50% reduction in missed doses [95% confidence interval (CI) 16-71; p = 0.008] and 77% (95% CI 33-92; p = 0.007) when comparing pill counts at quarterly visits just before and after iText enrollment. A mobile health intervention using weekly bidirectional messaging was highly acceptable and demonstrated promising effects on PrEP adherence warranting further evaluation for efficacy in a randomized controlled trial.

Text message reminders increased colorectal cancer screening in a randomized trial with Alaska Native and American Indian people.

PubMed

Muller, Clemma J; Robinson, Renee F; Smith, Julia J; Jernigan, Meghan A; Hiratsuka, Vanessa; Dillard, Denise A; Buchwald, Dedra

2017-04-15

Alaska Native and American Indian people (AN/AIs) have a high incidence of colorectal cancer (CRC) and CRC-related mortality. Screening can prevent death from CRC, but screening rates are low in racially and ethnically diverse populations. The authors conducted a randomized controlled trial using text messaging to increase CRC screening among unscreened AN/AIs in a tribal health care system in Anchorage, Alaska. The intervention entailed up to 3 text messages sent 1 month apart. The authors randomized 2386 AN/AIs aged 40 to 75 years who were eligible for CRC screening to the intervention or usual-care control conditions. Screening status was ascertained from electronic health records 3 months and 6 months after the last text message. Hazard ratios (HRs) were estimated to evaluate the effectiveness of the intervention, stratified by age and sex. The intervention increased CRC screening for AN/AIs aged 50 to 75 years (HR, 1.42; 95% confidence interval [95% CI], 0.97-2.09) and aged 40 to 49 years (HR, 1.24; 95% CI, 0.95-1.62). Within both age groups, the HRs were higher for women (HR, 1.69 [95% CI, 1.02-2.80] and HR, 1.37 [95% CI, 1.01-1.88]) compared with men (HR, 1.09 [95% CI, 0.59-1.99] and HR, 0.90 [95% CI, 0.54-1.53]). Interaction analysis yielded P values of .55 and .09, respectively, for age and sex. A simple text messaging intervention was found to increase CRC screening rates in AN/AIs, a group with high CRC morbidity and mortality. Text messaging may be a cost-effective means of reducing CRC screening disparities in AN/AIs and other populations. Cancer 2017;123:1382-1389. © 2016 American Cancer Society. © 2016 American Cancer Society.

Text-message reminders plus incentives increase adherence to antidiabetic medication in adults with type 2 diabetes.

PubMed

Raiff, Bethany R; Jarvis, Brantley P; Dallery, Jesse

2016-12-01

Some adults with Type 2 diabetes mellitus have difficulty adhering to their oral medication regimens. The current study used a multiple baseline design with 3 adults with Type 2 diabetes. Medication taking was monitored remotely in real time via an electronic pill bottle. During the intervention, monetary incentives were delivered contingent on evidence of adherence to taking medication at specified times. Text-message reminders were also sent if medication was not taken. Adherence increased for all participants. Future studies should separate the relative contributions of text-message and incentive components of the intervention. © 2016 Society for the Experimental Analysis of Behavior.

mHealth Intervention Elements and User Characteristics Determine Utility: A Mixed-Methods Analysis.

PubMed

Nelson, Lyndsay A; Mulvaney, Shelagh A; Johnson, Kevin B; Osborn, Chandra Y

2017-01-01

Mobile health (mHealth) interventions are improving the medication adherence of adults with type 2 diabetes mellitus (T2DM), but few studies examine how users experience these interventions. Therefore, we used a mixed-methods approach to understand how T2DM users experience a text messaging and interactive voice response (IVR)-delivered medication adherence intervention called MEssaging for Diabetes (MED). Adults with T2DM used MED as part of a 3-month pilot study. MED sends daily tailored text messages addressing adherence barriers, daily assessment text messages asking about adherence, and weekly tailored IVR calls providing adherence feedback, encouragement, and questions to facilitate problem solving. Sixty participants completed feedback interviews. We used a mixed-methods approach to understand their experience, examining associations between participants' characteristics and their feedback. Participants who completed feedback interviews were on average 50.0 ± 10.1 years old; 65% female, 62% non-white; 15% had less than a high school education, 70% had annual incomes less than $20K; and average hemoglobin A1c was 8.0% ± 1.9%. Participants rated each intervention element favorably; common reasons for MED's helpfulness included receiving novel information about diabetes medications, emotional support, and reminders to take medication. People who were younger and more recently diagnosed with T2DM had more favorable experiences using MED. In general, users valued text messages more than IVR calls. Consideration of the user experience is critical for developing engaging mHealth interventions. User feedback reveals what mHealth elements have the most value and why, which users to target, and how to optimize an intervention's utility and appeal.

A Comparison Between Phone-Based Psychotherapy With and Without Text Messaging Support In Between Sessions for Crisis Patients

PubMed Central

2014-01-01

Background Few studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation. Objective The intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises. Methods Over a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only. Results A total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3). Conclusions Both groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing the clinical impact of the tailored text messages, and utilizing designs with additional power to test for between-group effects. PMID:25295667

A comparison between phone-based psychotherapy with and without text messaging support in between sessions for crisis patients.

PubMed

Furber, Gareth; Jones, Gabrielle Margaret; Healey, David; Bidargaddi, Niranjan

2014-10-08

Few studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation. The intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises. Over a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only. A total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3). Both groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing the clinical impact of the tailored text messages, and utilizing designs with additional power to test for between-group effects.

Design and Multi-Country Validation of Text Messages for an mHealth Intervention for Primary Prevention of Progression to Hypertension in Latin America.

PubMed

Diez-Canseco, Francisco; Zavala-Loayza, J Alfredo; Beratarrechea, Andrea; Kanter, Rebecca; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Martinez, Homero; Miranda, J Jaime

2015-02-18

Mobile health (mHealth) has been posited to contribute to the reduction in health gaps and has shown fast and widespread growth in developing countries. This growth demands understanding of, and preparedness for, local cultural contexts. To describe the design and validation of text messages (short message service, SMS) that will be used for an mHealth behavioral change intervention to prevent hypertension in three Latin American countries: Argentina, Guatemala, and Peru. An initial set of 64 SMS text messages were designed to promote healthy lifestyles among individuals in different stages of behavior change, addressing four key domains: salt and sodium intake, fruit and vegetable intake, consumption of high fat and sugar foods, and physical activity. The 64 SMS text messages were organized into nine subsets for field validation. In each country 36 people were recruited, half of them being male. Of the participants, 4 per country evaluated each subset of SMS text messages, which contained between 6 and 8 SMS text messages regarding different key domains and stages of change. The understanding and appeal of each SMS text message was assessed using a 7-item questionnaire. The understanding and appeal ratings were used to reach a final set of 56 SMS text messages. Overall, each of the 64 SMS text messages received a total of 12 evaluations (4 per country). The majority of evaluations-742 out of a total of 767 (96.7%) valid responses-revealed an adequate understanding of the key idea contained in the SMS text message. On a scale from 1 to 10, the average appeal score was 8.7 points, with a range of 4 to 10 points. Based on their low scores, 8 SMS text messages per country were discarded. Once the final set of 56 SMS text messages was established, and based on feedback obtained in the field, wording and content of some SMS text messages were improved. Of the final set, 9, 8, and 16 of the SMS text messages were improved based on participant evaluations from Argentina, Guatemala, and Peru, respectively. Most SMS text messages selected for the final set (49/56, 88%) were the same in all countries, except for small wording differences. The final set of SMS text messages produced had very high rates of understanding and appeal in three different Latin American countries. This study highlights the importance of developing and validating a package of simple, preventative SMS text messages, grounded in evidence and theory, across three different Latin American countries with active engagement of end users.

Design and Multi-Country Validation of Text Messages for an mHealth Intervention for Primary Prevention of Progression to Hypertension in Latin America

PubMed Central

Diez-Canseco, Francisco; Zavala-Loayza, J Alfredo; Beratarrechea, Andrea; Kanter, Rebecca; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Martinez, Homero

2015-01-01

Background Mobile health (mHealth) has been posited to contribute to the reduction in health gaps and has shown fast and widespread growth in developing countries. This growth demands understanding of, and preparedness for, local cultural contexts. Objective To describe the design and validation of text messages (short message service, SMS) that will be used for an mHealth behavioral change intervention to prevent hypertension in three Latin American countries: Argentina, Guatemala, and Peru. Methods An initial set of 64 SMS text messages were designed to promote healthy lifestyles among individuals in different stages of behavior change, addressing four key domains: salt and sodium intake, fruit and vegetable intake, consumption of high fat and sugar foods, and physical activity. The 64 SMS text messages were organized into nine subsets for field validation. In each country 36 people were recruited, half of them being male. Of the participants, 4 per country evaluated each subset of SMS text messages, which contained between 6 and 8 SMS text messages regarding different key domains and stages of change. The understanding and appeal of each SMS text message was assessed using a 7-item questionnaire. The understanding and appeal ratings were used to reach a final set of 56 SMS text messages. Results Overall, each of the 64 SMS text messages received a total of 12 evaluations (4 per country). The majority of evaluations—742 out of a total of 767 (96.7%) valid responses—revealed an adequate understanding of the key idea contained in the SMS text message. On a scale from 1 to 10, the average appeal score was 8.7 points, with a range of 4 to 10 points. Based on their low scores, 8 SMS text messages per country were discarded. Once the final set of 56 SMS text messages was established, and based on feedback obtained in the field, wording and content of some SMS text messages were improved. Of the final set, 9, 8, and 16 of the SMS text messages were improved based on participant evaluations from Argentina, Guatemala, and Peru, respectively. Most SMS text messages selected for the final set (49/56, 88%) were the same in all countries, except for small wording differences. Conclusions The final set of SMS text messages produced had very high rates of understanding and appeal in three different Latin American countries. This study highlights the importance of developing and validating a package of simple, preventative SMS text messages, grounded in evidence and theory, across three different Latin American countries with active engagement of end users. PMID:25693595

Bidirectional Text Messaging to Improve Adherence to Recommended Lipid Testing.

PubMed

Baldwin, Laura-Mae; Morrison, Caitlin; Griffin, Jonathan; Anderson, Nick; Edwards, Kelly; Green, Jeff; Waldren, Cleary; Reiter, William

2017-01-01

Synergies between technology and health care in the United States are accelerating, increasing opportunities to leverage these technologies to improve patient care. This study was a collaboration between an academic study team, a rural primary care clinic, and a local nonprofit informatics company developing tools to improve patient care through population management. Our team created a text messaging management tool, then developed methods for and tested the feasibility of bidirectional text messaging to remind eligible patients about the need for lipid testing. We measured patient response to the text messages, then interviewed 8 patients to explore their text messaging experience. Of the 129 patients the clinic was able to contact by phone, 29.4% had no cell phone or text-messaging capabilities. An additional 20% refused to participate. Two thirds of the 28 patients who participated in the text messaging intervention (67.9%) responded to at least 1 of the up to 3 messages. Seven of 8 interviewed patients had a positive text-messaging experience. Bidirectional text messaging is a feasible and largely acceptable form of communication for test reminders that has the potential to reach large numbers of patients in clinical care. © Copyright 2017 by the American Board of Family Medicine.

Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam

PubMed Central

Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah OA; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

2017-01-01

Background: A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. Methods: We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. Results: A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of effective self-study, and technical/language-based barriers may be potential explanations for intervention failure. Conclusion: As a form of mCME, daily text messages were well-received by community-level health care providers in Vietnam. This mCME approach appears very promising in low-resource environments or where traditional forms of CME are impractical. Future models might consider enhancements to foster linkages to relevant medical materials, improve interaction with medical experts, and tailor medical content to the daily activities of medical staff. PMID:28655802

Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam.

PubMed

Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah Oa; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

2017-06-27

A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of effective self-study, and technical/language-based barriers may be potential explanations for intervention failure. As a form of mCME, daily text messages were well-received by community-level health care providers in Vietnam. This mCME approach appears very promising in low-resource environments or where traditional forms of CME are impractical. Future models might consider enhancements to foster linkages to relevant medical materials, improve interaction with medical experts, and tailor medical content to the daily activities of medical staff. © Sabin et al.

Protocol for a Randomized Controlled Trial Evaluating Mobile Text Messaging to Promote Retention and Adherence to Antiretroviral Therapy for People Living With HIV in Burkina Faso.

PubMed

Wagner, Natascha; Ouedraogo, Denis; Artavia-Mora, Luis; Bedi, Arjun; Thiombiano, Boundia Alexandre

2016-08-17

Retention in care and adherence to antiretroviral therapy (ART) among people living with human immunodeficiency virus (PLHIV) is a critical challenge in many African countries including Burkina Faso. Delivering text messaging (short message service, SMS) interventions through mobile phones may help facilitate health service delivery and improve patient health. Despite this potential, no evaluations have been delivered for national scale settings to demonstrate the impact of mobile health (mHealth) for PLHIV. This study aims to test the impact of SMS text messaging reminders for PLHIV in Burkina Faso, who are under ART. The evaluation identifies whether patients who receive SMS text messages are more likely to (1) retain in care (measured as a dichotomous variable), (2) adhere to antiretroviral regimens (measured as the number of doses missed in the past 7 days), and (3) experience slower disease progression (measured with T-lymphocytes cells). The second objective is to assess its effects on the frequency of health center visits, physical and psychosocial health, nutrition and whether the type of message (text vs image) and frequency (weekly vs semiweekly) have differential impacts including the possibility of message fatigue over time. This 24-month, wide-scale intervention implements a randomized controlled trial (RCT) to evaluate the impact of four variants of a mHealth intervention versus a control group. Our sample comprises adult patients (>15 years of age) undergoing antiretroviral therapy with access to mobile phone services. Multivariate regression analysis will be used to analyze the effect of the intervention on the study population. Data collection is done at baseline and three follow-up waves 6, 12, and 24 months after the intervention starts. The targeted 3800 patients were recruited between February 2015 and May 2015. But political uncertainty delayed the launch of the intervention until October 2015. Data analysis has not yet started. The first follow-up data collection started in April 2016. To the best of our knowledge, this is the first research that explores the effects of mobile message reminders using a wide-spread sample across an entire nation over a 2-year horizon, especially in a Francophone African country. We hypothesize that the interventions have a positive impact on retention in care and adherence to ART schemes and that a more sluggish disease progression will be observed in the short run. However, these benefits may fade out in the long run. The study expects to advance the research on how long mHealth interventions remain effective and when fatigue sets in the context of wide-scale interventions. This information will be useful in designing future wide-scale mHealth interventions in developing countries.

Protocol for a Randomized Controlled Trial Evaluating Mobile Text Messaging to Promote Retention and Adherence to Antiretroviral Therapy for People Living With HIV in Burkina Faso

PubMed Central

Ouedraogo, Denis; Artavia-Mora, Luis; Bedi, Arjun; Thiombiano, Boundia Alexandre

2016-01-01

Background Retention in care and adherence to antiretroviral therapy (ART) among people living with human immunodeficiency virus (PLHIV) is a critical challenge in many African countries including Burkina Faso. Delivering text messaging (short message service, SMS) interventions through mobile phones may help facilitate health service delivery and improve patient health. Despite this potential, no evaluations have been delivered for national scale settings to demonstrate the impact of mobile health (mHealth) for PLHIV. Objectives This study aims to test the impact of SMS text messaging reminders for PLHIV in Burkina Faso, who are under ART. The evaluation identifies whether patients who receive SMS text messages are more likely to (1) retain in care (measured as a dichotomous variable), (2) adhere to antiretroviral regimens (measured as the number of doses missed in the past 7 days), and (3) experience slower disease progression (measured with T-lymphocytes cells). The second objective is to assess its effects on the frequency of health center visits, physical and psychosocial health, nutrition and whether the type of message (text vs image) and frequency (weekly vs semiweekly) have differential impacts including the possibility of message fatigue over time. Methods This 24-month, wide-scale intervention implements a randomized controlled trial (RCT) to evaluate the impact of four variants of a mHealth intervention versus a control group. Our sample comprises adult patients (>15 years of age) undergoing antiretroviral therapy with access to mobile phone services. Multivariate regression analysis will be used to analyze the effect of the intervention on the study population. Data collection is done at baseline and three follow-up waves 6, 12, and 24 months after the intervention starts. Results The targeted 3800 patients were recruited between February 2015 and May 2015. But political uncertainty delayed the launch of the intervention until October 2015. Data analysis has not yet started. The first follow-up data collection started in April 2016. To the best of our knowledge, this is the first research that explores the effects of mobile message reminders using a wide-spread sample across an entire nation over a 2-year horizon, especially in a Francophone African country. Conclusions We hypothesize that the interventions have a positive impact on retention in care and adherence to ART schemes and that a more sluggish disease progression will be observed in the short run. However, these benefits may fade out in the long run. The study expects to advance the research on how long mHealth interventions remain effective and when fatigue sets in the context of wide-scale interventions. This information will be useful in designing future wide-scale mHealth interventions in developing countries. PMID:27535717

Effectiveness of 6 Months of Tailored Text Message Reminders for Obese Male Participants in a Worksite Weight Loss Program: Randomized Controlled Trial

PubMed Central

Oh, Sohee; Steinhubl, Steven; Kim, Sohye; Bae, Woo Kyung; Han, Jong Soo; Kim, Jeong-Hyun; Lee, Keehyuck; Kim, Mi Jin

2015-01-01

Background Worksite nutrition and physical activity interventions are important to help overweight and obese employees lose weight, but costs and insufficient sustained motivation prevent the majority of these programs from succeeding. Tailored text messaging in aiding weight management has been effective in several studies, but no studies have evaluated the effect of a tailored text message service on weight loss in a worksite health promotion program. Objective We studied the efficacy of a tailored text-messaging intervention for obese male participants in a worksite weight loss program of 6 months duration. Methods The study was an unblinded, randomized controlled trial. Men with a body mass index greater than 25 kg/m2 were recruited from the Korea District Heating Corporation, the Korea Expressway Corporation, and the Korea Gas Corporation. The participants were identified by nurse managers. Participants were randomly allocated to 1 of the following 2 groups for 24 weeks: (1) intervention group, which received tailored text message reminders every other day plus 4 offline education sessions and brief counseling with monthly weight check by nurses for weight control over 6 months and (2) control group, which received the 4 offline education sessions and brief counseling with monthly weight check by nurses about weight control over 6 months. The primary outcome was the difference in weight loss at 6 months. A mixed-model repeated-measures analysis was performed to evaluate the effect of the intervention group’s weight loss compared with the control group. Results A total of 205 obese men were randomized into either the intervention (n=104) or the control group (n=101). At the end of 6 months, the intervention group (n=63) had lost 1.71 kg (95% CI –2.53 to –0.88) and the control group (n=59) had lost 1.56 kg (95% CI –2.45 to –0.66); the difference between the 2 groups was not significant (mean difference –0.15, 95% CI –1.36 to 1.07). At the end of the study, 60% (34/57) of the intervention group rated the message program as helpful for weight control and 46% (26/57) would recommend the text message service to their friends. Conclusions Tailored text message reminders did not have a significant effect on weight loss in obese men as part of a worksite weight loss program. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 39629189; http://www.isrctn.com/ISRCTN39629189?q=39629189&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search (Archived by WebCite at http://www.webcitation.org/6VsFkwJH6). PMID:25648325

Toward mHealth Brief Contact Interventions in Suicide Prevention: Case Series From the Suicide Intervention Assisted by Messages (SIAM) Randomized Controlled Trial

PubMed Central

Mesmeur, Catherine; Gravey, Michel; Billot, Romain; Walter, Michel; Lemey, Christophe; Lenca, Philippe

2018-01-01

Background Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services after a suicide attempt (SA) can reduce reattempt risk. Pilot studies have demonstrated that interventions using mobile health (mHealth) technologies are feasible in a suicide prevention setting. Objective The aim of this study was to report three cases of patients recruited in the Suicide Intervention Assisted by Messages (SIAM) study to describe how a mobile intervention may influence follow-up. Methods SIAM is a 2-year, multicenter randomized controlled trial conducted by the Brest University Hospital, France. Participants in the intervention group receive SIAM text messages 48 hours after discharge, then at day 8 and day 15, and months 1, 2, 3, 4, 5, and 6. The study includes participants aged 18 years or older, who have attended a participating hospital for an SA, and have been discharged from the emergency department (ED) or a psychiatric unit (PU) for a stay of less than 7 days. Eligible participants are randomized between the SIAM intervention messages and a control group. In this study, we present three cases from the ongoing SIAM study that demonstrate the capability of a mobile-based brief contact intervention for triggering patient-initiated contact with a crisis support team at various time points throughout the mobile-based follow-up period. Results Out of the 244 patients recruited in the SIAM randomized controlled trial, three cases were selected to illustrate the impact of mHealth on suicide risk management. Participants initiated contact with the emergency crisis support service after receiving text messages up to 6 months following discharge from the hospital. Contact was initiated immediately following receipt of a text message or up to 6 days following a message. Conclusions This text message–based brief contact intervention has demonstrated the potential to reconnect suicidal individuals with crisis support services while they are experiencing suicidal ideation as well as in a period after receiving messages. As follow-up phone calls over an extended period of time may not be feasible, this intervention has the potential to offer simple technological support for individuals following discharge from the ED. Trial Registration ClinicalTrials.gov NCT02106949; https://clinicaltrials.gov/ct2/show/NCT02106949 (Archived by WebCite at http://www.webcitation.org/6wMtAFL49) PMID:29321126

Mobile phone messages to provide support to women during the home phase of medical abortion in South Africa: a randomised controlled trial.

PubMed

Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon

2014-09-01

Home use of misoprostol for medical abortion is more convenient for many women than in-clinic use but requires management of abortion symptoms at home without provider backup. This study evaluated whether automated text messages to women undergoing medical abortion can reduce anxiety and emotional discomfort, and whether the messages can better prepare women for symptoms they experience. A multisite randomized controlled trial was conducted in which women undergoing early medical abortion were allocated to receive standard of care (SOC) only (n=235) or SOC+a messaging intervention (n=234). Consenting women were interviewed at the clinic after taking mifepristone and again at their follow-up clinic visit 2-3 weeks later; the intervention group received text messages over the duration of this period. Emotional outcomes were evaluated using the Hospital Anxiety and Depression Scale, Adler's 12-item emotional scale and the Impact of Event Scale-Revised. Preparedness for the abortion symptoms and overall satisfaction with the procedure were assessed using 4-point Likert-type scales. Between baseline and follow-up, anxiety decreased more (p=0.013), and less emotional stress was experienced (adjusted for baseline anxiety, p=0.015), in the intervention compared to the SOC group. Participants in the intervention group were also more likely to report that they felt very well prepared for the bleeding (p<0.001), pain (p=0.042) and side effects (p=0.027) they experienced. Acceptability and other negative emotions relating to the abortion did not differ between study groups. Ninety-nine percent of the intervention group stated that they would recommend the messages to a friend having the same procedure. Text messages to women following mifepristone administration for early medical abortion may assist them in managing symptoms and appear highly acceptable to recipients. This randomized controlled trial provides evidence for the effectiveness of text messages following mifepristone administration in strengthening medical abortion care. The messages were associated with significant reductions in women's anxiety and stress during the abortion process; they improved preparedness for the abortion symptoms experienced and appeared highly acceptable. Copyright © 2014 Elsevier Inc. All rights reserved.

'Someone batting in my corner': experiences of smoking-cessation support via text message.

PubMed

Douglas, Nicolas; Free, Caroline

2013-11-01

The txt2stop trial demonstrated that smoking-cessation support delivered by text message doubles biochemically verified abstinence at 6 months. There was no significant heterogeneity in any of the pre-specified subgroups. To explore participants' experiences of the txt2stop intervention via a qualitative study using telephone interviews. Qualitative telephone interviews in the community. Thematic content analysis of 1283 feedback forms was conducted to develop a topic guide for 25 telephone interviews. Key themes were identified and described. Any differences in the experiences of those who did, and did not, successfully quit were specifically explored. Participants liked the fact that smoking-cessation support delivered by text message was convenient, easy to access, and chemical free. They reported that the intervention was a reminder that they were quitting and why, provided emotional support, was a reminder of the physical benefits of stopping smoking, and they saved messages so they could refer back to them. However, the intervention was not helpful for all. Receiving texts about smoking could also stimulate craving, and the timing, frequency, and duration of messages were not optimal for some participants. Those who did not quit reported that additional factors influenced them, such as periods of stress or social events, or reported that they had been unable to cope with the physical effects of withdrawal, and combining text-message support with medication could help with this. Although the intervention did stimulate craving in some participants at some times, recipients reported that it also provided emotional support and reinforcement at temporally appropriate moments. It was successful at helping people to quit smoking but could be used together with other forms of smoking-cessation support.

‘Someone batting in my corner’: experiences of smoking-cessation support via text message

PubMed Central

Douglas, Nicolas; Free, Caroline

2013-01-01

Background The txt2stop trial demonstrated that smoking-cessation support delivered by text message doubles biochemically verified abstinence at 6 months. There was no significant heterogeneity in any of the pre-specified subgroups. Aim To explore participants’ experiences of the txt2stop intervention via a qualitative study using telephone interviews. Design and setting Qualitative telephone interviews in the community. Method Thematic content analysis of 1283 feedback forms was conducted to develop a topic guide for 25 telephone interviews. Key themes were identified and described. Any differences in the experiences of those who did, and did not, successfully quit were specifically explored. Results Participants liked the fact that smoking-cessation support delivered by text message was convenient, easy to access, and chemical free. They reported that the intervention was a reminder that they were quitting and why, provided emotional support, was a reminder of the physical benefits of stopping smoking, and they saved messages so they could refer back to them. However, the intervention was not helpful for all. Receiving texts about smoking could also stimulate craving, and the timing, frequency, and duration of messages were not optimal for some participants. Those who did not quit reported that additional factors influenced them, such as periods of stress or social events, or reported that they had been unable to cope with the physical effects of withdrawal, and combining text-message support with medication could help with this. Conclusion Although the intervention did stimulate craving in some participants at some times, recipients reported that it also provided emotional support and reinforcement at temporally appropriate moments. It was successful at helping people to quit smoking but could be used together with other forms of smoking-cessation support. PMID:24267860

A Text Message Program as a Booster to In-Person Brief Interventions for Mandated College Students to Prevent Weekend Binge Drinking

ERIC Educational Resources Information Center

Suffoletto, Brian; Merrill, Jennifer E.; Chung, Tammy; Kristan, Jeffrey; Vanek, Marian; Clark, Duncan B.

2016-01-01

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and…

The Effect of Text Messaging on 9- and 10-Year-Old Children's Reading, Spelling and Phonological Processing Skills

ERIC Educational Resources Information Center

Wood, C.; Jackson, E.; Hart, L.; Plester, B.; Wilde, L.

2011-01-01

This paper reports on an intervention study that considered the impact of text messaging on 9- to 10-year-old children's literacy skills. One hundred and fourteen children who had never owned a mobile phone before were recruited and randomly allocated to either the intervention or control conditions. All children were pre- and post-tested on a…

Involving service users in intervention design: a participatory approach to developing a text‐messaging intervention to reduce repetition of self‐harm

PubMed Central

Owens, Christabel; Farrand, Paul; Darvill, Ruth; Emmens, Tobit; Hewis, Elaine; Aitken, Peter

2010-01-01

Abstract Objective  To engage a group of people with relevant lived experience in the development of a text‐messaging intervention to reduce repetition of self‐harm. Background  Contact‐based interventions, such as follow‐up letters, postcards and telephone calls, have shown potential to reduce repetition of self‐harm in those who present at Accident and Emergency departments. Text messaging offers a low‐cost alternative that has not been tested. We set out to develop a text‐based intervention. The process of intervention development is rarely reported and little is known about the impact of service user involvement on intervention design. Method  We held a series of six participatory workshops and invited service users and clinicians to help us work out how to get the right message to the right person at the right time, and to simulate and test prototypes of an intervention. Results  Service users rejected both the idea of a generic, ‘one size fits all’ approach and that of ‘audience segmentation’, maintaining that text messages could be safe and effective only if individualized. This led us to abandon our original thinking and develop a way of supporting individuals to author their own self‐efficacy messages and store them in a personal message bank for withdrawal at times of crisis. Conclusions  This paper highlights both the challenge and the impact of involving consumers at the development stage. Working with those with lived experience requires openness, flexibility and a readiness to abandon or radically revise initial plans, and may have unexpected consequences for intervention design. PMID:20860777

Qualitative Feedback From a Text Messaging Intervention for Depression: Benefits, Drawbacks, and Cultural Differences

PubMed Central

Berridge, Clara

2014-01-01

Background Mobile health interventions are often standardized and assumed to work the same for all users; however, we may be missing cultural differences in the experiences of interventions that may impact how and if an intervention is effective. Objective The objective of the study was to assess qualitative feedback from participants to determine if there were differences between Spanish speakers and English speakers. Daily text messages were sent to patients as an adjunct to group Cognitive Behavioral Therapy (CBT) for depression. Methods Messages inquired about mood and about specific themes (thoughts, activities, social interactions) of a manualized group CBT intervention. There were thirty-nine patients who participated in the text messaging pilot study. The average age of the participants was 53 years (SD 10.4; range of 23-72). Results Qualitative feedback from Spanish speakers highlighted feelings of social support, whereas English speakers noted increased introspection and self-awareness of their mood state. Conclusions These cultural differences should be explored further, as they may impact the effect of supportive mobile health interventions. Trial Registration Trial Registration: Clinicaltrials.gov NCT01083628; http://clinicaltrials.gov/ct2/show/study/NCT01083628 (Archived by WebCite at http://www.webcitation.org/6StpbdHuq). PMID:25373390

Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review.

PubMed

Badawy, Sherif M; Kuhns, Lisa M

2016-10-25

The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.

Use of Text Messaging for Monitoring Sugar-Sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

ERIC Educational Resources Information Center

Shapiro, Jennifer R.; Bauer, Stephanie; Hamer, Robert M.; Kordy, Hans; Ward, Dianne; Bulik, Cynthia M.

2008-01-01

Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via…

A Text Message Intervention with Adaptive Goal Support to Reduce Alcohol Consumption Among Non-Treatment-Seeking Young Adults: Non-Randomized Clinical Trial with Voluntary Length of Enrollment.

PubMed

Suffoletto, Brian; Chung, Tammy; Muench, Frederick; Monti, Peter; Clark, Duncan B

2018-02-16

Stand-alone text message-based interventions can reduce binge drinking episodes (≥4 drinks for women and ≥5 drinks for men) among nontreatment-seeking young adults, but may not be optimized. Adaptive text message support could enhance effectiveness by assisting context-specific goal setting and striving, but it remains unknown how to best integrate it into text message interventions. The objective of this study was to evaluate young adults' engagement with a text message intervention, Texting to Reduce Alcohol Consumption 2 (TRAC2), which focuses on reducing weekend alcohol consumption. TRAC2 incorporated preweekend drinking-limit goal-commitment ecological momentary assessments (EMA) tailored to past 2-week alcohol consumption, intraweekend goal reminders, self-efficacy EMA with support tailored to goal confidence, and maximum weekend alcohol consumption EMA with drinking limit goal feedback. We enrolled 38 nontreatment-seeking young adults (aged 18 to 25 years) who screened positive for hazardous drinking in an urban emergency department. Following a 2-week text message assessment-only run-in, subjects were given the opportunity to enroll in 4-week intervention blocks. We examined patterns of EMA responses and voluntary re-enrollment. We then examined how goal commitment and goal self-efficacy related to event-level alcohol consumption. Finally, we examined the association of length of TRAC2 exposure with alcohol-related outcomes from baseline to 3-month follow-up. Among a diverse sample of young adults (56% [28/50] female, 54% [27/50] black, 32% [12/50] college enrolled), response rates to EMA queries were, on average, 82% for the first 4-week intervention block, 75% for the second 4-week block, and 73% for the third 4-week block. In the first 4 weeks of the intervention, drinking limit goal commitment was made 68/71 times it was prompted (96%). The percentage of subjects being prompted to commit to a drinking limit goal above the binge threshold was 52% (15/29) in week 1 and decreased to 0% (0/15) by week 4. Subjects met their goal 130/146 of the times a goal was committed to (89.0%). There were lower rates of goal success when subjects reported lower confidence (score <4) in meeting the goal (76% [32/42 weekends]) compared with that when subjects reported high confidence (98% [56/57 weekends]; P=.001). There were reductions in alcohol consumption from baseline to 3 months, but reductions were not different by length of intervention exposure. Preliminary evidence suggests that nontreatment-seeking young adults will engage with a text message intervention incorporating self-regulation support features, resulting in high rates of weekend drinking limit goal commitment and goal success. ©Brian Suffoletto, Tammy Chung, Frederick Muench, Peter Monti, Duncan B Clark. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 16.02.2018.

Mobile Text Messaging to Improve Medication Adherence and Viral Load in a Vulnerable Canadian Population Living With Human Immunodeficiency Virus: A Repeated Measures Study

PubMed Central

King, Elizabeth; Kinvig, Karen; Steif, Jonathan; Qiu, Annie Q; Maan, Evelyn J; Albert, Arianne YK; Pick, Neora; Alimenti, Ariane; Kestler, Mary H; Money, Deborah M; Lester, Richard T

2017-01-01

Background Combination antiretroviral therapy (cART) as treatment for human immunodeficiency virus (HIV) infection is effective and available, but poor medication adherence limits benefits, particularly in vulnerable populations. In a Kenyan randomized controlled trial, a weekly text-messaging intervention (WelTel) improved cART adherence and HIV viral load (VL). Despite growing evidence for short message service (SMS) text-message interventions in HIV care, there is a paucity of data utilizing these interventions in marginalized or female cohorts. Objective This study was undertaken to assess whether the standardized WelTel SMS text-message intervention applied to a vulnerable, predominantly female, population improved cART adherence and VL. Methods We conducted a repeated measures study of the WelTel intervention in high-risk HIV-positive persons by measuring change in VL, CD4 count, and self-reported adherence 12 months before and 12 months after the WelTel intervention was introduced. Inclusion criteria included VL ≥200 copies/mL, indication for treatment, and meeting vulnerability criteria. Participants were given a mobile phone with unlimited texting (where required), and weekly check-in text messages were sent for one year from the WelTel computer platform. Clinical data were collected for control and intervention years. Participants were followed by a multidisciplinary team in a clinical setting. Outcomes were assessed using Wilcoxon signed ranks tests for change in CD4 and VL from control year to study end and mixed-effects logistic regressions for change in cART adherence and appointment attendance. A secondary analysis was conducted to assess the effect of response rate on the outcome by modeling final log10 VL by number of responses while controlling for mean log10 VL in the control year. Results Eighty-five participants enrolled in the study, but 5 withdrew (final N=80). Participants were predominantly female (90%, 72/80) with a variety of vulnerabilities. Mean VL decreased from 1098 copies/mL in the control year to 439 copies/mL at study end (P=.004). Adherence to cART significantly improved (OR 1.14, IQR 1.10-1.18; P<.001), whereas appointment attendance decreased slightly with the intervention (OR 0.81, IQR 0.67-0.99; P=.03). A response was received for 46.57% (1753/3764) of messages sent and 9.62% (362/3764) of text messages sent were replied to with a problem. An outcome analysis examining relationship between reply rate and VL did not meet statistical significance (P=.07), but may be worthy of investigating further in a larger study. Conclusions WelTel may be an effective tool for improving cART adherence and reducing VLs among high-risk, vulnerable HIV-positive persons. Trial Registration Clinicaltrials.gov NCT02603536; https://clinicaltrials.gov/ct2/show/NCT02603536 (Archived by WebCite at http://www.webcitation.org/6qK57zCwv) PMID:28572079

Mobile phone messaging reminders for attendance at healthcare appointments.

PubMed

Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Atun, Rifat; Car, Josip

2013-12-05

This review is an update of the original Cochrane review published in July 2012. Missed appointments are a major cause of inefficiency in healthcare delivery with substantial monetary costs for the health system, leading to delays in diagnosis and appropriate treatment. Patients' forgetfulness is one of the main reasons for missed appointments. Patient reminders may help reduce missed appointments. Modes of communicating reminders for appointments to patients include face-to-face communication, postal messages, calls to landlines or mobile phones, and mobile phone messaging. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), could provide an important, inexpensive delivery medium for reminders for healthcare appointments. To update our review assessing the effects of mobile phone messaging reminders for attendance at healthcare appointments. Secondary objectives include assessment of costs; health outcomes; patients' and healthcare providers' evaluation of the intervention and perceptions of safety; and possible harms and adverse effects associated with the intervention. Original searches were run in June 2009. For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2012, Issue 8), MEDLINE (OvidSP) (January 1993 to August 2012), EMBASE (OvidSP) (January 1993 to August 2012), PsycINFO (OvidSP) (January 1993 to August 2012) and CINAHL (EbscoHOST) (January 1993 to August 2012). We also reviewed grey literature (including trial registers) and reference lists of articles. Randomised controlled trials (RCTs) assessing mobile phone messaging as reminders for healthcare appointments. We only included studies in which it was possible to assess effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third author. Two authors assessed the risk of bias of the included studies. As the intervention characteristics and outcome measures were similar across included studies, we conducted a meta-analysis to estimate an overall effect size. We included eight randomised controlled trials involving 6615 participants. Four of these studies were newly identified during this update.We found moderate quality evidence from seven studies (5841 participants) that mobile text message reminders improved the rate of attendance at healthcare appointments compared to no reminders (risk ratio (RR) 1.14 (95% confidence interval (CI) 1.03 to 1.26)). There was also moderate quality evidence from three studies (2509 participants) that mobile text message reminders had a similar impact to phone call reminders (RR 0.99 (95% CI 0.95 to 1.02). Low quality evidence from one study (291 participants) suggests that mobile text message reminders combined with postal reminders improved the rate of attendance at healthcare appointments compared to postal reminders alone (RR 1.10 (95% CI 1.02 to 1.19)). Overall, the attendance to appointment rates were 67.8% for the no reminders group, 78.6% for the mobile phone messaging reminders group and 80.3% for the phone call reminders group. One study reported generally that there were no adverse effects during the study period; none of the studies reported in detail on specific adverse events such as loss of privacy, data misinterpretation, or message delivery failure. Two studies reported that the costs per text message per attendance were respectively 55% and 65% lower than costs per phone call reminder. The studies included in the review did not report on health outcomes or people's perceptions of safety related to receiving reminders by text message. Low to moderate quality evidence included in this review shows that mobile phone text messaging reminders increase attendance at healthcare appointments compared to no reminders, or postal reminders.Text messaging reminders were similar to telephone reminders in terms of their effect on attendance rates, and cost less than telephone reminders. However, the included studies were heterogeneous and the quality of the evidence therein is low to moderate. Further, there is a lack of information about health effects, adverse effects and harms, user evaluation of the intervention and user perceptions of its safety. The current evidence therefore still remains insufficient to conclusively inform policy decisions.There is a need for more high-quality randomised trials of mobile phone messaging reminders, that measure not only patients' attendance rates, but also focus on the cost-effectiveness of these interventions. Health outcomes, patients' and healthcare providers' evaluation and perceptions of the safety of the interventions, potential harms, and adverse effects of mobile phone messaging reminders should be assessed. Studies should report message content and timing in relation to the appointment.

Short message service (SMS) interventions for the prevention and treatment of sexually transmitted infections: a systematic review protocol

PubMed Central

2014-01-01

Background Globally, the incidence of sexually transmitted infections (STI) is rising, posing a challenge to its control and appropriate management. Text messaging has become the most common mode of communication among almost six billion mobile phone users worldwide. Text messaging can be used to remind patients about clinic appointments, to notify patients that it is time for STI re-testing, and to facilitate patient communication with their health professionals with any questions and concerns they may have about their sexual health. While there are a handful of systematic reviews published on short message service (SMS) interventions in a variety of health settings and issues, none are related to sexual health. We plan to conduct a systematic review to examine the impact text messaging might have on interventions for the prevention and care of patients with STIs. Methods/Design Eligible studies will include both quantitative and qualitative studies published after 1995 that discuss the efficacy and effectiveness of SMS interventions for STI prevention and management using text messaging. Data will be abstracted independently by two reviewers using a standardized pre-tested data abstraction form. Inter-rater reliability scores will be obtained to ensure consistency in the inclusion and data extraction of studies. Heterogeneity will be assessed using the I2 test and subgroup analyses. A nonhypothesis driven inductive reasoning approach as well as a coding framework will be applied to analyze qualitative studies. A meta-analysis may be conducted if sufficient quantitative studies are found using similar outcomes. Discussion For this protocol, we identified ten related systematic reviews. The reviews were limited to a particular disease or setting, were not exclusive to SMS interventions, or were out of date. This systematic review will be the first comprehensive examination of studies that discuss the effectiveness of SMS on multiple outcomes that relate to STI prevention and management, covering diverse settings and populations. Findings of the systematic review and any additional meta-analyses will be published and presented to our key knowledge users. This information will provide the evidence that is required to appropriately adopt text messaging into standard practice in STI care. PMID:24433348

[Online text-based psychosocial intervention for Youth in Quebec].

PubMed

Thoër, Christine; Noiseux, Kathia; Siche, Fabienne; Palardy, Caroline; Vanier, Claire; Vrignaud, Caroline

In 2013, Tel-jeunes created a text messaging intervention program to reach youth aged 12 to 17 years on their cell phones. Tel-jeunes was the first in the country to offer a text-based brief psychosocial interventions performed by professional counselors. Researchers were contacted to document and evaluate the program. The research aimed to: 1) determine motives, contexts and issues that lead young people to use the SMS service; 2) document the characteristics of text-based brief intervention; and 3) assess the advantages and difficulties encountered by counselors who respounded to youth text-messages. We conducted a multimethod research from November 2013 to May 2014. We held four focus groups with 23 adolescents aged 15 to 17 who had or not used the SMS service, conducted a content analysis of a corpus of 13,236 text messages (or 601 conversations), and two focus groups with 11 Tel-jeunes counselors, just over a year after the implantation of the service. Our findings show that the SMS service meets youth needs. They identify text messaging to be their prefered mode of communication with Tel-jeunes when they need support or information. Moreover, the service reaches young people who would not have felt confortable to contact Tel-jeunes by phone. We identified three dominant issues in youths demands: romantic relationships, psychological health and sexuality. Perceived benefits of the service include anonimity and privacy (cell phone providing the ability to text anywhere). Youth participants also appreciated writing to counselors as they felt they had more time to think abouth their questions and answers to the counselor. Counselors were more ambivalent. They considered text-based intervention to be very effective and satisfactory to adress youth information requests, but reported difficulties when dealing with more complex problems or with mental health issues. They reported that text-based communication makes it more difficult to assess youth emotional states, found the discontinuity of text-based conversations very frustrating, and experienced problems when dealing with several youth at the same time. They also struggled with some the computer-based platform features. Finding suggest that text-based intervention are now essential to reach out to youth seeking for information and help. But, Tel-jeunes text-based service required adaptations of the intervention model. Adjustment were made by the managment team when implementing the service which required taking into account youth needs, engaging in a continuous dialogue with counselors and working with the suppliers of the text-based platform to improve its features. Futur challenges include reaching out for boys, conducting interventions with younger youth who feel confortable contacting the service by SMS, and managing urgent requests initiated via web text-messaging apps rather than mobile phones.

Text messaging as an adjunct to a web-based intervention for college student alcohol use: A preliminary study.

PubMed

Tahaney, Kelli D; Palfai, Tibor P

2017-10-01

Brief, web-based motivational interventions have shown promising results for reducing alcohol use and associated harm among college students. However, findings regarding which alcohol use outcomes are impacted are mixed and effects tend to be small to moderate, with effect sizes decreasing over longer-term follow-up periods. As a result, these interventions may benefit from adjunctive strategies to bolster students' engagement with intervention material and to extend interventions beyond initial contacts into student's daily lives. This study tested the efficacy of text messaging as an adjunct to a web-based intervention for heavy episodic drinking college students. One-hundred and thirteen undergraduate student risky drinkers recruited from an introductory psychology class were randomly assigned to one of three conditions-assessment only (AO), web intervention (WI), and web intervention plus text messaging (WI+TXT). Heavy drinking episodes (HDEs), weekend quantity per occasion, and alcohol-related consequences were assessed at baseline and one month follow-up. Univariate analysis of covariance (ANCOVA) was used to assess the influence of condition assignment on 1-month outcomes, controlling for baseline variables. Planned contrasts showed that those in the WI+TXT condition showed significantly less weekend drinking than those in the AO and WI conditions. Although those in the WI+TXT condition showed significantly fewer HDEs compared to AO, it was not significantly different than the WI only condition. No differences were observed on alcohol-related problems. These findings provide partial support for the view that text messaging may be a useful adjunct to web-based interventions for reducing alcohol consumption among student drinkers. Copyright © 2017. Published by Elsevier Ltd.

Text messaging in health care: a systematic review of impact studies.

PubMed

Yeager, Valerie A; Menachemi, Nir

2011-01-01

Studies suggest text messaging is beneficial to health care; however, no one has synthesized the overall evidence on texting interventions. In response to this need, we conducted a systematic review of the impacts of text messaging in health care. PubMed database searches and subsequent reference list reviews sought English-language, peer-reviewed studies involving text messaging in health care. Commentaries, conference proceedings, and feasibilities studies were excluded. Data was extracted using an article coding sheet and input into a database for analysis. Of the 61 papers reviewed, 50 articles (82%) found text messaging had a positive effect on the primary outcome. Average sample sizes in articles reporting positive findings (n=813) were significantly larger than those that did not find a positive impact (n=178) on outcomes (p = 0.032). Articles were categorized into focal groups as follows: 27 articles (44.3%) investigated the impact of texting on disease management, 24 articles (39.3%) focused texting's impact to public health related outcomes, and 10 articles (16.4%) examined texting and its influence on administrative processes. Articles in focal groups differed by the purpose of the study, direction of the communication, and where they were published, but not in likelihood of reporting a positive impact from texting. Current evidence indicates that text messaging health care interventions are largely beneficial clinically, in public health related uses, and in terms of administrative processes. However, despite the promise of these findings, literature gaps exist, especially in primary care settings, across geographic regions and with vulnerable populations.

Opening communication channels with people living with HIV using mobile phone text messaging: insights from the CAMPS trial.

PubMed

Mbuagbaw, Lawrence; Thabane, Lehana; Ongolo-Zogo, Pierre

2013-04-04

Using two-way mobile phone text messages to improve adherence to antiretroviral medication enhances communication between patients and health workers. We describe the implications of participants' responses to text messages in the Cameroon Mobile Phone SMS (CAMPS) trial. This is a cross-sectional analysis of data from the intervention arm of the CAMPS trial. CAMPS was a randomized controlled trial of motivational text messaging versus usual care to improve adherence to antiretroviral medication among people living with HIV in Yaounde, Cameroon (n = 200) over a 6 month period. Participants in the intervention arm (n = 101) were given a contact phone number, but were not required to respond to their reminder messages. If they did, their responses were noted and reported as counts and percentages. We received 99 phone calls and 55 text messages (154 responses) from 48 participants during the study period. The median number of responses was 1 (first quartile [Q1]: 1; third quartile [Q3]: 3). Half (n = 79, 51.1%) of them were expressions of gratitude. The rest included requests for logistical (n = 21, 13.6%), medical (n = 20, 12.9%) and financial (n = 11, 7.1%) support. Initiating two-way mobile communication opens more channels for people living with HIV to express unmet needs. Researchers, policy makers and clinicians should be ready to respond to the needs expressed by patients who respond to text messages. Pan-African Clinical Trials Registry: PACTR201011000261458;

Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States.

PubMed

Christopoulos, Katerina A; Cunningham, William E; Beckwith, Curt G; Kuo, Irene; Golin, Carol E; Knight, Kevin; Flynn, Patrick M; Spaulding, Anne C; Coffin, Lara S; Kruszka, Bridget; Kurth, Ann; Young, Jeremy D; Mannheimer, Sharon; Crane, Heidi M; Kahana, Shoshana Y

2017-11-01

In the United States, little is known about interventions that rely on mobile phones and/or text messaging to improve engagement in HIV care for vulnerable populations. Domestic studies using these technologies as part of the National Institute on Drug Abuse "Seek, Test, Treat, Retain" research initiative were queried regarding intervention components, implementation issues, participant characteristics, and descriptive statistics of mobile phone service delivery. Across five studies with 1,135 predominantly male, minority participants, implementation challenges occurred in three categories: (1) service interruptions; (2) billing/overage issues, and; (3) the participant user experience. Response rules for automated text messages frequently frustrated participants. The inability to reload minutes/texting capacity remotely was a significant barrier to intervention delivery. No study encountered confidentiality breaches. Service interruption was common, even if studies provided mobile phones and plans. Future studies should attend to the type of mobile phone and service, the participant user experience, and human subjects concerns.

"Even if you know everything you can forget": health worker perceptions of mobile phone text-messaging to improve malaria case-management in Kenya.

PubMed

Jones, Caroline O H; Wasunna, Beatrice; Sudoi, Raymond; Githinji, Sophie; Snow, Robert W; Zurovac, Dejan

2012-01-01

This paper presents the results of a qualitative study to investigate the perceptions and experiences of health workers involved in a a cluster-randomized controlled trial of a novel intervention to improve health worker malaria case-management in 107 government health facilities in Kenya. The intervention involved sending text-messages about paediatric outpatient malaria case-management accompanied by "motivating" quotes to health workers' mobile phones. Ten malaria messages were developed reflecting recommendations from the Kenyan national guidelines. Two messages were delivered per day for 5 working days and the process was repeated for 26 weeks (May to October 2009). The accompanying quotes were unique to each message. The intervention was delivered to 119 health workers and there were significant improvements in correct artemether-lumefantrine (AL) management both immediately after the intervention (November 2009) and 6 months later (May 2010). In-depth interviews with 24 health workers were undertaken to investigate the possible drivers of this change. The results suggest high acceptance of all components of the intervention, with the active delivery of information in an on the job setting, the ready availability of new and stored text messages and the perception of being kept 'up to date' as important factors influencing practice. Applying the construct of stages of change we infer that in this intervention the SMS messages were operating primarily at the action and maintenance stages of behaviour change achieving their effect by creating an enabling environment and providing a prompt to action for the implementation of case management practices that had already been accepted as the clinical norm by the health workers. Future trials testing the effectiveness of SMS reminders in creating an enabling environment for the establishment of new norms in clinical practice as well as in providing a prompt to action for the implementation of the new case-management guidelines are justified.

“Even if You Know Everything You Can Forget”: Health Worker Perceptions of Mobile Phone Text-Messaging to Improve Malaria Case-Management in Kenya

PubMed Central

Jones, Caroline O. H.; Wasunna, Beatrice; Sudoi, Raymond; Githinji, Sophie; Snow, Robert W.; Zurovac, Dejan

2012-01-01

This paper presents the results of a qualitative study to investigate the perceptions and experiences of health workers involved in a a cluster-randomized controlled trial of a novel intervention to improve health worker malaria case-management in 107 government health facilities in Kenya. The intervention involved sending text-messages about paediatric outpatient malaria case-management accompanied by “motivating” quotes to health workers’ mobile phones. Ten malaria messages were developed reflecting recommendations from the Kenyan national guidelines. Two messages were delivered per day for 5 working days and the process was repeated for 26 weeks (May to October 2009). The accompanying quotes were unique to each message. The intervention was delivered to 119 health workers and there were significant improvements in correct artemether-lumefantrine (AL) management both immediately after the intervention (November 2009) and 6 months later (May 2010). In-depth interviews with 24 health workers were undertaken to investigate the possible drivers of this change. The results suggest high acceptance of all components of the intervention, with the active delivery of information in an on the job setting, the ready availability of new and stored text messages and the perception of being kept ‘up to date’ as important factors influencing practice. Applying the construct of stages of change we infer that in this intervention the SMS messages were operating primarily at the action and maintenance stages of behaviour change achieving their effect by creating an enabling environment and providing a prompt to action for the implementation of case management practices that had already been accepted as the clinical norm by the health workers. Future trials testing the effectiveness of SMS reminders in creating an enabling environment for the establishment of new norms in clinical practice as well as in providing a prompt to action for the implementation of the new case-management guidelines are justified. PMID:22719911

'MATRI-SUMAN' a capacity building and text messaging intervention to enhance maternal and child health service utilization among pregnant women from rural Nepal: study protocol for a cluster randomised controlled trial.

PubMed

Singh, Jitendra Kumar; Kadel, Rajendra; Acharya, Dilaram; Lombard, Daniel; Khanal, Saval; Singh, Shri Prakash

2018-06-14

Capacity development of health volunteers and text messaging to pregnant women through mobile phones have shown improved maternal and child health (MCH) outcomes and is associated with increased utilisation of MCH services. However, such interventions are uncommon in Nepal. We aim to carry out an intervention with the hypothesis that capacity building and text messaging intervention will increase the MCH service utilisation. MATRI-SUMAN is a 12-month cluster randomized controlled trial (RCT). The trial involves pregnant women from 52 clusters of six village development committees (VDCs) covering 66,000 populations of Dhanusha district of Nepal. In the intervention clusters, Female Community Health Volunteers (FCHVs) will receive capacity development skills through reinforcement training, supervision and monitoring skills for the promotion of health seeking behaviour among pregnant women and study participants will receive periodic promotional text messaging service about MCH components through mobile phones. A sample of 354with equal numbers in each study arm is estimated using power calculation formula. The primary outcomes of this study are the rate of utilization of skilled birth attendants and consumption of a specified diversified meal. The secondary outcomes are: four antenatal (ANC) visits, weight gain of women during pregnancy, delivery of a baby at the health facility, postnatal care (PNC) visits, positive changes in child feeding practices among mothers, performance of FCHVs in MCH service utilization. The intervention is designed to enhance the capacity of health volunteers for the promotion of health seeking behaviour among pregnant women and text messaging through a mobile phone to expecting mothers to increase MCH service utilization. The trial if proven effective will have policy implications in poor resource settings. ISRCTN60684155, ( https://doi.org/10.1186/ISRCTN60684155 ). The trial was registered retrospectively.

A Pilot Randomized Trial of Text-Messaging for Symptom Awareness and Diabetes Knowledge in Adolescents With Type 1 Diabetes

PubMed Central

Han, Yi; Faulkner, Melissa Spezia; Fritz, Heather; Fadoju, Doris; Muir, Andrew; Abowd, Gregory D.; Head, Lauren; Arriaga, Rosa I.

2015-01-01

Adolescents with type 1 diabetes typically receive clinical care every 3 months. Between visits, diabetes-related issues may not be frequently reflected, learned, and documented by the patients, limiting their self-awareness and knowledge about their condition. We designed a text-messaging system to help resolve this problem. In a pilot, randomized controlled trial with 30 adolescents, we examined the effect of text messages about symptom awareness and diabetes knowledge on glucose control and quality of life. The intervention group that received more text messages between visits had significant improvements in quality of life. PMID:25720675

Randomized controlled trial of a messaging intervention to increase fruit and vegetable intake in adolescents: Affective versus instrumental messages.

PubMed

Carfora, Valentina; Caso, Daniela; Conner, Mark

2016-11-01

The present research aimed to test the efficacy of affective and instrumental text messages compared with a no-message control as a strategy to increase fruit and vegetable intake (FVI) in adolescents. A randomized controlled trial was used test impact of different text messages compared with no message on FVI over a 2-week period. A total of 1,065 adolescents (14-19 years) from a high school of the South of Italy completed the baseline questionnaire and were randomly allocated to one of three conditions: instrumental messages (N = 238), affective messages (N = 300), and no messages (N = 521). Students in the message conditions received one message each day over a 2-week period. The messages targeted affective (affective benefits) or instrumental (instrumental benefits) information about FVI. Self-reported FVI at 2 weeks was the key dependent variable. Analyses were based on the N = 634 who completed all aspects of the study. Findings showed that messages significantly increased FVI, particularly in the affective condition and this effect was partially mediated by changes in affective attitude and intentions towards FVI. Text messages can be used to increase FVI in adolescents. Text messages based on affective benefits are more effective than text messages based on instrumental benefits. Statement of contribution What is already known on this subject? Text messages have been shown to promote positive change in health behaviours. However, the most appropriate target for such text messages is less clear although targeting attitudes may be effective. What does this study add? This randomized controlled study shows that text messages targeting instrumental or affective attitudes produce changes in fruit and vegetable intake (FVI) in adolescents. Text messages targeting affective attitudes are shown to be more effective than text messages targeting instrumental attitudes. The effect of affective text messages on FVI was partially mediated by changes in affective attitudes. © 2016 The British Psychological Society.

Methods to assess youth engagement in a text messaging supplement to an effective teen pregnancy program.

PubMed

Devine, Sharon; Leeds, Caroline; Shlay, Judith C; Leytem, Amber; Beum, Robert; Bull, Sheana

2015-08-01

Youth are prolific users of cell phone minutes and text messaging. Numerous programs using short message service text messaging (SMS) have been employed to help improve health behaviors and health outcomes. However, we lack information on whether and what type of interaction or engagement with SMS program content is required to realize any benefit. We explored youth engagement with an automated SMS program designed to supplement a 25-session youth development program with demonstrated efficacy for reductions in teen pregnancy. Using two years of program data, we report on youth participation in design of message content and response frequency to messages among youth enrolled in the intervention arm of a randomized controlled trial (RCT) as one indicator of engagement. There were 221 youth between the ages of 14-18 enrolled over two years in the intervention arm of the RCT. Just over half (51%) were female; 56% were Hispanic; and 27% African American. Youth were sent 40,006 messages of which 16,501 were considered bi-directional where youth were asked to text a response. Four-fifths (82%) responded at least once to a text. We found variations in response frequency by gender, age, and ethnicity. The most popular types of messages youth responded to include questions and quizzes. The first two months of the program in each year had the highest response frequency. An important next step is to assess whether higher response to SMS results in greater efficacy. This future work can facilitate greater attention to message design and content to ensure messages are engaging for the intended audience. Copyright © 2015 Elsevier Inc. All rights reserved.

Pilot RCT of bidirectional text messaging for ART adherence among nonurban substance users with HIV.

PubMed

Ingersoll, Karen S; Dillingham, Rebecca A; Hettema, Jennifer E; Conaway, Mark; Freeman, Jason; Reynolds, George; Hosseinbor, Sharzad

2015-12-01

This pilot study tested the preliminary efficacy of a theory-based bidirectional text messaging intervention (TEXT) on antiretroviral (ART) adherence, missed care visits, and substance use among people with HIV. Participants with recent substance use and ART nonadherence from 2 nonurban HIV clinics were randomized to TEXT or to usual care (UC). The TEXT intervention included daily queries of ART adherence, mood, and substance use. The system sent contingent intervention messages created by participants for reports of adherence/nonadherence, good mood/poor mood, and no substance use/use. Assessments were at preintervention, postintervention, and 3-month postintervention follow-up. Objective primary outcomes were adherence, measured by past 3-month pharmacy refill rate, and proportion of missed visits (PMV), measured by medical records. The rate of substance-using days from the timeline follow-back was a secondary outcome. Sixty-three patients participated, with 33 randomized to TEXT and 30 to UC. At preintervention, adherence was 64.0%, PMV was 26.9%, and proportion of days using substances was 53.0%. At postintervention, adherence in the TEXT condition improved from 66% to 85%, compared with 62% to 71% in UC participants (p = .04). PMV improved from 23% to 9% for TEXT participants and 31% to 28% in UC participants (p = .12). There were no significant differences between conditions in substance-using days at postintervention. At 3-month follow-up, differences were not significant. Personalized bidirectional text messaging improved adherence and shows promise to improve visit attendance, but did not reduce substance using days. This intervention merits further testing and may be cost-efficient given its automation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Text-Messaging-Enhanced HIV Intervention for African American Adolescents: A Feasibility Study

PubMed Central

Cornelius, Judith B.; Dmochowski, Jacek; Boyer, Cherrie; St Lawrence, Janet; Lightfoot, Marguerita; Moore, Michael

2013-01-01

We examined the feasibility and acceptability of an HIV prevention intervention for African American adolescents delivered via mobile cell phones and looked at intervention-related changes in beliefs and sexual behaviors. We used a longitudinal one-group comparison design with data collected at three points. Forty adolescents, 13–18 years old, participated in the Becoming a Responsible Teen intervention followed by the delivery of daily multimedia messages for 3 months. The mobile-cell-phone enhanced intervention was feasible and acceptable to the participants. Greater HIV knowledge, improved attitudes toward condoms, and increased perceived HIV risk scores were observed with older adolescents (16–18 years old). Behavior trends showed a decrease in the number of times participants reported engaging in unprotected sexual intercourse over the previous 2 months. Mobile-cell-phone multimedia-text-messaging boosters tested in this study provided preliminary evidence of efficacy of the enhanced HIV prevention intervention for African American youth. PMID:23122907

[Academic application of text messages in a first aid course: a pilot study in a private university in Lima, Peru].

PubMed

Carrillo-Larco, Rodrigo M; Shu-Yip, Sebastián B; Pérez-Lu, José E

2015-01-01

The aim of the study was to develop and evaluate the impact of an educational intervention with the use of text messages (SMS) in a first aid course. A prospective study and intervention was conducted. Two steps were implemented: 1) a qualitative study to design the SMS and 2) the intervention with the sending of the SMS messages. The outcome variable was the final grade of students. Multivariate models were constructed, prevalence ratios and confidence intervals at 95% were calculated. The first phase revealed that the SMS should be educational-theoretical, motivational, and multiple choice. In the intervention there were 66 participants in the control and intervention group. The average age was 17.7 (± 1.2) years. The intervention group obtained higher scores compared with the control group (PR = 4.82; 95% CI: 1.58 to 14.72). In conclusion, SMS with informative and motivational content is useful in the formation of undergraduate medicine.

The Experiences of Newly Diagnosed Men Who Have Sex with Men Entering the HIV Care Cascade in Lima, Peru, 2015-2016: A Qualitative Analysis of Counselor-Participant Text Message Exchanges.

PubMed

Bayona, Erik; Menacho, Luis; Segura, Eddy R; Mburu, Gitau; Roman, Fernando; Tristan, Consuelo; Bromley, Elizabeth; Cabello, Robinson

2017-06-01

Mobile phone technology (mHealth) is a promising tool that has been used to improve HIV care in high-risk populations worldwide. Understanding patient perspectives of newly diagnosed men who have sex with men (MSM) in Lima, Peru during linkage and engagement in the HIV care continuum can help close the gaps in care following initial HIV diagnosis and ensure retention in continuous care. From June 2015 to March 2016, as part of a randomized controlled trial, 40 MSM participants were linked to care with an mHealth intervention within 3 months of HIV diagnosis at Via Libre clinic. For 12 weeks, participants agreed to receive weekly predetermined, standardized short message service (SMS), WhatsApp©, and/or Facebook© messages from an assigned HIV counselor. Text messaging was bi-directional, meaning participants could also send messages to their counselor at any time. In this qualitative study, we coded and thematically analyzed 947 SMS, 918 WhatsApp, and 2,694 Facebook bi-directional messages. Mean age of participants was 29.8 years (20-50); with 70 percent reporting some post-high school education and 73 percent self-identifying as homosexual. We identified six recurring themes that emerged from the data: (a) mental health symptoms; (b) coping behaviors; (c) interpersonal support; (d) physical symptoms; (e) HIV knowledge; and (f) care coordination. Participants sent text messages describing depressive symptoms and seeking mental health services during this initial stage of HIV care. For newly diagnosed MSM entering the HIV care continuum, a bi-directional mHealth intervention provided support to facilitate care while eliciting deeply personal mental and emotional states. Future interventions could benefit from using mHealth interventions as ancillary support for clinicians.

Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults.

PubMed

Ybarra, Michele L; Holtrop, Jodi Summers; Prescott, Tonya L; Strong, David

2014-11-01

Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth smoking cessation program for young adult smokers. 164 18-24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of program messages was the most commonly noted program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and program features to be even more salient. Future young adult mHealth interventions could: Integrate models that are flexible to different "paths" of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Adolescents’ perceptions of a mobile cell phone text messaging-enhanced intervention and development of a mobile cell phone-based HIV prevention intervention

PubMed Central

Cornelius, Judith B.; St. Lawrence, Janet S.; Howard, Jacquelyn C.; Shah, Deval; Poka, Avinash; McDonald, Delilah; White, Ann C.

2013-01-01

Purpose This study examined African American adolescents’ perceptions of a mobile cell phone (MCP)-enhanced intervention and development of an MCP-based HIV prevention intervention. Design and Methods One focus group was conducted with 11 adolescents who participated in the Becoming a Responsible Teen Text Messaging project. Results Adolescents said they benefited from the MCP-enhanced approach and were receptive to the idea of developing an MCP-based intervention. Practice Implications Nurses can use the findings of this report as a starting point in examining the development of MCP-based sexuality education with parents and adolescents. PMID:22188273

A Qualitative Study of Client-Clinician Text Exchanges in a Mobile Health Intervention for Individuals With Psychotic Disorders and Substance Use.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Gill, Lydia E; Bartels, Stephen J; Ben-Zeev, Dror

2016-01-01

Mobile health (mHealth) approaches have the potential to transform prevention, wellness, and illness management for people with dual diagnosis consisting of co-occurring mental illness and substance use disorders by providing timely and cost-effective interventions in clients' natural environments. However, little is known about how clients interact with mHealth interventions to manage their illness. This qualitative study explored the content of mobile phone text messages between clients with dual diagnosis and a clinician who engaged them in daily assessment and intervention text exchanges. Seventeen participants with psychotic disorders and substance use were enrolled in a 12-week single-arm trial of an mHealth intervention focusing on illness management. The clinician (i.e., mobile interventionist) sent daily text messages to participants' privately owned mobile phones to assess their medication adherence and clinical status. The clinician provided other illness management and wellness suggestions flexibly, in response to participants' needs and preferences. In this qualitative study we conducted a thematic analysis of the client-clinician text exchanges that occurred over the course of the intervention. Seven major content themes in client-clinician text message exchanges were identified: mental health symptoms; mental health coping strategies; mental health treatment and management; lifestyle behaviors; social relationships and leisure activities; motivation and personal goal setting; and independent living. Participants were interested in discussing strategies for coping with mental health symptoms (e.g., cognitive restructuring, social support) and health behavior change (e.g., increased physical activity, dietary changes). Our findings suggest that client-centered text messaging has the potential to be an important component of illness management for people with dual diagnosis. This approach is able to offer coping strategies that are tailored to clients' needs and preferences in real time when help is needed.

Are Text Messages a Feasible and Acceptable Way to Reach Female Entertainment Workers in Cambodia with Health Messages? A Cross-Sectional Phone Survey

PubMed Central

2016-01-01

Background Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions. Objective The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services. Methods This cross-sectional phone survey was conducted in May 2015 with 97 FEWs aged 18–35 years and currently working at an entertainment venue in Phnom Penh. Results Of the 96 respondents, 51% reported sending text messages daily; of them, 47% used Khmer script and 45% used Romanized Khmer. Younger FEWs were more likely to report daily texting (P<.001). Most FEWs (98%) in this study reported feeling comfortable receiving private health messages despite the fact that 39% were sharing their phone with others. Younger FEWs were less likely to share their phone with others (P=.02). Of all of the FEWs, 47% reported owning a smartphone, and younger women were more likely to own a smartphone than were older women (P=.08). Conclusions The findings from this study support the development of mHealth interventions targeting high-risk groups in urban areas of Cambodia. Our data suggest that mHealth interventions using texting may be a feasible way of reaching FEWs in Phnom Penh. PMID:27207374

Are Text Messages a Feasible and Acceptable Way to Reach Female Entertainment Workers in Cambodia with Health Messages? A Cross-Sectional Phone Survey.

PubMed

Brody, Carinne; Dhaliwal, Sukhmani; Tuot, Sovannary; Johnson, Michael; Pal, Khuondyla; Yi, Siyan

2016-05-20

Despite great achievements in reducing the prevalence of HIV, eliminating new HIV infections remains a challenge in Cambodia. Entertainment venues such as restaurants, karaoke bars, beer gardens, cafes, pubs, and massage parlors are now considered important venues for HIV prevention efforts and other health outreach interventions. The purpose of this study was to explore phone use and texting practices of female entertainment workers (FEWs) in order to determine if text messaging is a feasible and acceptable way to link FEWs to health services. This cross-sectional phone survey was conducted in May 2015 with 97 FEWs aged 18-35 years and currently working at an entertainment venue in Phnom Penh. Of the 96 respondents, 51% reported sending text messages daily; of them, 47% used Khmer script and 45% used Romanized Khmer. Younger FEWs were more likely to report daily texting (P<.001). Most FEWs (98%) in this study reported feeling comfortable receiving private health messages despite the fact that 39% were sharing their phone with others. Younger FEWs were less likely to share their phone with others (P=.02). Of all of the FEWs, 47% reported owning a smartphone, and younger women were more likely to own a smartphone than were older women (P=.08). The findings from this study support the development of mHealth interventions targeting high-risk groups in urban areas of Cambodia. Our data suggest that mHealth interventions using texting may be a feasible way of reaching FEWs in Phnom Penh.

A mobile phone intervention to reduce binge drinking among disadvantaged men: study protocol for a randomised controlled cost-effectiveness trial.

PubMed

Crombie, Iain K; Irvine, Linda; Williams, Brian; Sniehotta, Falko F; Petrie, Dennis; Evans, Josie Mm; Emslie, Carol; Jones, Claire; Ricketts, Ian W; Humphris, Gerry; Norrie, John; Rice, Peter; Slane, Peter W

2014-12-19

Socially disadvantaged men are at a substantially higher risk of developing alcohol-related problems. The frequency of heavy drinking in a single session is high among disadvantaged men. Brief alcohol interventions were developed for, and are usually delivered in, healthcare settings. The group who binge drink most frequently, young to middle-aged disadvantaged men, have less contact with health services and there is a need for an alternative method of intervention delivery. Text messaging has been used successfully to modify other adverse health behaviours. This study will test whether text messages can reduce the frequency of binge drinking by disadvantaged men. Disadvantaged men aged 25 to 44 years who drank >8 units of alcohol at least twice in the preceding month will be recruited from the community. Two recruitment strategies will be used: contacting men listed in primary care registers, and a community outreach method (time-space sampling). The intended sample of 798 men will be randomised to intervention or control, stratifying by recruitment method. The intervention group will receive a series of text messages designed to reduce the frequency of binge drinking through the formation of specific action plans. The control group will receive behaviourally neutral text messages intended to promote retention in the study. The primary outcome measure is the proportion of men consuming >8 units on at least three occasions in the previous 30 days. Secondary outcomes include total alcohol consumption and the frequency of consuming more than 16 units of alcohol in one session in the previous month. Process measures, developed during a previous feasibility study, will monitor engagement with the key behaviour change components of the intervention. The study will incorporate an economic evaluation comparing the costs of recruitment and intervention delivery with the benefits of reduced alcohol-related harm. This study will assess the effectiveness of a brief intervention, delivered by text messages, aimed at reducing the frequency of binge drinking in disadvantaged men. The process measures will identify components of the intervention which contribute to effectiveness. The study will also determine whether any benefit of the intervention is justified by the costs of intervening. ISRCTN07695192. Date assigned: 14 August 2013.

Effects of Phone and Text Message Reminders on Completion of the Human Papillomavirus Vaccine Series.

PubMed

Rand, Cynthia M; Vincelli, Phyllis; Goldstein, Nicolas P N; Blumkin, Aaron; Szilagyi, Peter G

2017-01-01

To assess the effect of phone or text message reminders to parents of adolescents on human papillomavirus (HPV) vaccine series completion in Rochester, NY. We performed parallel randomized controlled trials of phone and text reminders for HPV vaccine for parents of 11- to 17-year olds in three urban primary care clinics. The main outcome measures were time to receipt of the third dose of HPV vaccine and HPV vaccination rates. We enrolled 178 phone intervention (180 control) and 191 text intervention (200 control) participants. In multivariate survival analysis controlling for gender, age, practice, insurance, race, and ethnicity, the time from enrollment to receipt of the third HPV dose for those receiving a phone reminder compared with controls was not significant overall (hazard ratio [HR] = 1.30, p = .12) but was for those enrolling at dose 1 (HR = 1.91, p = .007). There was a significant difference in those receiving a text reminder compared with controls (HR = 2.34, p < .0001; an average of 71 days earlier). At the end of the study, 48% of phone intervention versus 40% of phone control (p = .34), and 49% of text intervention versus 30% of text control (p = .001) adolescents had received 3 HPV vaccine doses. In this urban population of parents of adolescents, text message reminders for HPV vaccine completion for those who had already started the series were effective, whereas phone message reminders were only effective for those enrolled at dose 1. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Electronic Brief Intervention and Text Messaging for Marijuana Use During Pregnancy: Initial Acceptability of Patients and Providers

PubMed Central

Gray, Justin; Svikis, Dace S; Puder, Karoline S; Resnicow, Ken; Konkel, Janine; Rice, Shetoya; McGoron, Lucy; Ondersma, Steven J

2017-01-01

Background Marijuana is the most widely used illicit substance during pregnancy. Technology-delivered brief interventions and text messaging have shown promise in general and pregnant samples but have not yet been applied to marijuana use in pregnancy. Objective The objective of the study was to evaluate, among pregnant women and prenatal care providers, the acceptability of an electronic brief intervention and text messaging plan for marijuana use in pregnancy. Methods Participants included patients (n=10) and medical staff (n=12) from an urban prenatal clinic. Patient-participants were recruited directly during a prenatal care visit. Those who were eligible reviewed the interventions individually and provided quantitative and qualitative feedback regarding software acceptability and helpfulness during a one-on-one interview with research staff. Provider-participants took part in focus groups in which the intervention materials were reviewed and discussed. Qualitative and focus group feedback was transcribed, coded manually, and classified by category and theme. Results Patient-participants provided high ratings for satisfaction, with mean ratings for respectfulness, interest, ease of use, and helpfulness ranging between 4.4 and 4.7 on a 5-point Likert scale. Of the 10 participants, 5 reported that they preferred working with the program versus their doctor, and 9 of 10 said the intervention made them more likely to reduce their marijuana use. Provider-participants received the program favorably, stating the information presented was both relevant and important for their patient population. Conclusions The findings support the acceptability of electronic brief intervention and text messaging for marijuana use during pregnancy. This, combined with their ease of use and low barrier to initiation, suggests that further evaluation in a randomized trial is appropriate. PMID:29117931

Can a text message a week improve breastfeeding?

PubMed

Gallegos, Danielle; Russell-Bennett, Rebekah; Previte, Josephine; Parkinson, Joy

2014-11-06

Breastfeeding is recognised as the optimal method for feeding infants with health gains made by reducing infectious diseases in infancy; and chronic diseases, including obesity, in childhood, adolescence and adulthood. Despite this, exclusivity and duration in developed countries remains resistant to improvement. The objectives of this research were to test if an automated mobile phone text messaging intervention, delivering one text message a week, could increase "any" breastfeeding rates and improve breastfeeding self-efficacy and coping. Women were eligible to participate if they were: over eighteen years; had an infant less than three months old; were currently breastfeeding; no diagnosed mental illness; and used a mobile phone. Women in the intervention group received MumBubConnect, a text messaging service with automated responses delivered once a week for 8 weeks. Women in the comparison group received their usual care and were sampled two years after the intervention group. Data collection included online surveys at two time points, week zero and week nine, to measure breastfeeding exclusivity and duration, coping, emotions, accountability and self-efficacy. A range of statistical analyses were used to test for differences between groups. Hierarchical regression was used to investigate change in breastfeeding outcome, between groups, adjusting for co-variates. The intervention group had 120 participants at commencement and 114 at completion, the comparison group had 114 participants at commencement and 86 at completion. MumBubConnect had a positive impact on the primary outcome of breastfeeding behaviors with women receiving the intervention more likely to continue exclusive breastfeeding; with a 6% decrease in exclusive breastfeeding in the intervention group, compared to a 14% decrease in the comparison group (p < 0.001). This remained significant after controlling for infant age, mother's income, education and delivery type (p = 0.04). Women in the intervention group demonstrated active coping and were less likely to display emotions-focussed coping (p < .001). There was no discernible statistical effect on self-efficacy or accountability. A fully automated text messaging services appears to improve exclusive breastfeeding duration. The service provides a well-accepted, personalised support service that empowers women to actively resolve breastfeeding issues. Australian New Zealand Clinical Trials Registry: ACTRN12614001091695.

Bilingual Text4Walking Food Service Employee Intervention Pilot Study

PubMed Central

Ingram, Diana; Wilbur, JoEllen; Fogg, Louis; Sandi, Giselle; Moss, Angela; Ocampo, Edith V

2016-01-01

Background Half of all adults in the United States do not meet the level of recommended aerobic physical activity. Physical activity interventions are now being conducted in the workplace. Accessible technology, in the form of widespread usage of cell phones and text messaging, is available for promoting physical activity. Objective The purposes of this study, which was conducted in the workplace, were to determine (1) the feasibility of implementing a bilingual 12-week Text4Walking intervention and (2) the effect of the Text4Walking intervention on change in physical activity and health status in a food service employee population. Methods Before conducting the study reported here, the Text4Walking research team developed a database of motivational physical activity text messages in English. Because Hispanic or Latino adults compose one-quarter of all adults employed in the food service industry, the Text4Walking team translated the physical activity text messages into Spanish. This pilot study was guided by the Physical Activity Health Promotion Framework and used a 1-group 12-week pre- and posttest design with food service employees who self-reported as being sedentary. The aim of the study was to increase the number of daily steps over the baseline by 3000 steps. Three physical activity text messages were delivered weekly. In addition, participants received 3 motivational calls during the study. Results SPSS version 19.0 and R 3.0 were used to perform the data analysis. There were 33 employees who participated in the study (57.6% female), with a mean age of 43.7 years (SD 8.4). The study included 11 Hispanic or Latino participants, 8 of whom requested that the study be delivered in Spanish. There was a 100% retention rate in the study. At baseline, the participants walked 102 (SD 138) minutes/day (per self-report). This rate increased significantly (P=.008) to 182 (SD 219) minutes/day over the course of the study. The participants had a baseline mean of 10,416 (SD 5097) steps, which also increased significantly (P=.017) to 12,540 (SD 5149). They significantly improved their performance on their aerobic fitness test (P<.001). The participants had a baseline mean systolic blood pressure of 120 mm Hg and diastolic blood pressure of 76 mm Hg, a mean body mass index of 29.29 kg/m2, and a mean waist circumference of 36.95 inches, without significant changes seen at 12 weeks. Conclusions We were able to conduct a motivational physical activity text messaging intervention within the workplace setting. Both physical activity and aerobic fitness improved. However, at baseline, participants were more active than they perceived themselves to be. Although there is insufficient evidence to draw strong conclusions about the study findings, it would be useful to test this physical activity text messaging intervention in a sedentary sample within a larger workplace intervention study trial conducted over a longer time frame. PMID:27251878

Bilingual Text4Walking Food Service Employee Intervention Pilot Study.

PubMed

Buchholz, Susan Weber; Ingram, Diana; Wilbur, JoEllen; Fogg, Louis; Sandi, Giselle; Moss, Angela; Ocampo, Edith V

2016-06-01

Half of all adults in the United States do not meet the level of recommended aerobic physical activity. Physical activity interventions are now being conducted in the workplace. Accessible technology, in the form of widespread usage of cell phones and text messaging, is available for promoting physical activity. The purposes of this study, which was conducted in the workplace, were to determine (1) the feasibility of implementing a bilingual 12-week Text4Walking intervention and (2) the effect of the Text4Walking intervention on change in physical activity and health status in a food service employee population. Before conducting the study reported here, the Text4Walking research team developed a database of motivational physical activity text messages in English. Because Hispanic or Latino adults compose one-quarter of all adults employed in the food service industry, the Text4Walking team translated the physical activity text messages into Spanish. This pilot study was guided by the Physical Activity Health Promotion Framework and used a 1-group 12-week pre- and posttest design with food service employees who self-reported as being sedentary. The aim of the study was to increase the number of daily steps over the baseline by 3000 steps. Three physical activity text messages were delivered weekly. In addition, participants received 3 motivational calls during the study. SPSS version 19.0 and R 3.0 were used to perform the data analysis. There were 33 employees who participated in the study (57.6% female), with a mean age of 43.7 years (SD 8.4). The study included 11 Hispanic or Latino participants, 8 of whom requested that the study be delivered in Spanish. There was a 100% retention rate in the study. At baseline, the participants walked 102 (SD 138) minutes/day (per self-report). This rate increased significantly (P=.008) to 182 (SD 219) minutes/day over the course of the study. The participants had a baseline mean of 10,416 (SD 5097) steps, which also increased significantly (P=.017) to 12,540 (SD 5149). They significantly improved their performance on their aerobic fitness test (P<.001). The participants had a baseline mean systolic blood pressure of 120 mm Hg and diastolic blood pressure of 76 mm Hg, a mean body mass index of 29.29 kg/m2, and a mean waist circumference of 36.95 inches, without significant changes seen at 12 weeks. We were able to conduct a motivational physical activity text messaging intervention within the workplace setting. Both physical activity and aerobic fitness improved. However, at baseline, participants were more active than they perceived themselves to be. Although there is insufficient evidence to draw strong conclusions about the study findings, it would be useful to test this physical activity text messaging intervention in a sedentary sample within a larger workplace intervention study trial conducted over a longer time frame.

Text to Quit China: An mHealth Smoking Cessation Trial

PubMed Central

Augustson, Erik; Engelgau, Michael M.; Zhang, Shu; Cai, Ying; Cher, Willie; Li, Richun; Jiang, Yuan; Lynch, Krystal; Bromberg, Julie E.

2015-01-01

Purpose To assess the feasibility, acceptability, and efficacy of a text message–based smoking cessation intervention in China. Design Randomized control trial with a 6-month follow-up assessment of smoking status. Setting Zhejiang, Heilongjiang, and Shaanxi provinces in China. Subjects 8,000 adult smokers in China who use Nokia Life Tools and participated in Phase II (smoking education via text message) of the study. Intervention High Frequency Text Contact (HFTC) group received one to three messages daily containing smoking cessation advice, encouragement, and health education information. Low Frequency Text Contact (LFTC) group received one weekly message with smoking health effects information. Measures Our primary outcome was smoking status 0, 1, 3, and 6 months post-intervention. Secondary outcomes include participant perceptions of the HFTC intervention, and factors associated with smoking cessation among HFTC participants. Analysis Descriptive and chi-square analyses were conducted to assess smoking status and acceptability. Factors associated with quitting were assessed using multiple logistic regression analyses. Results Quit rates were high in both HFTC and LFTC groups (HFTC: 0 month 27.9%, 1 month 30.5%, 3 months 26.7%, 6 months 27.7%; LFTC: 0 month 26.7%, 1 month 30.4%, 3 months 28.1%, 6 months 27.7), with no significant difference between the two groups in an intent-to-treat analysis. Attitudes towards the HFTC intervention were largely positive. Conclusion Our findings suggest that a text message–based smoking cessation intervention can be successfully delivered in China and is acceptable to Chinese smokers, but further research is needed to assess the potential impact of this type of intervention. PMID:26730560

Web App- and Text Message-Based Patient Education in Mohs Micrographic Surgery-A Randomized Controlled Trial.

PubMed

Hawkins, Spencer D; Koch, Sarah B; Williford, Phillip M; Feldman, Steven R; Pearce, Daniel J

2018-07-01

Consent and wound care (WC) videos are used for education in Mohs micrographic surgery (MMS). Postoperative text messaging is poorly studied. Develop and evaluate perioperative resources for MMS patients-video modules (DermPatientEd.com) and postoperative text messaging (DermTexts.com). A study was conducted on 90 MMS patients. Patients were randomized 1:1:1:1 to videos with text messages, videos-only, text messages-only, or control. Primary outcomes included preoperative anxiety and knowledge of MMS and postoperative care. The secondary outcome included helpfulness/preference of interventions. Patients experienced a 19% reduction in anxiety as measured by a visual analog scale after the MMS video (p = .00062). There was no difference in knowledge after the WC video (p = .21498). Patients were more likely to report the WC video "very helpful" when compared with the pamphlet in understanding postoperative WC (p = .0016). Patients in text messaging groups were not more likely to report the service as "very helpful" when compared with the pamphlet (p = .3566), but preferred to receive WC instructions by text message for future visits (p = .0001). These resources proved helpful and effective in reducing preoperative anxiety. Patients prefer text message-based WC instructions over pamphlets after experiencing the service, but do not find them more helpful.

Improving treatment adherence for blood pressure lowering via mobile phone SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence SuppoRt (StAR) trial.

PubMed

Leon, Natalie; Surender, Rebecca; Bobrow, Kirsty; Muller, Jocelyn; Farmer, Andrew

2015-07-03

Effective use of proven treatments for high blood pressure, a preventable health risk, is challenging for many patients. Prompts via mobile phone SMS-text messaging may improve adherence to clinic visits and treatment, though more research is needed on impact and patient perceptions of such support interventions, especially in low-resource settings. An individually-randomised controlled trial in a primary care clinic in Cape Town (2012-14), tested the effect of an adherence support intervention delivered via SMS-texts, on blood pressure control and adherence to medication, for hypertensive patients. ( ClinicalTrials.gov NCT02019823). We report on a qualitative evaluation that explored the trial participants' experiences and responses to the SMS-text messages, and identified barriers and facilitators to delivering adherence support via patients' own mobile phones. Two focus groups and fifteen individual interviews were conducted. We used comparative and thematic analysis approaches to identify themes and triangulated our analysis amongst three researchers. Most participants were comfortable with the technology of using SMS-text messages. Messages were experienced as acceptable, relevant and useful to a broad range of participants. The SMS-content, the respectful tone and the delivery (timing of reminders and frequency) and the relational aspect of trial participation (feeling cared for) were all highly valued. A subgroup who benefitted the most, were those who had been struggling with adherence due to high levels of personal stress. The intervention appeared to coincide with their readiness for change, and provided practical and emotional support for improving adherence behaviour. Change may have been facilitated through increased acknowledgement of their health status and attitudinal change towards greater self-responsibility. Complex interaction of psycho-social stressors and health service problems were reported as broader challenges to adherence behaviours. Adherence support for treatment of raised blood pressure, delivered via SMS-text message on the patient's own phone, was found to be acceptable, relevant and helpful, even for those who already had their own reminder systems in place. Our findings begin to identify for whom and what core elements of the SMS-text message intervention appear to work best in a low-resource operational setting, issues that future research should explore in greater depth.

A Theory-Based Video Messaging Mobile Phone Intervention for Smoking Cessation: Randomized Controlled Trial

PubMed Central

Dorey, Enid; Bramley, Dale; Bullen, Chris; Denny, Simon; Elley, C Raina; Maddison, Ralph; McRobbie, Hayden; Parag, Varsha; Rodgers, Anthony; Salmon, Penny

2011-01-01

Background Advances in technology allowed the development of a novel smoking cessation program delivered by video messages sent to mobile phones. This social cognitive theory-based intervention (called “STUB IT”) used observational learning via short video diary messages from role models going through the quitting process to teach behavioral change techniques. Objective The objective of our study was to assess the effectiveness of a multimedia mobile phone intervention for smoking cessation. Methods A randomized controlled trial was conducted with 6-month follow-up. Participants had to be 16 years of age or over, be current daily smokers, be ready to quit, and have a video message-capable phone. Recruitment targeted younger adults predominantly through radio and online advertising. Registration and data collection were completed online, prompted by text messages. The intervention group received an automated package of video and text messages over 6 months that was tailored to self-selected quit date, role model, and timing of messages. Extra messages were available on demand to beat cravings and address lapses. The control group also set a quit date and received a general health video message sent to their phone every 2 weeks. Results The target sample size was not achieved due to difficulty recruiting young adult quitters. Of the 226 randomized participants, 47% (107/226) were female and 24% (54/226) were Maori (indigenous population of New Zealand). Their mean age was 27 years (SD 8.7), and there was a high level of nicotine addiction. Continuous abstinence at 6 months was 26.4% (29/110) in the intervention group and 27.6% (32/116) in the control group (P = .8). Feedback from participants indicated that the support provided by the video role models was important and appreciated. Conclusions This study was not able to demonstrate a statistically significant effect of the complex video messaging mobile phone intervention compared with simple general health video messages via mobile phone. However, there was sufficient positive feedback about the ease of use of this novel intervention, and the support obtained by observing the role model video messages, to warrant further investigation. Trial registration Australian New Zealand Clinical Trials Registry Number: ACTRN12606000476538; http://www.anzctr.org.au/trial_view.aspx?ID=81688 (Archived by WebCite at http://www.webcitation.org/5umMU4sZi) PMID:21371991

A theory-based video messaging mobile phone intervention for smoking cessation: randomized controlled trial.

PubMed

Whittaker, Robyn; Dorey, Enid; Bramley, Dale; Bullen, Chris; Denny, Simon; Elley, C Raina; Maddison, Ralph; McRobbie, Hayden; Parag, Varsha; Rodgers, Anthony; Salmon, Penny

2011-01-21

Advances in technology allowed the development of a novel smoking cessation program delivered by video messages sent to mobile phones. This social cognitive theory-based intervention (called "STUB IT") used observational learning via short video diary messages from role models going through the quitting process to teach behavioral change techniques. The objective of our study was to assess the effectiveness of a multimedia mobile phone intervention for smoking cessation. A randomized controlled trial was conducted with 6-month follow-up. Participants had to be 16 years of age or over, be current daily smokers, be ready to quit, and have a video message-capable phone. Recruitment targeted younger adults predominantly through radio and online advertising. Registration and data collection were completed online, prompted by text messages. The intervention group received an automated package of video and text messages over 6 months that was tailored to self-selected quit date, role model, and timing of messages. Extra messages were available on demand to beat cravings and address lapses. The control group also set a quit date and received a general health video message sent to their phone every 2 weeks. The target sample size was not achieved due to difficulty recruiting young adult quitters. Of the 226 randomized participants, 47% (107/226) were female and 24% (54/226) were Maori (indigenous population of New Zealand). Their mean age was 27 years (SD 8.7), and there was a high level of nicotine addiction. Continuous abstinence at 6 months was 26.4% (29/110) in the intervention group and 27.6% (32/116) in the control group (P = .8). Feedback from participants indicated that the support provided by the video role models was important and appreciated. This study was not able to demonstrate a statistically significant effect of the complex video messaging mobile phone intervention compared with simple general health video messages via mobile phone. However, there was sufficient positive feedback about the ease of use of this novel intervention, and the support obtained by observing the role model video messages, to warrant further investigation. Australian New Zealand Clinical Trials Registry Number: ACTRN12606000476538; http://www.anzctr.org.au/trial_view.aspx?ID=81688 (Archived by WebCite at http://www.webcitation.org/5umMU4sZi).

Change In Length of Stay and Readmissions among Hospitalized Medical Patients after Inpatient Medicine Service Adoption of Mobile Secure Text Messaging.

PubMed

Patel, Mitesh S; Patel, Neha; Small, Dylan S; Rosin, Roy; Rohrbach, Jeffrey I; Stromberg, Nathaniel; Hanson, C William; Asch, David A

2016-08-01

Changes in the medium of communication from paging to mobile secure text messaging may change clinical care, but the effects of these changes on patient outcomes have not been well examined. To evaluate the association between inpatient medicine service adoption of mobile secure text messaging and patient length of stay and readmissions. Observational study. Patients admitted to medicine services at the Hospital of the University of Pennsylvania (intervention site; n = 8995 admissions of 6484 patients) and Penn Presbyterian Medical Center (control site; n = 6799 admissions of 4977 patients) between May 1, 2012, and April 30, 2014. Mobile secure text messaging. Change in length of stay and 30-day readmissions, comparing patients at the intervention site to the control site before (May 1, 2012 to April 30, 2013) and after (May 1, 2013 to April 30, 2014) the intervention, adjusting for time trends and patient demographics, comorbidities, insurance, and disposition. During the pre-intervention period, the mean length of stay ranged from 4.0 to 5.0 days at the control site and from 5.2 to 6.7 days at the intervention site, but trends were similar. In the first month after the intervention, the mean length of stay was unchanged at the control site (4.7 to 4.7 days) but declined at the intervention site (6.0 to 5.4 days). Trends were mostly similar during the rest of the post-intervention period, ranging from 4.4 to 5.6 days at the control site and from 5.4 to 6.5 days at the intervention site. Readmission rates varied significantly within sites before and after the intervention, but overall trends were similar. In adjusted analyses, there was a significant decrease in length of stay for the intervention site relative to the control site during the post-intervention period compared to the pre-intervention period (-0.77 days ; 95 % CI, -1.14, -0.40; P < 0.001). There was no significant difference in the odds of readmission (OR, 0.97; 95 % CI: 0.81, 1.17; P = 0.77). These findings were supported by multiple sensitivity analyses. Compared to a control group over time, hospitalized medical patients on inpatient services whose care providers and staff were offered mobile secure text messaging showed a relative decrease in length of stay and no change in readmissions.

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention

PubMed Central

Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-01-01

Abstract Introduction: SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Methods: Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Results: Three main themes were identified: “impact”, “approach,” and “optimization.” Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Conclusion: Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. Implications: This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants’ desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. PMID:28403457

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention.

PubMed

Sloan, Melanie; Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-05-01

SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Three main themes were identified: "impact", "approach," and "optimization." Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants' desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

mHealth Pilot Study: Text Messaging Intervention to Promote HPV Vaccination

PubMed Central

Lee, Hee Yun; Koopmeiners, Joseph S.; McHugh, Jennifer; Raveis, Victoria H.; Ahluwalia, Jasjit S.

2016-01-01

Objectives To test the feasibility and efficacy of a culturally-tailored mobile health intervention designed to increase knowledge about, intent to obtain, and receipt of the HPV vaccine. Methods A 7-day text message HPV intervention was developed using a quasi-experimental research design for 30 Korean-American women. Results Participants demonstrated significant increases in knowledge of HPV with an intent to get vaccinated within one year, and 30% of participants received the first dose of the HPV vaccine. Conclusions Mobile health technology could be a promising tool in reducing the cancer burden for underserved populations. PMID:26685815

Mobile MyPlate: A Pilot Study Using Text Messaging to Provide Nutrition Education and Promote Better Dietary Choices in College Students

ERIC Educational Resources Information Center

Brown, Onikia N.; O'Connor, Lauren E.; Savaiano, Dennis

2014-01-01

Objective: To evaluate the acceptance and effectiveness of repetitive nutrition-related text messages on college students' nutrition knowledge and fruit and vegetable consumption. Participants: One hundred fifty undergraduate (18-24 years old) non-health major students with a texting mobile phone. Methods: The intervention group received biweekly…

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study

PubMed Central

Mays, Darren

2016-01-01

Background Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. Objective The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. Methods We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Results Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t6=–2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t20=1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. Conclusions This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. PMID:28007691

Design and Feasibility of a Text Messaging Intervention to Prevent Indoor Tanning Among Young Adult Women: A Pilot Study.

PubMed

Evans, William D; Mays, Darren

2016-12-22

Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages. The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs. We conducted a pilot study of indoor tanning prevention messages delivered via mobile phone text messaging in a sample of 21 young adult women who indoor tan. Participants completed baseline measures, were randomly assigned to receive gain-, loss-, or balanced-framed text messages, and completed postexposure outcome measures on indoor tanning cognitions and behaviors. Participants received daily mobile phone indoor tanning prevention text messages for 1 week and completed the same postexposure measures as at baseline. Over the 1-week period there were trends or significant changes after receipt of the text messages, including increased perceived susceptibility (P<.001), response efficacy beliefs (P<.001), and message receptivity (P=.03). Ordinary least squares stepwise linear regression models showed an effect of text message exposure on self-efficacy to quit indoor tanning (t 6 =-2.475, P<.02). Ordinary least squares linear regression including all measured scales showed a marginal effect of SMS texts on self-efficacy (t 20 =1.905, P=.08). Participants endorsed highly favorable views toward the text messaging protocol. This study supports this use of mobile text messaging as an indoor tanning prevention strategy. Given the nature of skin cancer risk perceptions, the addition of multimedia messaging service is another area of potential innovation for disseminating indoor tanning prevention messages. ©William Evans, Darren Mays. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 22.12.2016.

Mobile phone-based interventions for improving contraception use.

PubMed

Smith, Chris; Gold, Judy; Ngo, Thoai D; Sumpter, Colin; Free, Caroline

2015-06-26

Contraception provides significant benefits for women's and children's health, yet an estimated 225 million women had an unmet need for modern contraceptive methods in 2014. Interventions delivered by mobile phone have been demonstrated to be effective in other health areas, but their effects on use of contraception have not been established. To assess the effects of mobile phone-based interventions for improving contraception use. We searched for randomised controlled trials (RCTs) of client-provider interventions delivered by mobile phone to improve contraception use compared with standard care or another intervention. We searched the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Global Health, PsycINFO, POPLINE, Africa-Wide Information and Latin American Caribbean Health Sciences Literature (LILACS) from January 1993 to October 2014, as well as clinical trials registries, online mHealth resources and abstracts from key conferences. Randomised controlled trials of mobile phone-based interventions to improve any form of contraception use amongst users or potential users of contraception. Outcome measures included uptake of contraception, measures of adherence, pregnancy and abortion. Two review authors independently screened titles and abstracts of studies retrieved using the search strategy and extracted data from the included studies. We calculated the Mantel-Haenszel risk ratio (RR) for dichotomous outcomes and the mean difference (MD) for continuous outcomes, together with 95% confidence intervals (CIs). Differences in interventions and outcome measures did not permit us to undertake meta-analysis. Five RCTs met our inclusion criteria. Three trials aimed to improve adherence to a specific method of contraception amongst existing or new contraception users by comparing automated text message interventions versus standard care. Two trials aimed to improve both uptake and adherence, not limited to one method, in both users and non-users of contraception. No trials were at low risk of bias in all areas assessed.One trial in the USA reported improved self reported oral contraceptive (OC) continuation at six months from an intervention comprising a range of uni-directional and interactive text messages (RR 1.19, 95% CI 1.05 to 1.35). One trial in Cambodia reported increased self reported use of effective contraception at four months post abortion from an intervention comprising automated interactive voice messages and phone counsellor support (RR 1.39, 95% CI 1.17 to 1.66).One feasibility trial in the USA reported a lower mean number of days between scheduled and completed attendance for the first but not subsequent Depo-Provera appointments using clinic records from an intervention comprising reminders and healthy self management text messages (mean difference (MD) -8.60 days, 95% CI -16.74 to -0.46). Simple text message OC reminders had no effect on missed pills as assessed by electronic medication monitoring in a small trial in the USA (MD 0.5 missed pills, 95% CI -1.08 to 2.08). No effect on self reported contraception use was noted amongst isotretinoin users from an intervention that provided health information via two uni-directional text messages and mail (RR 1.26, 95% CI 0.84 to 1.89). One trial assessed potential adverse effects of the intervention and reported no evidence of road traffic accidents or domestic abuse. Our review provides limited evidence that interventions delivered by mobile phone can improve contraception use. Whilst evidence suggests that a series of interactive voice messages and counsellor support can improve post-abortion contraception, and that a mixture of uni-directional and interactive daily educational text messages can improve OC adherence, the cost-effectiveness and long-term effects of these interventions remain unknown. Further high-quality trials are required to robustly establish the effects of interventions delivered by mobile phone to improve contraception use.

Can Text Messages Increase Empathy and Prosocial Behavior? The Development and Initial Validation of Text to Connect.

PubMed

Konrath, Sara; Falk, Emily; Fuhrel-Forbis, Andrea; Liu, Mary; Swain, James; Tolman, Richard; Cunningham, Rebecca; Walton, Maureen

2015-01-01

To what extent can simple mental exercises cause shifts in empathic habits? Can we use mobile technology to make people more empathic? It may depend on how empathy is measured. Scholars have identified a number of different facets and correlates of empathy. This study is among the first to take a comprehensive, multidimensional approach to empathy to determine how empathy training could affect these different facets and correlates. In doing so, we can learn more about empathy and its multifaceted nature. Participants (N = 90) were randomly assigned to receive either an empathy-building text message program (Text to Connect) or one of two control conditions (active versus passive). Respondents completed measures of dispositional empathy (i.e. self-perceptions of being an empathic person), affective empathy (i.e. motivations to help, immediate feelings of empathic concern), and prosocial behavior (i.e. self-reports and observer-reports) at baseline, and then again after the 14 day intervention period. We found that empathy-building messages increased affective indicators of empathy and prosocial behaviors, but actually decreased self-perceptions of empathy, relative to control messages. Although the brief text messaging intervention did not consistently impact empathy-related personality traits, it holds promise for the use of mobile technology for changing empathic motivations and behaviors.

Can Text Messages Increase Empathy and Prosocial Behavior? The Development and Initial Validation of Text to Connect

PubMed Central

Konrath, Sara; Falk, Emily; Fuhrel-Forbis, Andrea; Liu, Mary; Swain, James; Tolman, Richard; Cunningham, Rebecca; Walton, Maureen

2015-01-01

To what extent can simple mental exercises cause shifts in empathic habits? Can we use mobile technology to make people more empathic? It may depend on how empathy is measured. Scholars have identified a number of different facets and correlates of empathy. This study is among the first to take a comprehensive, multidimensional approach to empathy to determine how empathy training could affect these different facets and correlates. In doing so, we can learn more about empathy and its multifaceted nature. Participants (N = 90) were randomly assigned to receive either an empathy-building text message program (Text to Connect) or one of two control conditions (active versus passive). Respondents completed measures of dispositional empathy (i.e. self-perceptions of being an empathic person), affective empathy (i.e. motivations to help, immediate feelings of empathic concern), and prosocial behavior (i.e. self-reports and observer-reports) at baseline, and then again after the 14 day intervention period. We found that empathy-building messages increased affective indicators of empathy and prosocial behaviors, but actually decreased self-perceptions of empathy, relative to control messages. Although the brief text messaging intervention did not consistently impact empathy-related personality traits, it holds promise for the use of mobile technology for changing empathic motivations and behaviors. PMID:26356504

Text Messaging and Mobile Phone Apps as Interventions to Improve Adherence in Adolescents With Chronic Health Conditions: A Systematic Review

PubMed Central

Barrera, Leonardo; Sinno, Mohamad G; Kaviany, Saara; O’Dwyer, Linda C; Kuhns, Lisa M

2017-01-01

Background The number of adolescents with chronic health conditions (CHCs) continues to increase. Medication nonadherence is a global challenge among adolescents across chronic conditions and is associated with poor health outcomes. While there has been growing interest in the use of mHealth technology to improve medication adherence among adolescents with CHCs, particularly text messaging and mobile phone apps, there has been no prior systematic review of their efficacy. Objective The purpose of this review was to systematically evaluate the most recent evidence for the efficacy of text messaging and mobile phone apps as interventions to promote medication adherence among adolescents with CHCs. Methods PubMed, Embase, CENTRAL, PsycINFO, Web of Science, Google Scholar, and additional databases were searched from 1995 until November 2015. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. The Preferred Reporting Results of Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data from included articles, and assessed their quality using Grades of Recommendation, Assessment, Development, and Evaluation criteria. Included studies were described in original research articles that targeted adherence in adolescents with CHCs (12-24 years-old). Results Of the 1423 records examined, 15 met predefined criteria: text messaging (n=12) and mobile phone apps (n=3). Most studies were performed in the United States (11/15, 73%), were randomized-controlled trials (8/15, 53%), had a sample size <50 (11/15, 73%), and included adherence self-report and/or biomarkers (9/15, 60%). Only four studies were designed based on a theoretical framework. Approaches for text messaging and mobile phone app interventions varied across studies. Seven articles (7/15, 47%) reported significant improvement in adherence with moderate to large standardized mean differences. Most of the included studies were of low or moderate quality. Studies varied in sample size, methods of adherence assessment, and definition of adherence, which prohibited performing a meta-analysis. Conclusions The use of text messaging and mobile phone app interventions to improve medication adherence among adolescents with CHCs has shown promising feasibility and acceptability, and there is modest evidence to support the efficacy of these interventions. Further evaluation of short- and long-term efficacy and cost-effectiveness of these interventions is warranted given the early and evolving state of the science. PMID:28506955

Text Messaging and Mobile Phone Apps as Interventions to Improve Adherence in Adolescents With Chronic Health Conditions: A Systematic Review.

PubMed

Badawy, Sherif M; Barrera, Leonardo; Sinno, Mohamad G; Kaviany, Saara; O'Dwyer, Linda C; Kuhns, Lisa M

2017-05-15

The number of adolescents with chronic health conditions (CHCs) continues to increase. Medication nonadherence is a global challenge among adolescents across chronic conditions and is associated with poor health outcomes. While there has been growing interest in the use of mHealth technology to improve medication adherence among adolescents with CHCs, particularly text messaging and mobile phone apps, there has been no prior systematic review of their efficacy. The purpose of this review was to systematically evaluate the most recent evidence for the efficacy of text messaging and mobile phone apps as interventions to promote medication adherence among adolescents with CHCs. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, Google Scholar, and additional databases were searched from 1995 until November 2015. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. The Preferred Reporting Results of Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data from included articles, and assessed their quality using Grades of Recommendation, Assessment, Development, and Evaluation criteria. Included studies were described in original research articles that targeted adherence in adolescents with CHCs (12-24 years-old). Of the 1423 records examined, 15 met predefined criteria: text messaging (n=12) and mobile phone apps (n=3). Most studies were performed in the United States (11/15, 73%), were randomized-controlled trials (8/15, 53%), had a sample size <50 (11/15, 73%), and included adherence self-report and/or biomarkers (9/15, 60%). Only four studies were designed based on a theoretical framework. Approaches for text messaging and mobile phone app interventions varied across studies. Seven articles (7/15, 47%) reported significant improvement in adherence with moderate to large standardized mean differences. Most of the included studies were of low or moderate quality. Studies varied in sample size, methods of adherence assessment, and definition of adherence, which prohibited performing a meta-analysis. The use of text messaging and mobile phone app interventions to improve medication adherence among adolescents with CHCs has shown promising feasibility and acceptability, and there is modest evidence to support the efficacy of these interventions. Further evaluation of short- and long-term efficacy and cost-effectiveness of these interventions is warranted given the early and evolving state of the science. ©Sherif M Badawy, Leonardo Barrera, Mohamad G Sinno, Saara Kaviany, Linda C O’Dwyer, Lisa M Kuhns. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.05.2017.

The Mobile Solutions for Immunization (M-SIMU) Trial: A Protocol for a Cluster Randomized Controlled Trial That Assesses the Impact of Mobile Phone Delivered Reminders and Travel Subsidies to Improve Childhood Immunization Coverage Rates and Timeliness in Western Kenya.

PubMed

Gibson, Dustin G; Kagucia, E Wangeci; Ochieng, Benard; Hariharan, Nisha; Obor, David; Moulton, Lawrence H; Winch, Peter J; Levine, Orin S; Odhiambo, Frank; O'Brien, Katherine L; Feikin, Daniel R

2016-05-17

Text message (short message service, SMS) reminders and incentives are two demand-side interventions that have been shown to improve health care-seeking behaviors by targeting participant characteristics such as forgetfulness, lack of knowledge, and transport costs. Applying these interventions to routine pediatric immunizations may improve vaccination coverage and timeliness. The Mobile Solutions for Immunization (M-SIMU) trial aims to determine if text message reminders, either with or without mobile phone-based incentives, sent to infant's parents can improve immunization coverage and timeliness of routine pediatric vaccines in rural western Kenya. This is a four-arm, cluster, randomized controlled trial. Villages are randomized to one of four study arms prior to enrollment of participants. The study arms are: (1) no intervention (a general health-related text message will be texted to this group at the time of enrollment), (2) text message reminders only, (3) text message reminders and a 75 Kenyan Shilling (KES) incentive, or (4) text message reminders and a KES200 incentive. Participants assigned to study arms 2-4 will receive two text message reminders; sent 3 days before and one day before the scheduled immunization visit at 6, 10, and 14 weeks for polio and pentavalent (containing diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenza type b antigens) type b antigens) vaccines, and at 9 months for measles vaccine. Participants in incentive arms will, in addition to text message reminders as above, receive mobile phone-based incentives after each timely vaccination, where timely is defined as vaccination within 2 weeks of the scheduled date for each of the four routine expanded program immunization (EPI) vaccination visits. Mother-infant pairs will be followed to 12 months of age where the primary outcome, a fully immunized child, will be ascertained. A fully immunized child is defined as a child receiving vaccines for bacille Calmette-Guerin, three doses of pentavalent and polio, and measles by 12 months of age. General estimating equation (GEE) models that account for clustering will be employed for primary outcome analyses. Enrollment was completed in October 2014. Twelve month follow-up visits to ascertain immunization status from the maternal and child health booklet were completed in February 2016. This is one of the first studies to examine the effect of text message reminders on immunization coverage and timeliness in a lower income country and is the first study to assess the effect of mobile money-based incentives to improve immunization coverage. Clinicaltrials.gov NCT01878435; https://clinicaltrials.gov/ct2/show/NCT01878435 (Archived by WebCite at http://www.webcitation.org/6hQlwGYJR).

Text messaging reminders for influenza vaccine in primary care: protocol for a cluster randomised controlled trial (TXT4FLUJAB).

PubMed

Herrett, Emily; van Staa, Tjeerd; Free, Caroline; Smeeth, Liam

2014-05-02

The UK government recommends that at least 75% of people aged under 64 with certain conditions receive an annual influenza vaccination. Primary care practices often fall short of this target and strategies to increase vaccine uptake are required. Text messaging reminders are already used in 30% of practices to remind patients about vaccination, but there has been no trial addressing their effectiveness in increasing influenza vaccine uptake in the UK. The aims of the study are (1) to develop the methodology for conducting cluster randomised trials of text messaging interventions utilising routine electronic health records and (2) to assess the effectiveness of using a text messaging influenza vaccine reminder in achieving an increase in influenza vaccine uptake in patients aged 18-64 with chronic conditions, compared with standard care. This cluster randomised trial will recruit general practices across three settings in English primary care (Clinical Practice Research Datalink, ResearchOne and London iPLATO text messaging software users) and randomise them to either standard care or a text messaging campaign to eligible patients. Flu vaccine uptake will be ascertained using routinely collected, anonymised electronic patient records. This protocol outlines the proposed study design and analysis methods. This study will determine the effectiveness of text messaging vaccine reminders in primary care in increasing influenza vaccine uptake, and will strengthen the methodology for using electronic health records in cluster randomised trials of text messaging interventions. This trial was approved by the Surrey Borders Ethics Committee (13/LO/0872). The trial results will be disseminated at national conferences and published in a peer-reviewed medical journal. The results will also be distributed to the Primary Care Research Network and to all participating general practices. This study is registered at controlled-trials.com ISRCTN48840025, July 2013.

Effect of an interactive text-messaging service on patient retention during the first year of HIV care in Kenya (WelTel Retain): an open-label, randomised parallel-group study.

PubMed

van der Kop, Mia Liisa; Muhula, Samuel; Nagide, Patrick I; Thabane, Lehana; Gelmon, Lawrence; Awiti, Patricia Opondo; Abunah, Bonface; Kyomuhangi, Lennie Bazira; Budd, Matthew A; Marra, Carlo; Patel, Anik; Karanja, Sarah; Ojakaa, David I; Mills, Edward J; Ekström, Anna Mia; Lester, Richard Todd

2018-03-01

Retention of patients in HIV care is crucial to ensure timely treatment initiation, viral suppression, and to avert AIDS-related deaths. We did a randomised trial to determine whether a text-messaging intervention improved retention during the first year of HIV care. This unmasked, randomised parallel-group study was done at two clinics in informal settlements in Nairobi, Kenya. Eligible participants were aged 18 years or older, HIV-positive, had their own mobile phone or access to one, and were able to use simple text messaging (or have somebody who could text message on their behalf). Participants were randomly assigned (1:1), with random block sizes of 2, 4, and 6, to the intervention or control group. Participants in the intervention group received a weekly text message from the automated WelTel service for 1 year and were asked to respond within 48 h. Participants in the control group did not receive text messages. Participants in both groups received usual care, which comprised psychosocial support and counselling; patient education; CD4 cell count; treatment; screening for tuberculosis, opportunistic infections, and sexually transmitted infections; prevention of mother-to-child transmission and family planning services; and up to two telephone calls for missed appointments. The primary outcome was retention in care at 12 months (ie, clinic attendance 10-14 months after the first visit). Participants who did not attend this 12-month appointment were traced, and we considered as retained those who were confirmed to be active in care elsewhere. The data analyst and clinic staff were masked to the group assignment, whereas participants and research nurses were not. We analysed the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01630304. Between April 4, 2013, and June 4, 2015, we screened 1068 individuals, of whom 700 were recruited. 349 people were allocated to the intervention group and 351 to the control group. Participants were followed up for a median of 55 weeks (IQR 51-60). At 12 months, 277 (79%) of 349 participants in the intervention group were retained, compared with 285 (81%) of 351 participants in the control group (risk ratio 0·98, 95% CI 0·91-1·05; p=0·54). There was one mild adverse event related to the intervention, a domestic dispute that occurred when a participant's partner became suspicious of the weekly messages and follow-up calls. This weekly text-messaging service did not improve retention of people in early HIV care. The intervention might have a modest role in improving self-perceived health-related quality of life in individuals in HIV care in similar settings. National Institutes of Health and Canadian Institutes of Health Research Canadian HIV Trials Network. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Family TXT: Feasibility and Acceptability of a mHealth Obesity Prevention Program for Parents of Pre-Adolescent African American Girls.

PubMed

Callender, Chishinga; Thompson, Deborah

2018-06-19

Obesity prevalence is greater in African American girls than their non-Hispanic white peers. Obesity prevention programs are needed to help parents create an obesity-preventive home environment. This paper reports the feasibility and acceptability of a mHealth child obesity prevention program consisting of self-determination theory-grounded text messages promoting a healthy home food and activity environment to parents of 8⁻10-year-old African American girls. A one-group design with baseline and immediate post-intervention assessments was utilized. Mothers ( n = 19) received 36 text messages over 12 weeks. Feasibility and acceptability were assessed through staff logs and post-intervention surveys and an interview. Feasibility and acceptability criteria were met. Mothers reported positive reactions to the intervention; they liked the program, used the information, and all but one gave it an A or B grade. The majority made changes and shared the text messages with others. This research provides evidence that a theoretically grounded mHealth child obesity prevention intervention is feasible and acceptable to parents of African American girls.

Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population.

PubMed

Kerrison, R S; Shukla, H; Cunningham, D; Oyebode, O; Friedman, E

2015-03-17

There is a need for interventions to promote uptake of breast screening throughout Europe. We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01). Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.

SIAM (Suicide intervention assisted by messages): the development of a post-acute crisis text messaging outreach for suicide prevention.

PubMed

Berrouiguet, Sofian; Alavi, Zarrin; Vaiva, Guillaume; Courtet, Philippe; Baca-García, Enrique; Vidailhet, Pierre; Gravey, Michel; Guillodo, Elise; Brandt, Sara; Walter, Michel

2014-11-18

Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also effective in preventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self-harm, from emergency services or after a short hospitalization. Participants will be recruited over a 12-month period. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly. The text message enquires about the patients' well-being and includes information regarding individual sources of help and evidence-based self help strategies. Participants will be assessed at the baseline, month 6 and 13. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, the number of suicide attempts in the intervention and control groups at 6 and 13 month, the number of death by suicide in the intervention and control groups at month 6 and 13. In both groups, suicidal ideations, will be assessed at the baseline, month 6 and 13. Medical costs and satisfaction will be assessed at month 13. This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts. We propose to assess its efficacy in reducing suicide reattempt in the suicide attempter (SA) population. The study was registered on Clinical Trials Registry (clinicaltrials.gov): NCT02106949, registered on 06 June 2014.

Randomized controlled trial of a mobile phone intervention for improving adherence to naltrexone for alcohol use disorders.

PubMed

Stoner, Susan A; Arenella, Pamela B; Hendershot, Christian S

2015-01-01

Naltrexone is a front-line treatment for alcohol use disorders, but its efficacy is limited by poor medication adherence. This randomized controlled trial evaluated whether a mobile health intervention could improve naltrexone adherence. Treatment-seeking participants with an alcohol use disorder (N = 76) were randomized to intervention and control conditions. All participants received naltrexone (50 mg/day) with a medication event monitoring system (MEMS) and a prepaid smartphone, and received a daily text message querying medication side effects, alcohol use, and craving. Those in the intervention arm received additional medication reminders and adherence assessment via text message. The primary outcome, proportion of participants with adequate adherence (defined as ≥80% of prescribed doses taken through Week 8), did not differ between groups in intent-to-treat analyses (p = .34). Mean adherence at study midpoint (Week 4) was 83% in the intervention condition and 77% in the control condition (p = .35). Survival analysis found that the intervention group sustained adequate adherence significantly longer (M = 19 days [95% CI = 0.0-44.0]) than those in the control group (M = 3 days [95% CI = 0.0-8.1]) during the first month of treatment (p = .04). Medication adherence did not predict drinking outcomes. These results suggest that in the context of daily monitoring and assessment via cell phone, additional text message reminders do not further improve medication adherence. Although this initial trial does not provide support for the efficacy of text messaging to improve adherence to pharmacotherapy for alcohol use disorders, additional trials with larger samples and alternate designs are warranted. ClinicalTrials.gov: NCT01349985.

Patient perceptions of text-messages, email, and video in dermatologic surgery patients.

PubMed

Hawkins, Spencer D; Barilla, Steven; Williford, Phillip Williford M; Feldman, Steven R; Pearce, Daniel J

2017-04-14

We developed dermatology patient education videos and a post-operative text message service that could be accessed universally via web based applications. A secondary outcome of the study was to assess patient opinions of text-messages, email, and video in the health care setting which is reported here. An investigator-blinded, randomized, controlled intervention was evaluated in 90 nonmelanoma MMS patients at Wake Forest Baptist Dermatology. Patients were randomized 1:1:1:1 for exposure to: 1) videos with text messages, 2) videos only, 3) text messages-only, or 4) standard of care. Assessment measures were obtained by the use of REDCap survey questions during the follow up visit. 1) 67% would like to receive an email with information about the procedure beforehand 2) 98% of patients reported they would like other doctors to use educational videos as a form of patient education 3) 88% of our patients think it is appropriate for physicians to communicate to patients via text message in certain situations. Nearly all patients desired physicians to use text-messages and video in their practice and the majority of patients preferred to receive an email with information about their procedure beforehand.

Cluster randomized trial of text message reminders to retail staff in tanzanian drug shops dispensing artemether-lumefantrine: effect on dispenser knowledge and patient adherence.

PubMed

Bruxvoort, Katia; Festo, Charles; Kalolella, Admirabilis; Cairns, Matthew; Lyaruu, Peter; Kenani, Mitya; Kachur, S Patrick; Goodman, Catherine; Schellenberg, David

2014-10-01

Artemisinin combination therapies are available in private outlets, but patient adherence might be compromised by poor advice from dispensers. In this cluster randomized trial in drug shops in Tanzania, 42 of 82 selected shops were randomized to receive text message reminders about what advice to provide when dispensing artemether-lumefantrine (AL). Eligible patients purchasing AL at shops in both arms were followed up at home and questioned about each dose taken. Dispensers were interviewed regarding knowledge of AL dispensing practices and receipt of the malaria-related text messages. We interviewed 904 patients and 110 dispensers from 77 shops. Although there was some improvement in dispenser knowledge, there was no difference between arms in adherence measured as completion of all doses (intervention 68.3%, control 69.8%, p [adjusted] = 0.6), or as completion of each dose at the correct time (intervention 33.1%, control 32.6%, p [adjusted] = 0.9). Further studies on the potential of text messages to improve adherence are needed. © The American Society of Tropical Medicine and Hygiene.

Innovations in technology: social media and mobile technology in the care of adolescents with asthma.

PubMed

Nickels, Andrew; Dimov, Vesselin

2012-12-01

This literature review analyzed technological interventions in the adolescent asthmatic population. A PubMed search was performed with terms of asthma, adolescents, social media, Internet, website, mobile phone, text messaging, SMS, Facebook, Twitter, MySpace, and Technology during a 2.5-year period and identified 64 abstracts. Three studies fulfilled the criteria for adolescent intervention using Internet-based sites but did not provide evidence for effectiveness. Two studies focused on mobile technology. One study included text message reminders for controller medication use in asthma patients. Perceived usefulness, satisfaction, and ease of use of text messages were high, but there was no improvement in asthma control. The literature search did not find any studies exploring the use of smartphone applications or social media services. Current studies of technology use in adolescents with asthma do not provide consistent evidence of effectiveness. The positive attitude toward use of social media or mobile technology opens the possibility for future studies to further explore the potential benefits of such interventions.

Promoting Engagement With a Digital Health Intervention (HeLP-Diabetes) Using Email and Text Message Prompts: Mixed-Methods Study

PubMed Central

Modrow, Kerstin; Hamilton, Fiona; Pal, Kingshuk; Ross, Jamie

2017-01-01

Background Engagement with digital health interventions (DHIs) may be regarded as a prerequisite for the intervention to achieve positive health or behavior change outcomes. One method employed to promote engagement is the use of prompts such as emails and text messages. However, little is known about the characteristics of prompts that promote engagement. This study explored the association between the content and delivery mode of prompts and the users’ engagement with HeLP-Diabetes (Healthy Living for People with type 2 Diabetes), a DHI that aimed to promote self-management in adults with type 2 diabetes. Objective The objective of this study was to identify the characteristics of prompts, specifically the content and delivery mode, which were associated with increased engagement. Methods This was a mixed-methods study. Email and text message prompts were sent to the registered users of HeLP-Diabetes. Use of the intervention was recorded and examined to identify which email and text message prompts were associated with subsequent visits to the DHI. Characteristics of prompts that were identified as particularly effective or ineffective were explored through think-aloud interviews with the participants. Results Of a total of 39 email prompts, 49% (19/39) prompts showed a significant association with subsequent visits to the DHI. However, none of the text message prompts were associated with subsequent visits to the DHI. Furthermore, think-aloud interviews were carried out with 6 experienced participants with type 2 diabetes. The findings suggest that these participants preferred email prompts that were clear, relatively short, and empowering; used nondirective advice; included health professional references; were visually appealing; and contained news and updates. Conclusions The findings of this study contribute to the existing evidence supporting the role of email prompts in promoting and maintaining engagement with DHIs. This study described the content of prompts that may be engaging. However, the results should be interpreted with caution, as prompts may be context-specific interventions and the results may not be generalizable across other DHIs or other types of interventions targeting self-management of type 2 diabetes. PMID:28829328

Mobile Text Messaging to Improve Medication Adherence and Viral Load in a Vulnerable Canadian Population Living With Human Immunodeficiency Virus: A Repeated Measures Study.

PubMed

King, Elizabeth; Kinvig, Karen; Steif, Jonathan; Qiu, Annie Q; Maan, Evelyn J; Albert, Arianne Yk; Pick, Neora; Alimenti, Ariane; Kestler, Mary H; Money, Deborah M; Lester, Richard T; Murray, Melanie Caroline Margaret

2017-06-01

Combination antiretroviral therapy (cART) as treatment for human immunodeficiency virus (HIV) infection is effective and available, but poor medication adherence limits benefits, particularly in vulnerable populations. In a Kenyan randomized controlled trial, a weekly text-messaging intervention (WelTel) improved cART adherence and HIV viral load (VL). Despite growing evidence for short message service (SMS) text-message interventions in HIV care, there is a paucity of data utilizing these interventions in marginalized or female cohorts. This study was undertaken to assess whether the standardized WelTel SMS text-message intervention applied to a vulnerable, predominantly female, population improved cART adherence and VL. We conducted a repeated measures study of the WelTel intervention in high-risk HIV-positive persons by measuring change in VL, CD4 count, and self-reported adherence 12 months before and 12 months after the WelTel intervention was introduced. Inclusion criteria included VL ≥200 copies/mL, indication for treatment, and meeting vulnerability criteria. Participants were given a mobile phone with unlimited texting (where required), and weekly check-in text messages were sent for one year from the WelTel computer platform. Clinical data were collected for control and intervention years. Participants were followed by a multidisciplinary team in a clinical setting. Outcomes were assessed using Wilcoxon signed ranks tests for change in CD4 and VL from control year to study end and mixed-effects logistic regressions for change in cART adherence and appointment attendance. A secondary analysis was conducted to assess the effect of response rate on the outcome by modeling final log 10 VL by number of responses while controlling for mean log 10 VL in the control year. Eighty-five participants enrolled in the study, but 5 withdrew (final N=80). Participants were predominantly female (90%, 72/80) with a variety of vulnerabilities. Mean VL decreased from 1098 copies/mL in the control year to 439 copies/mL at study end (P=.004). Adherence to cART significantly improved (OR 1.14, IQR 1.10-1.18; P<.001), whereas appointment attendance decreased slightly with the intervention (OR 0.81, IQR 0.67-0.99; P=.03). A response was received for 46.57% (1753/3764) of messages sent and 9.62% (362/3764) of text messages sent were replied to with a problem. An outcome analysis examining relationship between reply rate and VL did not meet statistical significance (P=.07), but may be worthy of investigating further in a larger study. WelTel may be an effective tool for improving cART adherence and reducing VLs among high-risk, vulnerable HIV-positive persons. Clinicaltrials.gov NCT02603536; https://clinicaltrials.gov/ct2/show/NCT02603536 (Archived by WebCite at http://www.webcitation.org/6qK57zCwv). ©Elizabeth King, Karen Kinvig, Jonathan Steif, Annie Q Qiu, Evelyn J Maan, Arianne YK Albert, Neora Pick, Ariane Alimenti, Mary H Kestler, Deborah M Money, Richard T Lester, Melanie Caroline Margaret Murray. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.06.2017.

Texting and Mobile Phone App Interventions for Improving Adherence to Preventive Behavior in Adolescents: A Systematic Review.

PubMed

Badawy, Sherif M; Kuhns, Lisa M

2017-04-19

Many preventable behaviors contribute to adolescent mortality and morbidity. Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population. The widespread use of electronic communication technologies by adolescents, particularly the use of text messaging (short message service, SMS) and mobile phones, presents new opportunities to intervene on risk and preventive risk behavior, but little is known about their efficacy. This study aimed to systematically evaluate evidence for the efficacy of text messaging and mobile phone app interventions to improve adherence to preventive behavior among adolescents and describe intervention approaches to inform intervention development. This review covers literature published between 1995 and 2015. Searches included PubMed, Embase, CENTRAL, PsycINFO, CINAHL, INSPEC, Web of Science, Google Scholar, and additional databases. The search strategy sought articles on text messaging and mobile phone apps combined with adherence or compliance, and adolescents and youth. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. Included studies reflect original research-experimental or preexperimental designs with text messaging or mobile phone app interventions-targeting adherence to preventive behavior among adolescents (12-24 years old). The preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting results, and findings were critically appraised against the Oxford Centre for Evidence-based Medicine criteria. Of 1454 records, 19 met inclusion criteria, including text messaging (n=15) and mobile phone apps (n=4). Studies targeted clinic attendance, contraceptive use, oral health, physical activity and weight management, sun protection, human papillomavirus (HPV) vaccination, smoking cessation, and sexual health. Most studies were performed in the United States (47%, 9/19), included younger adolescents (63%, 12/19), and had sample size <100 (63%, 12/19). Although most studies were randomized controlled trials (RCTs; 58%, 11/19), only 5 followed an intent-to-treat analysis. Only 6 of 19 studies (32%) incorporated a theoretical framework in their design. Most studies reported good feasibility with high acceptability and satisfaction. About half of the included studies (42%, 8/19) demonstrated significant improvement in preventive behavior with moderate standardized mean differences. As early efforts in this field to establish feasibility and initial efficacy, most studies were low to moderate in quality. Studies varied in sample size and methods of preventive behavior adherence or outcome assessment, which prohibited performing a meta-analysis. Despite the promising feasibility and acceptability of text messaging and mobile phone apps in improving preventive behavior among adolescents, overall findings were modest in terms of efficacy. Further research evaluating the efficacy, effectiveness, and cost-effectiveness of these intervention approaches in promoting preventive behavior among adolescents is needed. ©Sherif M Badawy, Lisa M Kuhns. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 19.04.2017.

Evaluation of Text Messaging Effects on Health Goal Adherence in the Management of Participants With Chronic Diseases.

PubMed

Stagg, Sharon J; Speroni, Karen Gabel; Daniel, Marlon G; Eigenbrode, Melissa; Geisler, Lori

The study purpose was to determine whether text messaging health-related messages, questions, and reminders to community case management participants with chronic diseases increased health goal adherence. This study was conducted by a rural community case management, hospital-affiliated program. This pilot, quasiexperimental study measured health goal adherence, the degree to which an individual continues work toward self-identified health goals under limited supervision, before and after a text messaging intervention. All participants were receiving community case management services for chronic disease. Participants completed baseline and follow-up surveys regarding a text messaging intervention. Most participants were African Americans, had diabetes, with equal numbers by gender, an average age of 57.8 years, and had been in the community case management program for 3-5 years. Participants were sent a total of 1,654 messages/questions and 571 reminders. At follow-up, respondents who reported "Did you work on your health goals?" increased significantly (p = .0430). However, no differences were found for "Did you go to your health care appointments?" and "Did you take your medicines as you should?" No differences were noted in reported visits/hospitalizations overall or specifically at the research site. Lastly, study member visit/hospitalization numbers did not change significantly at follow-up. Although text messaging is not meant to take the place of face-to-face interactions, it does provide community case managers with an additional modality of communication with patients to offer support and important care reminders, and to facilitate patient participation in his or her care.

Assessing the National Cancer Institute's SmokefreeMOM Text-Messaging Program for Pregnant Smokers: Pilot Randomized Trial.

PubMed

Abroms, Lorien C; Chiang, Shawn; Macherelli, Laura; Leavitt, Leah; Montgomery, Margaret

2017-10-03

Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers. This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers. Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment. Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the control condition in its helpfulness at 3-month follow-up (P<.01) and in its frequency of messaging at both 1-month and 3-month follow-ups (P<.001, P<.01, respectively). Despite the presence of technical problems, the vast majority of intervention participants read all program messages, and few participants unsubscribed from the program. There were no significant differences between groups on the use of extra treatment resources or on smoking-related outcomes. However, at the 3-month follow-up, some outcomes favored the intervention group. SmokefreeMOM is acceptable for pregnant smokers. It is recommended that SmokefreeMOM be further refined and evaluated. Clinicaltrials.gov NCT02412956; https://clinicaltrials.gov/ct2/show/NCT02412956 (Archived by WebCite at http://www.webcitation.org/6tcmeRnbC). ©Lorien C Abroms, Shawn Chiang, Laura Macherelli, Leah Leavitt, Margaret Montgomery. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.10.2017.

Preventing Risky Drinking in Veterans Treated with Prescription Opioids

DTIC Science & Technology

2017-04-01

assessment, brief intervention, monitoring, and extended prevention services delivered through a combination of clinical visits, telephone calls, and text ...tailored text messages and brief monthly telephone contacts. Veterans who continue to drink at risky levels are instead placed in a track that provides...tailored text messages and more frequent telephone calls. In addition to monitoring, these calls provide further prevention/BI services to help the

Preventing Risky Drinking in Veterans Treated with Prescription Opioids

DTIC Science & Technology

2016-04-01

intervention, monitoring, and extended prevention services delivered through a combination of clinical visits, telephone calls, and text messages. We...Veterans who reduce alcohol use to non-hazardous levels during this one-month period continue in a monitoring track, consisting of tailored text ...messages and brief monthly telephone contacts. Veterans who continue to drink at risky levels are instead placed in a track that provides tailored text

The Mobile Insulin Titration Intervention (MITI) for Insulin Adjustment in an Urban, Low-Income Population: Randomized Controlled Trial.

PubMed

Levy, Natalie; Moynihan, Victoria; Nilo, Annielyn; Singer, Karyn; Bernik, Lidia S; Etiebet, Mary-Ann; Fang, Yixin; Cho, James; Natarajan, Sundar

2015-07-17

Diabetes patients are usually started on a low dose of insulin and their dose is adjusted or "titrated" according to their blood glucose levels. Insulin titration administered through face-to-face visits with a clinician can be time consuming and logistically burdensome for patients, especially those of low socioeconomic status (SES). Given the wide use of mobile phones among this population, there is the potential to use short message service (SMS) text messaging and phone calls to perform insulin titration remotely. The goals of this pilot study were to (1) evaluate if our Mobile Insulin Titration Intervention (MITI) intervention using text messaging and phone calls was effective in helping patients reach their optimal insulin glargine dose within 12 weeks, (2) assess the feasibility of the intervention within our clinic setting and patient population, (3) collect data on the cost savings associated with the intervention, and (4) measure patient satisfaction with the intervention. This was a pilot study evaluating an intervention for patients requiring insulin glargine titration in the outpatient medical clinic of Bellevue Hospital Center in New York City. Patients in the intervention arm received weekday SMS text messages from a health management platform requesting their fasting blood glucose values. The clinic's diabetes nurse educator monitored the texted responses on the platform website each weekday for alarm values. Once a week, the nurse reviewed the glucose values, consulted the MITI titration algorithm, and called patients to adjust their insulin dose. Patients in the usual care arm continued to receive their standard clinic care for insulin titration. The primary outcome was whether a patient reached his/her optimal insulin glargine dose within 12 weeks. A total of 61 patients consented and were randomized into the study. A significantly greater proportion of patients in the intervention arm reached their optimal insulin glargine dose than patients in the usual care arm (88%, 29/33 vs 37%, 10/27; P<.001). Patients responded to 84.3% (420/498) of the SMS text messages requesting their blood glucose values. The nurse reached patients within 2 attempts or by voicemail 91% of the time (90/99 assigned calls). When patients traveled to the clinic, they spent a median of 45 minutes (IQR 30-60) on travel and 39 minutes (IQR 30-64) waiting prior to appointments. A total of 61% (37/61) of patients had appointment copays. After participating in the study, patients in the intervention arm reported higher treatment satisfaction than those in the usual care arm. MITI is an effective way to help low-SES patients reach their optimal insulin glargine dose using basic SMS text messaging and phone calls. The intervention was feasible and patients were highly satisfied with their treatment. The intervention was cost saving in terms of time for patients, who were able to have their insulin titrated without multiple clinic appointments. Similar interventions should be explored to improve care for low-SES patients managing chronic disease. Clinicaltrials.gov NCT01879579; https://clinicaltrials.gov/ct2/show/NCT01879579 (Archived by WebCite at http://www.webcitation.org/6YZik33L3).

Mobile phone messaging for facilitating self-management of long-term illnesses.

PubMed

de Jongh, Thyra; Gurol-Urganci, Ipek; Vodopivec-Jamsek, Vlasta; Car, Josip; Atun, Rifat

2012-12-12

Long-term illnesses affect a significant proportion of the population in developed and developing countries. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), may present convenient, cost-effective ways of supporting self-management and improving patients' self-efficacy skills through, for instance, medication reminders, therapy adjustments or supportive messages. To assess the effects of mobile phone messaging applications designed to facilitate self-management of long-term illnesses, in terms of impact on health outcomes and patients' capacity to self-manage their condition. Secondary objectives include assessment of: user evaluation of the intervention; health service utilisation and costs; and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009).We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We selected only studies where it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions. Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third. Primary outcomes of interest were health outcomes as a result of the intervention and capacity to self-manage long-term conditions. We also considered patients' and providers' evaluation of the intervention, perceptions of safety, health service utilisation and costs, and potential harms or adverse effects. The included studies were heterogeneous in type of condition addressed, intervention characteristics and outcome measures. Therefore, a meta-analysis to derive an overall effect size for the main outcome categories was not considered justified and findings are presented narratively. We included four randomised controlled trials involving 182 participants.For the primary outcome of health outcomes, including physiological measures, there is moderate quality evidence from two studies involving people with diabetes showing no statistical difference from text messaging interventions compared with usual care or email reminders for glycaemic control (HbA1c), the frequency of diabetic complications, or body weight. There is moderate quality evidence from one study of hypertensive patients that the mean blood pressure and the proportion of patients who achieved blood pressure control were not significantly different in the intervention and control groups, and that there was no statistically significant difference in mean body weight between the groups. There is moderate quality evidence from one study that asthma patients receiving a text messaging intervention experienced greater improvements on peak expiratory flow variability (mean difference (MD) -11.12, 95% confidence interval (CI) -19.56 to -2.68) and the pooled symptom score comprising four items (cough, night symptoms, sleep quality, and maximum tolerated activity) (MD -0.36, 95% CI -0.56 to -0.17) compared with the control group. However, the study found no significant differences between the groups in impact on forced vital capacity or forced expiratory flow in 1 second.For the primary outcome of capacity to self-manage the condition, there is moderate quality evidence from one study that diabetes patients receiving the text messaging intervention demonstrated improved scores on measures of self-management capacity (Self-Efficacy for Diabetes score (MD 6.10, 95% CI 0.45 to 11.75), Diabetes Social Support Interview pooled score (MD 4.39, 95% CI 2.85 to 5.92)), but did not show improved knowledge of diabetes. There is moderate quality evidence from three studies of the effects on treatment compliance. One study showed an increase in hypertensive patients' rates of medication compliance in the intervention group (MD 8.90, 95% CI 0.18 to 17.62) compared with the control group, but in another study there was no statistically significant effect on rates of compliance with peak expiratory flow measurement in asthma patients. Text message prompts for diabetic patients initially also resulted in a higher number of blood glucose results sent back (46.0) than email prompts did (23.5).For the secondary outcome of participants' evaluation of the intervention, there is very low quality evidence from two studies that patients receiving mobile phone messaging support reported perceived improvement in diabetes self-management, wanted to continue receiving messages, and preferred mobile phone messaging to email as a method to access a computerised reminder system.For the secondary outcome of health service utilisation, there is very low quality evidence from two studies. Diabetes patients receiving text messaging support made a comparable number of clinic visits and calls to an emergency hotline as patients without the support. For asthma patients the total number of office visits was higher in the text messaging group, whereas the number of hospital admissions was higher for the control group.Because of the small number of trials included, and the low overall number of participants, for any of the reviewed outcomes the quality of the evidence can at best be considered moderate. We found some, albeit very limited, indications that in certain cases mobile phone messaging interventions may provide benefit in supporting the self-management of long-term illnesses. However, there are significant information gaps regarding the long-term effects, acceptability, costs, and risks of such interventions. Given the enthusiasm with which so-called mHealth interventions are currently being implemented, further research into these issues is needed. 

mHealth Intervention to Improve Diabetes Risk Behaviors in India: A Prospective, Parallel Group Cohort Study.

PubMed

Pfammatter, Angela; Spring, Bonnie; Saligram, Nalini; Davé, Raj; Gowda, Arun; Blais, Linelle; Arora, Monika; Ranjani, Harish; Ganda, Om; Hedeker, Donald; Reddy, Sethu; Ramalingam, Sandhya

2016-08-05

In low/middle income countries like India, diabetes is prevalent and health care access limited. Most adults have a mobile phone, creating potential for mHealth interventions to improve public health. To examine the feasibility and initial evidence of effectiveness of mDiabetes, a text messaging program to improve diabetes risk behaviors, a global nonprofit organization (Arogya World) implemented mDiabetes among one million Indian adults. A prospective, parallel cohort design was applied to examine whether mDiabetes improved fruit, vegetable, and fat intakes and exercise. Intervention participants were randomly selected from the one million Nokia subscribers who elected to opt in to mDiabetes. Control group participants were randomly selected from non-Nokia mobile phone subscribers. mDiabetes participants received 56 text messages in their choice of 12 languages over 6 months; control participants received no contact. Messages were designed to motivate improvement in diabetes risk behaviors and increase awareness about the causes and complications of diabetes. Participant health behaviors (exercise and fruit, vegetable, and fat intake) were assessed between 2012 and 2013 via telephone surveys by blinded assessors at baseline and 6 months later. Data were cleaned and analyzed in 2014 and 2015. 982 participants in the intervention group and 943 in the control group consented to take the phone survey at baselne. At the end of the 6-month period, 611 (62.22%) in the intervention and 632 (67.02%) in the control group completed the follow-up telephone survey. Participants receiving texts demonstrated greater improvement in a health behavior composite score over 6 months, compared with those who received no messages F(1, 1238) = 30.181, P<.001, 95% CI, 0.251-0.531. Fewer intervention participants demonstrated health behavior decline compared with controls. Improved fruit, vegetable, and fat consumption (P<.01) but not exercise were observed in those receiving messages, as compared with controls. A text messaging intervention was feasible and showed initial evidence of effectiveness in improving diabetes-related health behaviors, demonstrating the potential to facilitate population-level behavior change in a low/middle income country. Australian New Zealand Clinical Trials Registry (ACTRN): 12615000423516; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367946&isReview=true (Archived by WebCite at http://www.webcitation.org/6j5ptaJgF).

Effects of Messages Delivered by Mobile Phone on Increasing Compliance With Shoulder Exercises Among Patients With a Frozen Shoulder.

PubMed

Chen, Hui-Chun; Chuang, Tai-Yuan; Lin, Pi-Chu; Lin, Yen-Kuang; Chuang, Yeu-Hui

2017-07-01

The aim of this study was to examine the effects of reminders, encouragement, and educational messages delivered by mobile phone on shoulder exercise compliance and improvements in shoulder function among patients with a frozen shoulder. A randomized controlled trial design was used. A convenience sample of patients with a frozen shoulder in an orthopedic outpatient clinic was recruited. All participants were instructed on how to do shoulder exercises and were provided with a printed pamphlet about shoulder exercises. Then, the intervention group received reminders, encouragement, and educational messages by mobile phone daily for the next 2 weeks, while the comparison group did not. The intervention group had higher compliance with shoulder exercises than did the comparison group (t = 2.263, p = .03) and had significant improvements in shoulder forward flexion (F = 12.067, p = .001), external rotation (F = 13.61, p = .001), and internal rotation (F = 5.903, p = .018) compared to those in the comparison group after the 2-week intervention. The text messages significantly increased patient compliance with shoulder exercises and thus improved patients' shoulder range of motion. Hospital or clinics can send appropriate messages to patients via text message platforms in order to remind and encourage them to do shoulder exercises. © 2017 Sigma Theta Tau International.

Perceptions of adult trauma patients on the acceptability of text messaging as an aid to reduce harmful drinking behaviours

PubMed Central

2014-01-01

Background Brief interventions (BIs) have been shown to be effective in modifying hazardous drinking behaviours in a range of settings. However, they are underutilised in hospitals due to resource constraints. We explored the perspectives of admitted trauma patients about the appeal, acceptability and content of a Brief Intervention (BI) delivered via text messages. Methods Thirty mobile phone users (≥16 years old) admitted to Auckland City Hospital as a result of injury were recruited (December 2010 – January 2011). Participants were interviewed face-to-face during their hospital stay using a semi-structured interview guide that explored topics including perceptions of the proposed intervention to reduce hazardous drinking and related harm, and perceived acceptability of an m-health program. Where issues relating to content of messages were raised by participants these were also captured. In addition, a brief survey captured information on demographic information, mobile phone usage and type of phone, along with the frequency of alcohol use. Results 22 of the 30 participants were male, and almost half were aged 20 to 39 years. The majority of participants identified as New Zealand Europeans, six as Māori (New Zealand's indigenous population) and of the remainder two each identified as Pacific and of Asian ethnicity. Most (28/30) participants used a mobile phone daily. 18 participants were deemed to be drinking in a non-hazardous manner, seven were hazardous drinkers, and three were non-drinkers. Most participants (21/30) indicated that text messages could be effective in reducing hazardous drinking and related harms, with more than half (17/30) signalling they would sign-up. Factors identified that would increase receptiveness included: awareness that the intervention was evidence-based; participants readiness-to-change; informative messages that include the consequences of drinking and practical advice; non-judgemental messages; and ease-of-use. Areas of potential concern included: confidentiality and frequency of messages. The cultural relevance of the messages for Māori was highlighted as important. Conclusions This study indicates that trauma patients recognize potential benefits of mobile-health interventions designed to reduce hazardous drinking. The feedback provided will inform the development of an intervention to be evaluated in a randomised controlled trial. PMID:24387293

Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient–Provider Communication in the START Study

PubMed Central

Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A.; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B.; Howard, Andrea A.

2017-01-01

Background: mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Methods: Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. Findings: From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. Conclusions: The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers. PMID:27930610

Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

PubMed

Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

2017-01-01

mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

Mobile Phone Short Messages to Improve Exclusive Breastfeeding and Reduce Adverse Infant Feeding Practices: Protocol for a Randomized Controlled Trial in Yangon, Myanmar.

PubMed

Hmone, Myat Pan; Li, Mu; Alam, Ashraful; Dibley, Michael J

2017-06-28

Myanmar has a high burden of mortality for children aged younger than 5 years in which undernutrition plays a major role. Despite current efforts, the exclusive breastfeeding rate for children under 6 months is only 24%. To date there have been no interventions using mobile phones to improve breastfeeding and other feeding practices in Myanmar. This study aims to implement a breastfeeding promotion intervention using mobile phone text messages in Yangon, Myanmar, and evaluate its impact on breastfeeding practices. M528 is a 2-group parallel-arm randomized controlled trial with 9 months follow-up from recruitment until 6 months post-delivery. A total of 353 pregnant women between 28 and 34 weeks' gestation who had access to a mobile phone and were able to read and write have been recruited from the Central Women's Hospital, Yangon, and allocated randomly to an intervention or control group in a 1:1 ratio. The intervention group received breastfeeding promotional SMS messages 3 times a week while the control group received maternal and child health care messages (excluding breastfeeding-related messages) once a week. The SMS messages were tailored for the women's stage of gestation or the child's age. A formative qualitative study was conducted prior to the trial to inform the study design and text message content. We hypothesize that the exclusive breastfeeding rate in the intervention group will be double that in the control group. The primary outcome is exclusive breastfeeding from birth to 6 months and secondary outcomes are median durations of exclusive breastfeeding and other infant feeding practices. Both primary and secondary outcomes were assessed by monthly phone calls at 1 to 6 months postdelivery in both groups. Participants' delivery status was tracked through text messages, phone calls, and hospital records, and delivery characteristics were assessed 1 month after delivery. Child morbidity and breastfeeding self-efficacy scores were assessed at 1, 3, and 5 months postdelivery. Social desirability was measured at 5 months, and text messages expressing delivery success and user experience were assessed at the end of the study. The targeted 353 pregnant women were recruited between January and March 2015. Baseline data have been collected; SMS messages have been developed and pretested and sent to the women from both groups. Follow-up data collection via phone calls has been completed. Data analysis is being done and results are expected soon. This is the first RCT study examining the effects of mobile text messaging for promoting exclusive breastfeeding. This trial is timely in Myanmar following the telecommunications market opening in 2014. Our results will help determine whether text messaging is an effective and feasible method for promoting appropriate feeding practices and will inform further research to assess how this model could be replicated in the broader community. Australian New Zealand Clinical Trial Registry ACTRN12615000063516; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367704 (Archived by WebCite at http://www.webcitation.org/ 6rGif3l81). ©Myat Pan Hmone, Mu Li, Ashraful Alam, Michael J Dibley. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.06.2017.

Beyond Basic Feedback in Mobile Brief Interventions: Designing SMS Message Content for Delivery to Young Adults During Risky Drinking Events

PubMed Central

Dietze, Paul M; Lim, Megan S C

2017-01-01

Background Brief interventions can reduce alcohol consumption in young people through screening and delivery of personally relevant feedback. Recently, Web and mobile platforms have been harnessed to increase the reach of brief interventions. Existing literature on mobile-based alcohol brief interventions indicates mixed use of theory in developing interventions. There is no research available to guide the development of SMS text messaging (short message service, SMS) interventions delivered during risky drinking events. Objective The aim of this study was to develop and pilot an alcohol-related risk-reduction brief intervention delivered by SMS to Australian young adults during drinking events. This paper describes the development of intervention message content, with specific focus on the context of delivery during drinking events. Methods A sample of 42 young adults attended 4 workshops; these comprised focus-group style discussion on drinking habits and motivations, discussion of intervention design, analysis of existing alcohol media campaigns, and participant development of message content. Data were analyzed thematically. Results Participants described a focus on having fun and blocking out any incongruent negative influences during drinking episodes. For content to be acceptable, nonjudgmental and non-authoritative language was deemed essential. A preference for short, actionable messages was observed, including suggestions for reminders around drinking water, organizing transport home, checking on friends, and plans the next day. Participants were excited about the potential for messages to be tailored to individuals, as previous alcohol-related campaigns were deemed too generic and often irrelevant. Normative-based messages were also perceived as largely irrelevant as participants felt that they understood the drinking-related norms of their immediate peers already. Conclusions Findings from this study offer insights into young adults’ drinking events and practical advice for designing alcohol-related brief interventions. During our formative development process, we demonstrated a neat correspondence between young people’s preferences for alcohol harm reduction interventions and the theoretical principles of brief interventions, including acceptable topics and message style. PMID:28634153

Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial

PubMed Central

Whittaker, Robyn; Jiang, Yannan; Maddison, Ralph; Shepherd, Matthew; McNamara, Catherine; Cutfield, Richard; Khanolkar, Manish; Murphy, Rinki

2018-01-01

Abstract Objective To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. Design Nine month, two arm, parallel randomised controlled trial. Setting Primary and secondary healthcare services in New Zealand. Participants 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control). Interventions The intervention group received a tailored package of text messages for up to nine months in addition to usual care. Text messages provided information, support, motivation, and reminders related to diabetes self management and lifestyle behaviours. The control group received usual care. Messages were delivered by a specifically designed automated content management system. Main outcome measures Primary outcome measure was change in glycaemic control (HbA1c) from baseline to nine months. Secondary outcomes included change in HbA1c at three and six months, and self efficacy, diabetes self care behaviours, diabetes distress, perceptions and beliefs about diabetes, health related quality of life, perceived support for diabetes management, and intervention engagement and satisfaction at nine months. Regression models adjusted for baseline outcome, health district category, diabetes type, and ethnicity. Results The reduction in HbA1c at nine months was significantly greater in the intervention group (mean −8.85 mmol/mol (standard deviation 14.84)) than in the control group (−3.96 mmol/mol (17.02); adjusted mean difference −4.23 (95% confidence interval −7.30 to −1.15), P=0.007). Of 21 secondary outcomes, only four showed statistically significant improvements in favour of the intervention group at nine months. Significant improvements were seen for foot care behaviour (adjusted mean difference 0.85 (95% confidence interval 0.40 to 1.29), P<0.001), overall diabetes support (0.26 (0.03 to 0.50), P=0.03), health status on the EQ-5D visual analogue scale (4.38 (0.44 to 8.33), P=0.03), and perceptions of illness identity (−0.54 (−1.04 to −0.03), P=0.04). High levels of satisfaction with SMS4BG were found, with 161 (95%) of 169 participants reporting it to be useful, and 164 (97%) willing to recommend the programme to other people with diabetes. Conclusion A tailored, text message based, self management support programme resulted in modest improvements in glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, the findings support further investigation into the use of SMS4BG and other text message based support for this patient population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12614001232628. PMID:29773539

Supporting Head Start Parents: Impact of a Text Message Intervention on Parent-Child Activity Engagement

ERIC Educational Resources Information Center

Hurwitz, Lisa B.; Lauricella, Alexis R.; Hanson, Ann; Raden, Anthony; Wartella, Ellen

2015-01-01

Head Start emphasises parent engagement as a critical strategy in promoting children's long-term learning. Parents can support children's positive development by engaging them in stimulating activities. The following study assessed whether a service that delivered parenting tips via text message could prompt parents of children enrolled in Head…

User Preferences for a Text Message-Based Smoking Cessation Intervention

ERIC Educational Resources Information Center

Bock, Beth C.; Heron, Kristin E.; Jennings, Ernestine G.; Magee, Joshua C.; Morrow, Kathleen M.

2013-01-01

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants ("N" = 21, "M" age = 25.6…

Feasibility of a Text-Based Smoking Cessation Intervention in Rural Older Adults

ERIC Educational Resources Information Center

Noonan, D.; Silva, S.; Njuru, J.; Bishop, T.; Fish, L. J.; Simmons, L. A.; Choi, S. H.; Pollak, K. I.

2018-01-01

Text-based interventions are effective for smoking cessation, but have not been tested in rural older adults. The purpose of this study was to compare the feasibility, acceptability and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) program to a non-SGR text messaging support condition among rural older adults. Adults over…

Design Considerations in Development of a Mobile Health Intervention Program: The TEXT ME and TEXTMEDS Experience

PubMed Central

Thakkar, Jay; Barry, Tony; Thiagalingam, Aravinda; Redfern, Julie; McEwan, Alistair L; Rodgers, Anthony

2016-01-01

Background Mobile health (mHealth) has huge potential to deliver preventative health services. However, there is paucity of literature on theoretical constructs, technical, practical, and regulatory considerations that enable delivery of such services. Objectives The objective of this study was to outline the key considerations in the development of a text message-based mHealth program; thus providing broad recommendations and guidance to future researchers designing similar programs. Methods We describe the key considerations in designing the intervention with respect to functionality, technical infrastructure, data management, software components, regulatory requirements, and operationalization. We also illustrate some of the potential issues and decision points utilizing our experience of developing text message (short message service, SMS) management systems to support 2 large randomized controlled trials: TEXT messages to improve MEDication adherence & Secondary prevention (TEXTMEDS) and Tobacco, EXercise and dieT MEssages (TEXT ME). Results The steps identified in the development process were: (1) background research and development of the text message bank based on scientific evidence and disease-specific guidelines, (2) pilot testing with target audience and incorporating feedback, (3) software-hardware customization to enable delivery of complex personalized programs using prespecified algorithms, and (4) legal and regulatory considerations. Additional considerations in developing text message management systems include: balancing the use of customized versus preexisting software systems, the level of automation versus need for human inputs, monitoring, ensuring data security, interface flexibility, and the ability for upscaling. Conclusions A merging of expertise in clinical and behavioral sciences, health and research data management systems, software engineering, and mobile phone regulatory requirements is essential to develop a platform to deliver and manage support programs to hundreds of participants simultaneously as in TEXT ME and TEXTMEDS trials. This research provides broad principles that may assist other researchers in developing mHealth programs. PMID:27847350

Design Considerations in Development of a Mobile Health Intervention Program: The TEXT ME and TEXTMEDS Experience.

PubMed

Thakkar, Jay; Barry, Tony; Thiagalingam, Aravinda; Redfern, Julie; McEwan, Alistair L; Rodgers, Anthony; Chow, Clara K

2016-11-15

Mobile health (mHealth) has huge potential to deliver preventative health services. However, there is paucity of literature on theoretical constructs, technical, practical, and regulatory considerations that enable delivery of such services. The objective of this study was to outline the key considerations in the development of a text message-based mHealth program; thus providing broad recommendations and guidance to future researchers designing similar programs. We describe the key considerations in designing the intervention with respect to functionality, technical infrastructure, data management, software components, regulatory requirements, and operationalization. We also illustrate some of the potential issues and decision points utilizing our experience of developing text message (short message service, SMS) management systems to support 2 large randomized controlled trials: TEXT messages to improve MEDication adherence & Secondary prevention (TEXTMEDS) and Tobacco, EXercise and dieT MEssages (TEXT ME). The steps identified in the development process were: (1) background research and development of the text message bank based on scientific evidence and disease-specific guidelines, (2) pilot testing with target audience and incorporating feedback, (3) software-hardware customization to enable delivery of complex personalized programs using prespecified algorithms, and (4) legal and regulatory considerations. Additional considerations in developing text message management systems include: balancing the use of customized versus preexisting software systems, the level of automation versus need for human inputs, monitoring, ensuring data security, interface flexibility, and the ability for upscaling. A merging of expertise in clinical and behavioral sciences, health and research data management systems, software engineering, and mobile phone regulatory requirements is essential to develop a platform to deliver and manage support programs to hundreds of participants simultaneously as in TEXT ME and TEXTMEDS trials. This research provides broad principles that may assist other researchers in developing mHealth programs. ©Jay Thakkar, Tony Barry, Aravinda Thiagalingam, Julie Redfern, Alistair L McEwan, Anthony Rodgers, Clara K Chow. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 15.11.2016.

Mobile Phone Support for Diabetes Self-Care Among Diverse Adults: Protocol for a Three-Arm Randomized Controlled Trial.

PubMed

Nelson, Lyndsay A; Wallston, Kenneth A; Kripalani, Sunil; Greevy, Robert A; Elasy, Tom A; Bergner, Erin M; Gentry, Chad K; Mayberry, Lindsay S

2018-04-10

Nonadherence to self-care is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Moreover, patients with T2D who have low socioeconomic status and are racial/ethnic minorities disproportionately experience barriers to adherence and poor outcomes. Basic phone technology (text messages and phone calls) provides a practical medium for delivering content to address patients' barriers to adherence; however, trials are needed to explore long-term and sustainable effects of mobile phone interventions among diverse patients. The aim of this study is to evaluate the effects of mobile phone-based diabetes support interventions on self-care and hemoglobin A 1c (HbA 1c ) among adults with T2D using a 3-arm, 15-month randomized controlled trial with a Type 1 hybrid effectiveness-implementation approach. The intervention arms are (1) Rapid Encouragement/Education And Communications for Health (REACH) and (2) REACH + Family-focused Add-on for Motivating Self-care (FAMS). We recruited primary care patients with T2D (N=512) from Federally Qualified Health Centers and an academic medical center, prioritizing recruitment of publicly insured and minority patients from the latter. Eligible patients were prescribed daily diabetes medication and owned a cell phone with text messaging capability. We excluded patients whose most recent HbA 1c result within 12 months was <6.8% to support detection of intervention effects on HbA 1c . Participants were randomly assigned to REACH only, REACH + FAMS, or the control condition. REACH provides text messages tailored to address patient-specific barriers to medication adherence based on the Information-Motivation-Behavioral skills model, whereas FAMS provides monthly phone coaching with related text message content focused on family and friend barriers to diet and exercise adherence. We collect HbA 1c and self-reported survey data at baseline and at 3, 6, and 12 months, and again at 15 months to assess sustained changes. We will use generalized estimating equation models to test the effects of REACH (either intervention arm) on HbA 1c relative to the control group, the potential additive effects of FAMS, and effects of either intervention on adherence to self-care behaviors and diabetes self-efficacy. The trial is ongoing; recruitment closed December 2017. We plan to perform analyses on 6-month outcomes for FAMS in July 2018, and project to have 15-month data for REACH analyses in April 2019. Our study will be one of the first to evaluate a long-term, theory-based text messaging intervention to promote self-care adherence among racially/ethnically and socioeconomically diverse adults with T2D. Moreover, our study will assess the feasibility of a family-focused intervention delivered via mobile phones and compare the effects of text messaging alone versus text messaging plus phone coaching. Findings will advance our understanding of how interventions delivered by phone can benefit diverse patients with chronic conditions. ClinicalTrials.gov NCT02409329; https://clinicaltrials.gov/ct2/show/NCT02409329 (Archived by WebCite at http://www.webcitation.org/6yHkg9SSl); NCT02481596; https://clinicaltrials.gov/ct2/show/NCT02481596 (Archived by WebCite at http://www.webcitation.org/6yHkj9XD4). ©Lyndsay A Nelson, Kenneth A Wallston, Sunil Kripalani, Robert A Greevy Jr, Tom A Elasy, Erin M Bergner, Chad K Gentry, Lindsay S Mayberry. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.04.2018.

Mobile Phone Support for Diabetes Self-Care Among Diverse Adults: Protocol for a Three-Arm Randomized Controlled Trial

PubMed Central

Nelson, Lyndsay A; Wallston, Kenneth A; Kripalani, Sunil; Greevy Jr, Robert A; Elasy, Tom A; Bergner, Erin M; Gentry, Chad K

2018-01-01

Background Nonadherence to self-care is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Moreover, patients with T2D who have low socioeconomic status and are racial/ethnic minorities disproportionately experience barriers to adherence and poor outcomes. Basic phone technology (text messages and phone calls) provides a practical medium for delivering content to address patients’ barriers to adherence; however, trials are needed to explore long-term and sustainable effects of mobile phone interventions among diverse patients. Objective The aim of this study is to evaluate the effects of mobile phone–based diabetes support interventions on self-care and hemoglobin A1c (HbA1c) among adults with T2D using a 3-arm, 15-month randomized controlled trial with a Type 1 hybrid effectiveness-implementation approach. The intervention arms are (1) Rapid Encouragement/Education And Communications for Health (REACH) and (2) REACH + Family-focused Add-on for Motivating Self-care (FAMS). Methods We recruited primary care patients with T2D (N=512) from Federally Qualified Health Centers and an academic medical center, prioritizing recruitment of publicly insured and minority patients from the latter. Eligible patients were prescribed daily diabetes medication and owned a cell phone with text messaging capability. We excluded patients whose most recent HbA1c result within 12 months was <6.8% to support detection of intervention effects on HbA1c. Participants were randomly assigned to REACH only, REACH + FAMS, or the control condition. REACH provides text messages tailored to address patient-specific barriers to medication adherence based on the Information-Motivation-Behavioral skills model, whereas FAMS provides monthly phone coaching with related text message content focused on family and friend barriers to diet and exercise adherence. We collect HbA1c and self-reported survey data at baseline and at 3, 6, and 12 months, and again at 15 months to assess sustained changes. We will use generalized estimating equation models to test the effects of REACH (either intervention arm) on HbA1c relative to the control group, the potential additive effects of FAMS, and effects of either intervention on adherence to self-care behaviors and diabetes self-efficacy. Results The trial is ongoing; recruitment closed December 2017. We plan to perform analyses on 6-month outcomes for FAMS in July 2018, and project to have 15-month data for REACH analyses in April 2019. Conclusions Our study will be one of the first to evaluate a long-term, theory-based text messaging intervention to promote self-care adherence among racially/ethnically and socioeconomically diverse adults with T2D. Moreover, our study will assess the feasibility of a family-focused intervention delivered via mobile phones and compare the effects of text messaging alone versus text messaging plus phone coaching. Findings will advance our understanding of how interventions delivered by phone can benefit diverse patients with chronic conditions. Trial Registration ClinicalTrials.gov NCT02409329; https://clinicaltrials.gov/ct2/show/NCT02409329 (Archived by WebCite at http://www.webcitation.org/6yHkg9SSl); NCT02481596; https://clinicaltrials.gov/ct2/show/NCT02481596 (Archived by WebCite at http://www.webcitation.org/6yHkj9XD4) PMID:29636319

Mobile phone text message reminders: Measuring preferences of people with antipsychotic medication.

PubMed

Kauppi, Kaisa; Kannisto, Kati A; Hätönen, Heli; Anttila, Minna; Löyttyniemi, Eliisa; Adams, Clive E; Välimäki, Maritta

2015-10-01

Mobile technology use, including Short Messaging Service (SMS) text messaging, has increased in health care services. Preferences regarding the type or timing of text messages sent by healthcare providers to people with antipsychotic medication have not yet been fully investigated. This study examines the relationship between patients' demographic characteristics and the tailored messages they select. The study ("Mobile.Net", 27704027) includes a structured analysis of a random sub-sample of participants who received messages for 12months. The data were collected in 24 sites and 45 psychiatric hospitals in Finland and analyzed with descriptive statistics and Poisson regression models. The study sample involved 562 people on antipsychotic medication, and a total of 2112 text messages (2 to 25 monthly) were analysed. Regarding message content, there was no significant variation in the proportions relating to 'medication', 'treatment appointments' or 'free time'. Monday was the most popular day to receive messages and morning was preferred to later in the day. Age was most closely associated with 'number of messages' and 'time of messages'. Older women and younger men preferred higher numbers of messages (p=0.0031). Participants preferred positive, encouraging and slightly humorous messages. The findings suggest that messages may be acceptable for difficult to access groups in follow-up. This type of intervention may be useful for various types of patients especially for younger males. To further support the evidence about factors related to message utilization and use, it is important to evaluate the effectiveness of text messages in psychiatric care. Copyright © 2015. Published by Elsevier B.V.

Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial.

PubMed

Fischer, Henry H; Fischer, Ilana P; Pereira, Rocio I; Furniss, Anna L; Rozwadowski, Jeanne M; Moore, Susan L; Durfee, Michael J; Raghunath, Silvia G; Tsai, Adam G; Havranek, Edward P

2016-08-01

Although the benefits of in-person Diabetes Prevention Program (DPP) classes for diabetes prevention have been demonstrated in trials, effectiveness in clinical practice is limited by low participation rates. This study explores whether text message support enhances weight loss in patients offered DPP classes. English- and Spanish-speaking patients with prediabetes (n = 163) were randomized to the control group, which only received an invitation to DPP classes as defined by the Centers for Disease Control and Prevention, or to the text message-augmented intervention group, which also received text messages adapted from the DPP curriculum for 12 months. Mean weight decreased 0.6 pounds (95% CI -2.7 to 1.6) in the control group and 2.6 pounds (95% CI -5.5 to 0.2) in the intervention group (P value 0.05). Three percent weight loss was achieved by 21.5% of participants in the control group (95% CI 12.5-30.6), compared with 38.5% in the intervention group (95% CI 27.7-49.3) (absolute difference 17.0%; P value 0.02). Mean glycated hemoglobin (HbA1c) increased by 0.19% or 2.1 mmol/mol (95% CI -0.1 to 0.5%) and decreased by 0.09% or 1.0 mmol/mol (95% CI -0.2 to 0.0%) in the control group and intervention participants, respectively (absolute difference 0.28%; P value 0.07). Stratification by language demonstrated a significant treatment effect in Spanish speakers but not in English speakers. Text message support can lead to clinically significant weight loss in patients with prediabetes. Further study assessing effect by primary language and in an operational setting is warranted. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Risks and benefits of text message-delivered and small group-delivered sexual health interventions among African American women in the Midwestern U.S.

PubMed Central

Broaddus, Michelle R.; Marsch, Lisa A.

2014-01-01

Interventions to decrease acquisition and transmission of sexually transmitted diseases among African American women using text messages versus small group delivery modalities pose distinct research risks and benefits. Determining the relative risk-benefit ratio of studies using these different modalities has relied on the expertise of investigators and their institutional review boards. In this study, African American women participated in focus groups and surveys to elicit and compare risks and benefits inherent in these two intervention delivery modalities, focusing on issues such as convenience, privacy, and stigma of participation. Some risk/benefit variables were implicated in willingness to participate the two intervention modalities. PMID:25750497

The impact of health education transmitted via social media or text messaging on adolescent and young adult risky sexual behavior: a systematic review of the literature.

PubMed

Jones, Krista; Eathington, Patricia; Baldwin, Kathleen; Sipsma, Heather

2014-07-01

Despite the increased use of social media and text messaging among adolescents, it is unclear how effective education transmitted via these mechanisms is for reducing sexual risk behavior. Accordingly, we conducted a systematic review of the literature to examine the effectiveness of social media and text messaging interventions designed to increase sexually transmitted disease (STD) knowledge, increase screening/testing, decrease risky sexual behaviors, and reduce the incidence of STDs among young adults aged 15 through 24 years. Eleven studies met our inclusion criteria. Most of the included studies used a control group to explore intervention effects and included both young men and women. Sample sizes ranged from 32 to 7606 participants, and follow-up periods ranged between 4 weeks and 12 months. These studies provide preliminary evidence indicating that social media and text messaging can increase knowledge regarding the prevention of STDs. These interventions may also affect behavior, such as screening/testing for STDs, sexual risk behaviors, and STD acquisition, but the evidence for effect is weak. Many of these studies had several limitations that future research should address, including a reliance on self-reported data, small sample sizes, poor retention, low generalizability, and low analytic rigor. Additional research is needed to determine the most effective and engaging approaches for young men and women.

Influence of delivery strategy on message-processing mechanisms and future adherence to a Dutch computer-tailored smoking cessation intervention.

PubMed

Stanczyk, Nicola Esther; Crutzen, Rik; Bolman, Catherine; Muris, Jean; de Vries, Hein

2013-02-06

Smoking tobacco is one of the most preventable causes of illness and death. Web-based tailored smoking cessation interventions have shown to be effective. Although these interventions have the potential to reach a large number of smokers, they often face high attrition rates, especially among lower educated smokers. A possible reason for the high attrition rates in the latter group is that computer-tailored smoking cessation interventions may not be attractive enough as they are mainly text-based. Video-based messages might be more effective in attracting attention and stimulating comprehension in people with a lower educational level and could therefore reduce attrition rates. The objective of the present study was to investigate whether differences exist in message-processing mechanisms (attention, comprehension, self-reference, appreciation, processing) and future adherence (intention to visit/use the website again, recommend the website to others), according to delivery strategy (video or text based messages) and educational level, to a Dutch computer-tailored smoking cessation program. Smokers who were motivated to quit within the following 6 months and who were aged over 16 were included in the program. Participants were randomly assigned to one of two conditions (video/text CT). The sample was stratified into 2 categories: lower and higher educated participants. In total, 139 participants completed the first session of the web-based tailored intervention and were subsequently asked to fill out a questionnaire assessing message-processing mechanisms and future adherence. ANOVAs and regression analyses were conducted to investigate the differences in message-processing mechanisms and future adherence with regard to delivery strategy and education. No interaction effects were found between delivery strategy (video vs text) and educational level on message-processing mechanisms and future adherence. Delivery strategy had no effect on future adherence and processing mechanisms. However, in both groups results indicated that lower educated participants showed higher attention (F(1,138)=3.97; P=.05) and processing levels (F(1,138)=4.58; P=.04). Results revealed also that lower educated participants were more inclined to visit the computer-tailored intervention website again (F(1,138)=4.43; P=.04). Computer-tailored programs have the potential to positively influence lower educated groups as they might be more involved in the computer-tailored intervention than higher educated smokers. Longitudinal studies with a larger sample are needed to gain more insight into the role of delivery strategy in tailored information and to investigate whether the intention to visit the intervention website again results in the ultimate goal of behavior change. Netherlands Trial Register (NTR3102).

Influence of Delivery Strategy on Message-Processing Mechanisms and Future Adherence to a Dutch Computer-Tailored Smoking Cessation Intervention

PubMed Central

Crutzen, Rik; Bolman, Catherine; Muris, Jean; de Vries, Hein

2013-01-01

Background Smoking tobacco is one of the most preventable causes of illness and death. Web-based tailored smoking cessation interventions have shown to be effective. Although these interventions have the potential to reach a large number of smokers, they often face high attrition rates, especially among lower educated smokers. A possible reason for the high attrition rates in the latter group is that computer-tailored smoking cessation interventions may not be attractive enough as they are mainly text-based. Video-based messages might be more effective in attracting attention and stimulating comprehension in people with a lower educational level and could therefore reduce attrition rates. Objective The objective of the present study was to investigate whether differences exist in message-processing mechanisms (attention, comprehension, self-reference, appreciation, processing) and future adherence (intention to visit/use the website again, recommend the website to others), according to delivery strategy (video or text based messages) and educational level, to a Dutch computer-tailored smoking cessation program. Methods Smokers who were motivated to quit within the following 6 months and who were aged over 16 were included in the program. Participants were randomly assigned to one of two conditions (video/text CT). The sample was stratified into 2 categories: lower and higher educated participants. In total, 139 participants completed the first session of the web-based tailored intervention and were subsequently asked to fill out a questionnaire assessing message-processing mechanisms and future adherence. ANOVAs and regression analyses were conducted to investigate the differences in message-processing mechanisms and future adherence with regard to delivery strategy and education. Results No interaction effects were found between delivery strategy (video vs text) and educational level on message-processing mechanisms and future adherence. Delivery strategy had no effect on future adherence and processing mechanisms. However, in both groups results indicated that lower educated participants showed higher attention (F 1,138=3.97; P=.05) and processing levels (F 1,138=4.58; P=.04). Results revealed also that lower educated participants were more inclined to visit the computer-tailored intervention website again (F 1,138=4.43; P=.04). Conclusions Computer-tailored programs have the potential to positively influence lower educated groups as they might be more involved in the computer-tailored intervention than higher educated smokers. Longitudinal studies with a larger sample are needed to gain more insight into the role of delivery strategy in tailored information and to investigate whether the intention to visit the intervention website again results in the ultimate goal of behavior change. Trial Registration Netherlands Trial Register (NTR3102). PMID:23388554

Use of mobile phone text message reminders in health care services: a narrative literature review.

PubMed

Kannisto, Kati Anneli; Koivunen, Marita Hannele; Välimäki, Maritta Anneli

2014-10-17

Mobile text messages are a widely recognized communication method in societies, as the global penetration of the technology approaches 100% worldwide. Systematic knowledge is still lacking on how the mobile telephone text messaging (short message service, SMS) has been used in health care services. This study aims to review the literature on the use of mobile phone text message reminders in health care. We conducted a systematic literature review of studies on mobile telephone text message reminders. The data sources used were PubMed (MEDLINE), CINAHL, Proquest Databases/ PsycINFO, EMBASE, Cochrane Library, Scopus, and hand searching since 2003. Studies reporting the use of SMS intended to remind patients in health services were included. Given the heterogeneity in the studies, descriptive characteristics, purpose of the study, response rates, description of the intervention, dose and timing, instruments, outcome measures, and outcome data from the studies were synthesized using a narrative approach. From 911 initial citations, 60 studies were included in the review. The studies reported a variety of use for SMS. Mobile telephone text message reminders were used as the only intervention in 73% (44/60) of the studies, and in 27% (16/60) of the remaining studies, SMS was connected to another comprehensive health intervention system. SMS reminders were sent to different patient groups: patients with HIV/AIDS (15%, 9/60) and diabetes (13%, 8/60) being the most common groups. The response rates of the studies varied from 22-100%. Typically, the text message reminders were sent daily. The time before the specific intervention to be rendered varied from 10 minutes (eg, medication taken) to 2 weeks (eg, scheduled appointment). A wide range of different evaluation methods and outcomes were used to assess the impact of SMS varying from existing databases (eg, attendance rate based on medical records), questionnaires, and physiological measures. About three quarters of the studies (77%, 46/60) reported improved outcomes: adherence to medication or to treatment reportedly improved in 40% (24/60) of the studies, appointment attendance in 18% (11/60) of the studies, and non-attendance rates decreased in 18% (11/60) of the studies. Other positive impacts were decreased amount of missed medication doses, more positive attitudes towards medication, and reductions in treatment interruptions. We can conclude that although SMS reminders are used with different patient groups in health care, SMS is less systematically studied with randomized controlled trial study design. Although the amount of evidence for SMS application recommendations is still limited, having 77% (46/60) of the studies showing improved outcomes may indicate its use in health care settings. However, more well-conducted SMS studies are still needed.

Use of Mobile Phone Text Message Reminders in Health Care Services: A Narrative Literature Review

PubMed Central

Koivunen, Marita Hannele; Välimäki, Maritta Anneli

2014-01-01

Background Mobile text messages are a widely recognized communication method in societies, as the global penetration of the technology approaches 100% worldwide. Systematic knowledge is still lacking on how the mobile telephone text messaging (short message service, SMS) has been used in health care services. Objective This study aims to review the literature on the use of mobile phone text message reminders in health care. Methods We conducted a systematic literature review of studies on mobile telephone text message reminders. The data sources used were PubMed (MEDLINE), CINAHL, Proquest Databases/ PsycINFO, EMBASE, Cochrane Library, Scopus, and hand searching since 2003. Studies reporting the use of SMS intended to remind patients in health services were included. Given the heterogeneity in the studies, descriptive characteristics, purpose of the study, response rates, description of the intervention, dose and timing, instruments, outcome measures, and outcome data from the studies were synthesized using a narrative approach. Results From 911 initial citations, 60 studies were included in the review. The studies reported a variety of use for SMS. Mobile telephone text message reminders were used as the only intervention in 73% (44/60) of the studies, and in 27% (16/60) of the remaining studies, SMS was connected to another comprehensive health intervention system. SMS reminders were sent to different patient groups: patients with HIV/AIDS (15%, 9/60) and diabetes (13%, 8/60) being the most common groups. The response rates of the studies varied from 22-100%. Typically, the text message reminders were sent daily. The time before the specific intervention to be rendered varied from 10 minutes (eg, medication taken) to 2 weeks (eg, scheduled appointment). A wide range of different evaluation methods and outcomes were used to assess the impact of SMS varying from existing databases (eg, attendance rate based on medical records), questionnaires, and physiological measures. About three quarters of the studies (77%, 46/60) reported improved outcomes: adherence to medication or to treatment reportedly improved in 40% (24/60) of the studies, appointment attendance in 18% (11/60) of the studies, and non-attendance rates decreased in 18% (11/60) of the studies. Other positive impacts were decreased amount of missed medication doses, more positive attitudes towards medication, and reductions in treatment interruptions. Conclusions We can conclude that although SMS reminders are used with different patient groups in health care, SMS is less systematically studied with randomized controlled trial study design. Although the amount of evidence for SMS application recommendations is still limited, having 77% (46/60) of the studies showing improved outcomes may indicate its use in health care settings. However, more well-conducted SMS studies are still needed. PMID:25326646

Electronic Brief Intervention and Text Messaging for Marijuana Use During Pregnancy: Initial Acceptability of Patients and Providers.

PubMed

Gray, Justin; Beatty, Jessica R; Svikis, Dace S; Puder, Karoline S; Resnicow, Ken; Konkel, Janine; Rice, Shetoya; McGoron, Lucy; Ondersma, Steven J

2017-11-08

Marijuana is the most widely used illicit substance during pregnancy. Technology-delivered brief interventions and text messaging have shown promise in general and pregnant samples but have not yet been applied to marijuana use in pregnancy. The objective of the study was to evaluate, among pregnant women and prenatal care providers, the acceptability of an electronic brief intervention and text messaging plan for marijuana use in pregnancy. Participants included patients (n=10) and medical staff (n=12) from an urban prenatal clinic. Patient-participants were recruited directly during a prenatal care visit. Those who were eligible reviewed the interventions individually and provided quantitative and qualitative feedback regarding software acceptability and helpfulness during a one-on-one interview with research staff. Provider-participants took part in focus groups in which the intervention materials were reviewed and discussed. Qualitative and focus group feedback was transcribed, coded manually, and classified by category and theme. Patient-participants provided high ratings for satisfaction, with mean ratings for respectfulness, interest, ease of use, and helpfulness ranging between 4.4 and 4.7 on a 5-point Likert scale. Of the 10 participants, 5 reported that they preferred working with the program versus their doctor, and 9 of 10 said the intervention made them more likely to reduce their marijuana use. Provider-participants received the program favorably, stating the information presented was both relevant and important for their patient population. The findings support the acceptability of electronic brief intervention and text messaging for marijuana use during pregnancy. This, combined with their ease of use and low barrier to initiation, suggests that further evaluation in a randomized trial is appropriate. ©Justin Gray, Jessica R Beatty, Dace S Svikis, Karoline S Puder, Ken Resnicow, Janine Konkel, Shetoya Rice, Lucy McGoron, Steven J Ondersma. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.11.2017.

Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

PubMed Central

Person, Anna K.; Blain, Michela L.M.; Jiang, Helen; Rasmussen, Petra W.

2011-01-01

Abstract Objectives: The objective of this study was to assess knowledge, attitudes, and behaviors surrounding healthcare-related mobile phone use and text messaging among persons at risk for or infected with tuberculosis (TB) or the human immunodeficiency virus (HIV). Methods: An anonymous survey was conducted in three groups of subjects: (1) HIV-infected persons attending an HIV clinic; (2) persons with latent TB infection at a public health clinic; and (3) persons presenting for TB, HIV, and syphilis screening at a community screening site. Results: Three hundred fifteen (n  = 315) persons responded to the survey, of whom 241 (76.5%) owned a cell phone. Cell phone owners were younger and more educated than nonowners. Transportation difficulty and forgetting appointments were cited as significant barriers by 34.2% and 39.5% of respondents, respectively. Fifty-six percent of subjects felt it would be acceptable to receive text message appointment reminders, and 33% felt that text message reminders to take medications would be acceptable. Younger age and cell phone ownership were significantly associated with acceptance of text message reminders. Black and Hispanic subjects were more likely to feel that text message reminders for appointments or medications were helpful than White subjects. Further, Black and Hispanic subjects, as well as subjects with lower educational attainment, were more receptive to healthcare-related educational text messages. Conclusions: Cell phones and text messaging were prevalent among our subjects attending HIV and TB clinics, and subjects were generally receptive to text messaging for healthcare-related communication. Interventions that explore the potential for text messaging to improve clinic attendance, medication adherence, and health knowledge should be explored. PMID:21457085

An intervention delivered by text message to increase the acceptability of effective contraception among young women in Palestine: study protocol for a randomised controlled trial.

PubMed

McCarthy, Ona L; Wazwaz, Ola; Jado, Iman; Leurent, Baptiste; Edwards, Phil; Adada, Samia; Stavridis, Amina; Free, Caroline

2017-10-03

Unintended pregnancy can negatively impact women's lives and is associated with poorer health outcomes for women and children. Many women, particularly in low- and middle-income countries, continue to face obstacles in avoiding unintended pregnancy. In the State of Palestine, a survey conducted in 2006 estimated that 38% of pregnancies are unintended. In 2014, unmet need for contraception was highest among young women aged 20-24 years, at 15%. Mobile phones are increasingly being used to deliver health support. Once developed, interventions delivered by mobile phone are often cheaper to deliver than face-to-face support. The London School of Hygiene and Tropical Medicine and the Palestinian Family Planning and Protection Association have partnered to develop and evaluate a contraceptive behavioural intervention for young women in Palestine delivered by mobile phone. The intervention was developed guided by behavioural science and consists of short, mobile phone text messages that contain information about contraception and behaviour change methods delivered over 4 months. We will evaluate the intervention by conducting a randomised controlled trial. Five hundred and seventy women aged 18-24 years, who do not report using an effective method of contraception, will be allocated with a 1:1 ratio to receive the intervention text messages or control text messages about trial participation. The primary outcome is self-reported acceptability of at least one method of effective contraception at 4 months. Secondary outcomes include the use of effective contraception, acceptability of individual methods, discontinuation, service uptake, unintended pregnancy and abortion. Process outcomes include knowledge, perceived norms, personal agency and intervention dose received. Outcomes at 4 months will be compared between arms using logistic regression. This trial will determine the effect of the intervention on young women's attitudes towards the most effective methods of contraception. If the intervention is found to be effective, the intervention will be implemented widely across Palestine. The results could also be used to design a larger trial to establish its effect on unintended pregnancy. ClinicalTrials.gov, ID: NCT02905461 . Registered on 14 September 2016.

A Wireless Text Messaging System Improves Communication for Neonatal Resuscitation.

PubMed

Hughes Driscoll, Colleen A; Schub, Jamie A; Pollard, Kristi; El-Metwally, Dina

Handoffs for neonatal resuscitation involve communicating critical delivery information (CDI). The authors sought to achieve ≥95% communication of CDI during resuscitation team requests. CDI included name of caller, urgency of request, location of delivery, gestation of fetus, status of amniotic fluid, and indication for presence of the resuscitation team. Three interventions were implemented: verbal scripted handoff, Spök text messaging, and Engage text messaging. Percentages of CDI communications were analyzed using statistical process control. Following implementation of Engage, the communication of all CDI, except for indication, was ≥95%; communication of indication occurred 93% of the time. Control limits for most CDI were narrower with Engage, indicating greater reliability of communication compared to the verbal handoff and Spök. Delayed resuscitation team arrival, a countermeasure, was not higher with text messaging compared to verbal handoff ( P = 1.00). Text messaging improved communication during high-risk deliveries, and it may represent an effective tool for other delivery centers.

A Mobile Text Message Intervention to Reduce Repeat Suicidal Episodes: Design and Development of Reconnecting After a Suicide Attempt (RAFT)

PubMed Central

Shand, Fiona; Morley, Kirsten; Batterham, Philip J; Petrie, Katherine; Reda, Bill; Berrouiguet, Sofian; Haber, Paul S; Carter, Gregory; Christensen, Helen

2017-01-01

Background Suicide is a leading cause of death, particularly among young people. Continuity of care following discharge from hospital is critical, yet this is a time when individuals often lose contact with health care services. Offline brief contact interventions following a suicide attempt can reduce the number of repeat attempts, and text message (short message service, SMS) interventions are currently being evaluated. Objective The aim of this study was to extend postattempt caring contacts by designing a brief Web-based intervention targeting proximal risk factors and the needs of this population during the postattempt period. This paper details the development process and describes the realized system. Methods To inform the design of the intervention, a lived experience design group was established. Participants were asked about their experiences of support following their suicide attempt, their needs during this time, and how these could be addressed in a brief contact eHealth intervention. The intervention design was also informed by consultation with lived experience panels external to the project and a clinical design group. Results Prompt outreach following discharge, initial distraction activities with low cognitive demands, and ongoing support over an extended period were identified as structural requirements of the intervention. Key content areas identified included coping with distressing feelings, safety planning, emotional regulation and acceptance, coping with suicidal thoughts, connecting with others and interpersonal relationships, and managing alcohol consumption. Conclusions The RAFT (Reconnecting AFTer a suicide attempt) text message brief contact intervention combines SMS contacts with additional Web-based brief therapeutic content targeting key risk factors. It has the potential to reduce the number of repeat suicidal episodes and to provide accessible, acceptable, and cost-effective support for individuals who may not otherwise seek face-to-face treatment. A pilot study to test the feasibility and acceptability of the RAFT intervention is underway. PMID:29237584

Positive psychotherapy for smoking cessation enhanced with text messaging: Protocol for a randomized controlled trial.

PubMed

Kahler, Christopher W; Surace, Anthony; Rebecca, E F; Gordon, B A; Cioe, Patricia A; Spillane, Nichea S; Parks, Acacia; Bock, Beth C; Brown, Richard A

2018-06-21

Despite reductions in cigarette smoking in the U.S., improvements in the efficacy of smoking cessation treatments are needed, as rates of sustained abstinence remain disappointingly low. Both low positive affect and high negative affect contribute to smoking relapse and constitute viable targets for smoking cessation interventions. Although some clinical trials have evaluated interventions to address depression as a smoking relapse risk factor, very few have focused on positive affect. Recently, we developed and conducted a preliminary clinical trial of a smoking cessation treatment that targets positive affect and cognitions by incorporating interventions rooted in positive psychology. The current randomized controlled trial will expand upon this preliminary trial to test whether this positive psychology-informed approach results in higher smoking cessation rates compared to a time-matched standard smoking cessation treatment control. Three hundred and forty adult daily smokers will be randomly assigned to either positive psychotherapy for smoking cessation or standard behavioral smoking cessation counseling. Participants will meet weekly with a study counselor for 6 weeks and will receive transdermal nicotine patch and text messaging smoking cessation support. Additionally, text messaging in the positive psychotherapy condition will encourage engagement in positive psychology-specific strategies for boosting mood and staying smoke free. Smoking cessation outcomes will be measured at 12, 26, and 52 weeks following target quit date. Results from this study will provide evidence on whether incorporating positive psychology interventions into smoking cessation treatment can improve smoking cessation outcomes relative to standard behavioral counseling with nicotine patch and text messaging. Copyright © 2018. Published by Elsevier Inc.

Controller adherence following hospital discharge in high risk children: A pilot randomized trial of text message reminders.

PubMed

Kenyon, Chén C; Gruschow, Siobhan M; Quarshie, William O; Griffis, Heather; Leach, Michelle C; Zorc, Joseph J; Bryant-Stephens, Tyra C; Miller, Victoria A; Feudtner, Chris

2018-02-13

To assess the feasibility of a mobile health, inhaled corticosteroid (ICS) adherence reminder intervention and to characterize adherence trajectories immediately following severe asthma exacerbation in high-risk urban children with persistent asthma. Children aged 2-13 with persistent asthma were enrolled in this pilot randomized controlled trial during an asthma emergency department (ED) visit or hospitalization. Intervention arm participants received daily text message reminders for 30 days, and both arms received electronic sensors to measure ICS use. Primary outcomes were feasibility of sensor use and text message acceptability. Secondary outcomes included adherence to prescribed ICS regimen and 30-day adherence trajectories. Group-based trajectory modeling was used to examine adherence trajectories. Forty-one participants (mean age 5.9) were randomized to intervention (n = 21) or control (n = 20). Overall, 85% were Black, 88% had public insurance, and 51% of the caregivers had a high school education or less. Thirty-two participant families (78%) transmitted medication adherence data; of caregivers who completed the acceptability survey, 25 (96%) chose to receive daily reminders beyond that study interval. Secondary outcome analyses demonstrated similar average daily adherence between groups (intervention = 36%; control = 32%, P = 0.73). Three adherence trajectories were identified with none ever exceeding 80% adherence. Within a high-risk pediatric cohort, electronic monitoring of ICS use and adherence reminders delivered via text message were feasible for most participants, but there was no signal of effect. Adherence trajectories following severe exacerbation were suboptimal, demonstrating an important opportunity for asthma care improvement.

SMS for Sexual Health: A Comparison of Service Types and Recommendations for Sexual Health Text Message Service Providers

ERIC Educational Resources Information Center

Willoughby, Jessica Fitts; Muldrow, Adrienne

2017-01-01

Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions.

PubMed

Maar, Marion A; Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-22

Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations' capability, opportunity, and motivation for behavior change. The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes.

Unpacking the Black Box: A Formative Research Approach to the Development of Theory-Driven, Evidence-Based, and Culturally Safe Text Messages in Mobile Health Interventions

PubMed Central

Yeates, Karen; Toth, Zsolt; Barron, Marcia; Boesch, Lisa; Hua-Stewart, Diane; Liu, Peter; Perkins, Nancy; Sleeth, Jessica; Wabano, Mary Jo; Williamson, Pamela; Tobe, Sheldon W

2016-01-01

Background Mobile-cellular subscriptions have increased steadily over the past decade. The accessibility of SMS messages over existing mobile networks is high and has almost universal availability even on older and unsophisticated mobile phones and in geographic settings where wireless coverage is weak. There is intensive exploration of this inexpensive mobile telecommunication technology to improve health services and promote behavior change among vulnerable populations. However, a neglected area of research is the documentation and critical analysis of the formative research process required in the development and refinement of effective SMS messages. Objective The objective of this qualitative research study was to identify major factors that may impact on the effectiveness of evidence-based SMS messages designed to reduce health inequities in hypertension management in low resource settings, including Aboriginal populations in high-income countries and rural populations in low-income countries. Specifically, we were interested in uncovering the range of mediators that impact on appropriate message content transmission and, ultimately, on health behavior improvements in a range of these sociocultural settings. Methods Collaborative qualitative research with Canadian Aboriginal and Tanzanian participants was conducted to deconstruct the content and transmission of evidence-based health information contained in SMS messages in the context of an international research project designed to address health inequalities in hypertension, and to develop a grounded theory of the major factors that mediate the effectiveness of this communication. We also examined the interrelationship of these mediators with the three essential conditions of the behavior system of the Behavioral Change Wheel model (capability, opportunity, and motivation) and cultural safety. Results Four focus groups with a total of 45 participants were conducted. Our grounded theory research revealed how discrepancies develop between the evidence-based text message created by researchers and the message received by the recipient in mobile health interventions. These discrepancies were primarily generated by six mediators of meaning in SMS messages: (1) negative or non-affirming framing of advocacies, (2) fear- or stress-inducing content, (3) oppressive or authoritarian content, (4) incongruity with cultural and traditional practices, (5) disconnect with the reality of the social determinants of health and the diversity of cultures within a population, and (6) lack of clarity and/or practicality of content. These 6 mediators of meaning provide the basis for sound strategies for message development because they impact directly on the target populations’ capability, opportunity, and motivation for behavior change. Conclusions The quality of text messages impacts significantly on the effectiveness of a mobile health intervention. Our research underscores the urgent need for interventions to incorporate and evaluate the quality of SMS messages and to examine the mediators of meaning within each targeted cultural and demographic group. Reporting on this aspect of mobile health intervention research will allow researchers to move away from the current black box of SMS text message development, thus improving the transparency of the process as well as the quality of the outcomes. PMID:26800712

OMG Do Not Say LOL: Obese Adolescents’ Perspectives on the Content of Text Messages to Enhance Weight Loss Efforts

PubMed Central

Woolford, Susan J.; Barr, Kathryn L.C.; Derry, Holly A.; Jepson, Christina M.; Clark, Sarah J.; Strecher, Victor J.; Resnicow, Kenneth

2011-01-01

Adolescents participating in weight loss programs experience difficulty adhering to behavior change recommendations. Communications technology provides a low cost means to increase the frequency of contact with adolescents which can improve their engagement and also lead to behavior change. Within a larger project on the development of tailored text messages for adolescents enrolled in an existing multidisciplinary weight management program, this study explored participants’ perspectives about message content. A library of messages was developed focused on topics central to weight management. Four focus groups were conducted with a total of 24 participants from the weight management program to gage their reactions to the messages. Detailed notes from the focus groups were analyzed to assess the acceptability of individual messages and to identify overriding themes. Results indicate that participants were very enthusiastic about receiving text messages. They preferred messages that provided recipe ideas, included successful weight loss strategies used by peers, and requested feedback regarding their progress. They preferred positive, encouraging, and direct messages. They were unanimous that messages should include encouraging symbols (e.g., exclamation points and “smiley faces”) as often as possible. They emphasized that any mention of unhealthy foods or behaviors would trigger them to eat those foods or engage in those behaviors. Text messaging acronyms (e.g., LOL) were considered too informal for messages from healthcare providers. This study suggests that including text messages in obesity interventions is acceptable to obese adolescents as a means of supporting their weight loss efforts, and it highlights the need for such messages to be carefully constructed. PMID:21869762

Mobile Phone Intervention to Reduce Youth Suicide in Rural Communities: Field Test.

PubMed

Pisani, Anthony R; Wyman, Peter A; Gurditta, Kunali; Schmeelk-Cone, Karen; Anderson, Carolyn L; Judd, Emily

2018-05-31

Suicide is a leading cause of death among 10- to 19-year-olds in the United States, with 5% to 8% attempting suicide each year. Suicide risk rises significantly during early adolescence and is higher in rural and underserved communities. School-based universal prevention programs offer a promising way of reducing suicide by providing strategies for emotion regulation and encouraging help-seeking behaviors and youth-adult connectedness. However, such programs frequently run into difficulties in trying to engage a broad range of students. Text messaging is a dominant medium of communication among youths, and studies show both efficacy and uptake in text messaging interventions aimed at adolescents. Text-based interventions may, thus, offer a means for school-based universal prevention programs to engage adolescents who would otherwise be difficult to reach. We field tested Text4Strength, an automated, interactive text messaging intervention that seeks to reach a broad range of early adolescents in rural communities. Text4Strength extends Sources of Strength, a peer-led school suicide prevention program, by encouraging emotion regulation, help-seeking behaviors, and youth-adult connectedness in adolescents. The study tested the appeal and feasibility of Text4Strength and its potential to extend universal school-based suicide prevention. We field tested Text4Strength with 42 ninth-grade students. Over 9 weeks, students received 28 interactive message sequences across 9 categories (Sources of Strength introduction, positive friend, mentors, family support, healthy activities, generosity, spirituality, medical access, and emotion regulation strategies). The message sequences included games, requests for advice, questions about students' own experiences, and peer testimonial videos. We measured baseline mental health characteristics, frequency of replies, completion of sequences and video viewing, appeal to students, and their perception of having benefited from the program. Of the 42 participating students, 38 (91%) responded to at least one sequence and 22 (52%) responded to more than a third of the sequences. The proportion of students who completed multistep sequences they had started ranged from 35% (6/17) to 100% (3/3 to 28/28), with responses dropping off when more than 4 replies were needed. With the exception of spirituality and generosity, each of the content areas generated at least a moderate number of student replies from both boys and girls. Students with higher and lower levels of risk and distress interacted with the sequences at similar rates. Contrary to expectations, few students watched videos. Students viewed the intervention as useful-even those who rarely responded to messages. More than 70% found the texts useful (3 items, n range 29-34) and 90% (36) agreed the program should be repeated. Text4Strength offers a potentially engaging way to extend school-based interventions that promote protective factors for suicide. Text4Strength is ready to be revised, based on findings and student feedback from this field test, and rigorously tested for efficacy. ©Anthony R Pisani, Peter A Wyman, Kunali Gurditta, Karen Schmeelk-Cone, Carolyn L Anderson, Emily Judd. Originally published in JMIR Mental Health (http://mental.jmir.org), 31.05.2018.

Effectiveness of a Text Messaging-Based Intervention Targeting Alcohol Consumption Among University Students: Randomized Controlled Trial.

PubMed

Thomas, Kristin; Müssener, Ulrika; Linderoth, Catharina; Karlsson, Nadine; Bendtsen, Preben; Bendtsen, Marcus

2018-06-25

Excessive drinking among university students is a global challenge, leading to significant health risks. However, heavy drinking among students is widely accepted and socially normalized. Mobile phone interventions have attempted to reach students who engage in excessive drinking. A growing number of studies suggest that text message-based interventions could potentially reach many students and, if effective, such an intervention might help reduce heavy drinking in the student community. The objective of this study was to test the effectiveness of a behavior change theory-based 6-week text message intervention among university students. This study was a two-arm, randomized controlled trial with an intervention group receiving a 6-week text message intervention and a control group that was referred to treatment as usual at the local student health care center. Outcome measures were collected at baseline and at 3 months after the initial invitation to participate in the intervention. The primary outcome was total weekly alcohol consumption. Secondary outcomes were frequency of heavy episodic drinking, highest estimated blood alcohol concentration, and number of negative consequences attributable to excessive drinking. A total of 896 students were randomized to either the intervention or control group. The primary outcome analysis included 92.0% of the participants in the intervention group and 90.1% of the control group. At follow-up, total weekly alcohol consumption decreased in both groups, but no significant between-group difference was seen. Data on the secondary outcomes included 49.1% of the participants in the intervention group and 41.3% of the control group. No significant between-group difference was seen for any of the secondary outcomes. The present study was under-powered, which could partly explain the lack of significance. However, the intervention, although theory-based, needs to be re-assessed and refined to better support the target group. Apart from establishing which content forms an effective intervention, the optimal length of an alcohol intervention targeting students also needs to be addressed in future studies. International Standard Randomised Controlled Trial Number ISRCTN95054707; http://www.isrctn.com/ISRCTN95054707 (Archived by WebCite at http://www.webcitation.org/70Ax4vXhd). ©Kristin Thomas, Ulrika Müssener, Catharina Linderoth, Nadine Karlsson, Preben Bendtsen, Marcus Bendtsen. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.06.2018.

Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus.

PubMed

Agboola, Stephen; Jethwani, Kamal; Lopez, Lenny; Searl, Meghan; O'Keefe, Sandra; Kvedar, Joseph

2016-11-18

Text messages are increasingly being used because of the low cost and the ubiquitous nature of mobile phones to engage patients in self-care behaviors. Self-care is particularly important in achieving treatment outcomes in type 2 diabetes mellitus (T2DM). This study examined the effect of personalized text messages on physical activity, as measured by a pedometer, and clinical outcomes in a diverse population of patients with T2DM. Text to Move (TTM) incorporates physical activity monitoring and coaching to provide automated and personalized text messages to help patients with T2DM achieve their physical activity goals. A total of 126 English- or Spanish-speaking patients with glycated hemoglobin A 1c (HbA 1c ) >7 were enrolled in-person to participate in the study for 6 months and were randomized into either the intervention arm that received the full complement of the intervention or a control arm that received only pedometers. The primary outcome was change in physical activity. We also assessed the effect of the intervention on HbA 1c , weight, and participant engagement. All participants (intervention: n=64; control: n=62) were included in the analyses. The intervention group had significantly higher monthly step counts in the third (risk ratio [RR] 4.89, 95% CI 1.20 to 19.92, P=.03) and fourth (RR 6.88, 95% CI 1.21 to 39.00, P=.03) months of the study compared to the control group. However, over the 6-month follow-up period, monthly step counts did not differ statistically by group (intervention group: 9092 steps; control group: 3722 steps; RR 2.44, 95% CI 0.68 to 8.74, P=.17). HbA 1c decreased by 0.07% (95% CI -0.47 to 0.34, P=.75) in the TTM group compared to the control group. Within groups, HbA 1c decreased significantly from baseline in the TTM group by -0.43% (95% CI -0.75 to -0.12, P=.01), but nonsignificantly in the control group by -0.21% (95% CI -0.49 to 0.06, P=.13). Similar changes were observed for other secondary outcomes. Personalized text messaging can be used to improve outcomes in patients with T2DM by employing optimal patient engagement measures. ©Stephen Agboola, Kamal Jethwani, Lenny Lopez, Meghan Searl, Sandra O’Keefe, Joseph Kvedar. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.11.2016.

Effect of a Counseling Session Bolstered by Text Messaging on Self-Selected Health Behaviors in College Students: A Preliminary Randomized Controlled Trial.

PubMed

Sandrick, Janice; Tracy, Doreen; Eliasson, Arn; Roth, Ashley; Bartel, Jeffrey; Simko, Melanie; Bowman, Tracy; Harouse-Bell, Karen; Kashani, Mariam; Vernalis, Marina

2017-05-17

The college experience is often the first time when young adults live independently and make their own lifestyle choices. These choices affect dietary behaviors, exercise habits, techniques to deal with stress, and decisions on sleep time, all of which direct the trajectory of future health. There is a need for effective strategies that will encourage healthy lifestyle choices in young adults attending college. This preliminary randomized controlled trial tested the effect of coaching and text messages (short message service, SMS) on self-selected health behaviors in the domains of diet, exercise, stress, and sleep. A second analysis measured the ripple effect of the intervention on health behaviors not specifically selected as a goal by participants. Full-time students aged 18-30 years were recruited by word of mouth and campuswide advertisements (flyers, posters, mailings, university website) at a small university in western Pennsylvania from January to May 2015. Exclusions included pregnancy, eating disorders, chronic medical diagnoses, and prescription medications other than birth control. Of 60 participants, 30 were randomized to receive a single face-to-face meeting with a health coach to review results of behavioral questionnaires and to set a health behavior goal for the 8-week study period. The face-to-face meeting was followed by SMS text messages designed to encourage achievement of the behavioral goal. A total of 30 control subjects underwent the same health and behavioral assessments at intake and program end but did not receive coaching or SMS text messages. The texting app showed that 87.31% (2187/2505) of messages were viewed by intervention participants. Furthermore, 28 of the 30 intervention participants and all 30 control participants provided outcome data. Among intervention participants, 22 of 30 (73%) showed improvement in health behavior goal attainment, with the whole group (n=30) showing a mean improvement of 88% (95% CI 39-136). Mean improvement in any behavioral domains was not seen in the control group. Intervention participants also increased their exercise significantly compared with controls, regardless of their self-selected goal category. The increased exercise was paralleled by significantly lower fasting glucose levels. The health coaching session plus tailored SMS text messages improved self-selected health behaviors with a modest ripple effect to include unselected health behaviors. Clinicaltrials.gov NCT02476604; https://clinicaltrials.gov/ct2/show/NCT02476604 (Archived by WebCite at http://www.webcitation.org/6qAAryS5t). ©Janice Sandrick, Doreen Tracy, Arn Eliasson, Ashley Roth, Jeffrey Bartel, Melanie Simko, Tracy Bowman, Karen Harouse-Bell, Mariam Kashani, Marina Vernalis. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 17.05.2017.

The Mobile Insulin Titration Intervention (MITI) for Insulin Glargine Titration in an Urban, Low-Income Population: Randomized Controlled Trial Protocol.

PubMed

Levy, Natalie; Moynihan, Victoria; Nilo, Annielyn; Singer, Karyn; Bernik, Lidia S; Etiebet, Mary-Ann; Fang, Yixin; Cho, James; Natarajan, Sundar

2015-03-13

Patients on insulin glargine typically visit a clinician to obtain advice on how to adjust their insulin dose. These multiple clinic visits can be costly and time-consuming, particularly for low-income patients. It may be feasible to achieve insulin titration through text messages and phone calls with patients instead of face-to-face clinic visits. The objectives of this study are to (1) evaluate if the Mobile Insulin Titration Intervention (MITI) is clinically effective by helping patients reach their optimal dose of insulin glargine, (2) determine if the intervention is feasible within the setting and population, (3) assess patient satisfaction with the intervention, and (4) measure the costs associated with this intervention. This is a pilot study evaluating an approach to insulin titration using text messages and phone calls among patients with insulin-dependent type 2 diabetes in the outpatient medical clinic of Bellevue Hospital Center, a safety-net hospital in New York City. Patients will be randomized in a 1:1 ratio to either the MITI arm (texting/phone call intervention) or the usual-care arm (in-person clinic visits). Using a Web-based platform, weekday text messages will be sent to patients in the MITI arm, asking them to text back their fasting blood glucose values. In addition to daily reviews for alarm values, a clinician will rereview the texted values weekly, consult our physician-approved titration algorithm, and call the patients with advice on how to adjust their insulin dose. The primary outcome will be whether or not a patient reaches his/her optimal dose of insulin glargine within 12 weeks. Recruitment for this study occurred between June 2013 and December 2014. We are continuing to collect intervention and follow-up data from our patients who are currently enrolled. The results of our data analysis are expected to be available in 2015. This study explores the use of widely-available text messaging and voice technologies for insulin titration. We aim to show that remote insulin titration is clinically effective, feasible, satisfactory, and cost saving for low-income patients in a busy, urban clinic. Clinicaltrials.gov NCT01879579; http://clinicaltrials.gov/ct2/show/NCT01879579 (Archived by WebCite at http://www.webcitation.org/6WUEgjZUO).

Text Message Intervention to Improve Cardiac Rehab Participation

ClinicalTrials.gov

2017-11-14

Myocardial Infarction; Percutaneous Coronary Intervention; Coronary Artery Bypass Surgery; Heart Valve Repair or Replacement; Heart Transplant; Left Ventricular Assist Device; Chronic Stable Angina; Chronic Stable Heart Failure

Mindfulness predicts less texting while driving among young adults: Examining attention- and emotion-regulation motives as potential mediators

PubMed Central

Feldman, Greg; Greeson, Jeff; Renna, Megan; Robbins-Monteith, Kendra

2011-01-01

Many young adult drivers read and send text messages while driving despite clear safety risks. Understanding predictors of texting-while-driving may help to indentify relevant targets for interventions to reduce this dangerous behavior. The present study examined whether individual differences in mindfulness is associated with texting-while-driving in a sample of young-adult drivers. Using path analysis, we tested whether this relationship would be mediated by the degree to which individuals use text-messaging as a means of reducing unpleasant emotions (emotion-regulation motives) and the degree to which individuals limit texting in order to focus on present-moment experiences (attention-regulation motives). Individuals lower in mindfulness reported more frequent texting-while-driving and this relationship appeared to be mediated primarily by emotion-regulation motives. Results may help inform the development of mindfulness-based interventions to prevent texting-while-driving. PMID:22031789

Do Fitness Apps Need Text Reminders? An Experiment Testing Goal-Setting Text Message Reminders to Promote Self-Monitoring.

PubMed

Liu, Shuang; Willoughby, Jessica F

2018-01-01

Fitness tracking apps have the potential to change unhealthy lifestyles, but users' lack of compliance is an issue. The current intervention examined the effectiveness of using goal-setting theory-based text message reminders to promote tracking activities on fitness apps. We conducted a 2-week experiment with pre- and post-tests with young adults (n = 50). Participants were randomly assigned to two groups-a goal-setting text message reminder group and a generic text message reminder group. Participants were asked to use a fitness tracking app to log physical activity and diet for the duration of the study. Participants who received goal-setting reminders logged significantly more physical activities than those who only received generic reminders. Further, participants who received goal-setting reminders liked the messages and showed significantly increased self-efficacy, awareness of personal goals, motivation, and intention to use the app. The study shows that incorporating goal-setting theory-based text message reminders can be useful to boost user compliance with self-monitoring fitness apps by reinforcing users' personal goals and enhancing cognitive factors associated with health behavior change.

Mobile Link - a theory-based messaging intervention for improving sexual and reproductive health of female entertainment workers in Cambodia: study protocol of a randomized controlled trial.

PubMed

Brody, Carinne; Tuot, Sovannary; Chhoun, Pheak; Swendenman, Dallas; Kaplan, Kathryn C; Yi, Siyan

2018-04-19

In Cambodia, HIV prevalence is concentrated in key populations including among female entertainment workers (FEWs) who may engage in direct or indirect sex work. Reaching FEWs with sexual and reproductive health (SRH) services has been difficult because of their hidden and stigmatized nature. Mobile-phone-based interventions may be an effective way to reach this population and connect them with the existing services. This article describes study design and implementation of a randomized controlled trial (RCT) of a mobile health intervention (the Mobile Link) aiming to improve SRH and related outcomes among FEWs in Cambodia. A two-arm RCT will be used to determine the effectiveness of a mobile-phone-based text/voice messaging intervention. The intervention will be developed through a participatory process. Focus group discussions and in-depth interviews have been conducted to inform and tailor behavior change theory-based text and voice messages. During the implementation phase, 600 FEWs will be recruited and randomly assigned into one of the two arms: (1) a control group and (2) a mobile phone message group (either text messages [SMS] or voice messages [VM], a delivery method chosen by participants). Participants in the control group will also receive a weekly monitoring survey, which will provide real-time information to implementing partners to streamline outreach efforts and be able to quickly identify geographic trends. The primary outcome measures will include self-reported HIV and sexually transmitted infections (STI) testing and treatment, condom use, contraceptive use, and gender-based violence (GBV). If the Mobile Link trial is successful, participants will report an increase in condom use, linkages to screening and treatment for HIV and STI, and contraception use as well as a reduction in GBV. This trial is unique in a number of ways. First, the option of participation mode (SMS or VM) allows participants to choose the message medium that best links them to services. Second, this is the first RCT of a mobile-phone-based behavior change intervention using SMS/VMs to support linkage to SRH services in Cambodia. Lastly, we are working with a hidden, hard-to-reach, and dynamic population with which existing methods of outreach have not been fully successful. Clinical trials.gov, NCT03117842 . Registered on 31 March 2017.

Piloting a Text Message-based Social Support Intervention for Patients With Chronic Pain: Establishing Feasibility and Preliminary Efficacy.

PubMed

Guillory, Jamie; Chang, Pamara; Henderson, Charles R; Shengelia, Rouzi; Lama, Sonam; Warmington, Marcus; Jowza, Maryam; Waldman, Seth; Gay, Geri; Reid, M Carrington

2015-06-01

To examine preliminarily the effectiveness of a short message service (SMS) text message-based social support intervention for reducing daily pain and pain interference levels, improving affect and perceptions of social support in patients with chronic noncancer pain, and exploring the feasibility of a novel mobile application to track perceptions of pain and pain interference. Participants (17 men, 51 women) from 2 pain clinics in New York City downloaded a pain tracking application (App) on their Smartphone and used it to record twice-daily pain, pain interference, and affect scores over the 4-week study period. Participants were randomly assigned to receive standard care (control) or standard care along with receipt of twice-daily supportive SMS text messages delivered during the second and third week of the study (intervention). Demographic and clinical data were obtained at baseline, and social support measures were administered at baseline and at 4 weeks. Statistical analysis was carried out using general linear mixed models, taking into account variances associated with time of assessments and with patients. The social support intervention reduced perceptions of pain and pain interference and improved positive affect for chronic noncancer pain patients assigned to the intervention condition in comparison with controls. Participants completed approximately 80% of the daily measurements requested. These findings establish the feasibility of collecting daily pain data using a mobile tracking App and provide significant implications and insight into a nuanced approach to reducing the daily experience of pain through mobile technology, especially because of its accessibility.

Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial.

PubMed

Dobson, Rosie; Whittaker, Robyn; Jiang, Yannan; Maddison, Ralph; Shepherd, Matthew; McNamara, Catherine; Cutfield, Richard; Khanolkar, Manish; Murphy, Rinki

2018-05-17

To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. Nine month, two arm, parallel randomised controlled trial. Primary and secondary healthcare services in New Zealand. 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control). The intervention group received a tailored package of text messages for up to nine months in addition to usual care. Text messages provided information, support, motivation, and reminders related to diabetes self management and lifestyle behaviours. The control group received usual care. Messages were delivered by a specifically designed automated content management system. Primary outcome measure was change in glycaemic control (HbA1c) from baseline to nine months. Secondary outcomes included change in HbA1c at three and six months, and self efficacy, diabetes self care behaviours, diabetes distress, perceptions and beliefs about diabetes, health related quality of life, perceived support for diabetes management, and intervention engagement and satisfaction at nine months. Regression models adjusted for baseline outcome, health district category, diabetes type, and ethnicity. The reduction in HbA1c at nine months was significantly greater in the intervention group (mean -8.85 mmol/mol (standard deviation 14.84)) than in the control group (-3.96 mmol/mol (17.02); adjusted mean difference -4.23 (95% confidence interval -7.30 to -1.15), P=0.007). Of 21 secondary outcomes, only four showed statistically significant improvements in favour of the intervention group at nine months. Significant improvements were seen for foot care behaviour (adjusted mean difference 0.85 (95% confidence interval 0.40 to 1.29), P<0.001), overall diabetes support (0.26 (0.03 to 0.50), P=0.03), health status on the EQ-5D visual analogue scale (4.38 (0.44 to 8.33), P=0.03), and perceptions of illness identity (-0.54 (-1.04 to -0.03), P=0.04). High levels of satisfaction with SMS4BG were found, with 161 (95%) of 169 participants reporting it to be useful, and 164 (97%) willing to recommend the programme to other people with diabetes. A tailored, text message based, self management support programme resulted in modest improvements in glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, the findings support further investigation into the use of SMS4BG and other text message based support for this patient population. Australian New Zealand Clinical Trials Registry ACTRN12614001232628. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Electronic communication based interventions for hazardous young drinkers: A systematic review.

PubMed

O Rourke, L; Humphris, G; Baldacchino, A

2016-09-01

Previous reviews have specifically looked at computer-based or Internet-based approaches. However, there has been no systematic review focused upon electronic communication based interventions for hazardous young drinkers. Out of 3298 relevant citations, 13 papers consisting of 11 studies met the inclusion criteria. Effectiveness of intervention delivery was assessed using behavioural outcomes. Eight papers delivered interventions using the Web, three implemented text messaging, one used a mobile phone app and the remaining paper used a social networking site. The ability to provide personalized electronic feedback resulted in a reduction in alcohol consumption, frequency of binge drinking, and drinking in a non-risky way. However, intervention length did not appear to have an impact on overall effectiveness. Usage of text messaging and Social Network Sites (SNS) increased accessibility and ease of engaging in an intervention that is appealing and acceptable for young adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Direct-to-adolescent text messaging for vaccine reminders: What will parents permit?

PubMed

Roberts, James R; Morella, Kristen; Dawley, Erin H; Madden, Christi A; Jacobson, Robert M; Pope, Charlene; Davis, Boyd; Thompson, David; O'Brien, Elizabeth S; Darden, Paul M

2018-05-11

Direct-to-adolescent text messaging may be a consideration for vaccine reminders, including human papilloma virus (HPV), but no studies have explored the minimum age at which parents would allow adolescents to receive a text message. We distributed a survey to parents of 10-17 year olds during any office visit in two practice based research networks in South Carolina and Oklahoma. We asked about parental preference for receiving vaccine reminders for their adolescent, whether they would allow the healthcare provider to directly message their adolescent, and if so, what would be the acceptable minimum age. In 546 surveys from 11 practices, parents of females were more supportive of direct-to-teen text message reminders than were parents of males, (75% v. 60%, p < .001). The median age at which parents would allow direct text messages from physicians' offices was 14 in females compared to 15 in males, p = .049. We found a correlation between the child's age and the youngest age at which parents would allow a direct text message. Of the parents who permitted a text message directly to their adolescent, most reported an allowable age higher than their adolescent's current age until the age of 15. Our study suggests that direct-to-adolescent text messaging would be allowed by parents for older adolescents. This supports an intervention aimed at older adolescents, such as for receipt of MCV4 dose #2, delayed HPV vaccine series completion and annual influenza vaccination. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

PubMed

Bruehlman-Senecal, Emma; Aguilera, Adrian; Schueller, Stephen M

2017-09-01

Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy. Copyright © 2017. Published by Elsevier Ltd.

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

PubMed

Naughton, Felix; Cooper, Sue; Foster, Katharine; Emery, Joanne; Leonardi-Bee, Jo; Sutton, Stephen; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

2017-07-01

To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. Sixteen antenatal clinics in England. Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were < 25 weeks gestation, smoked at least one daily cigarette (> 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

An Investigation of the Impact of an Intervention to Reduce Academic Procrastination Using Short Message Service (SMS) Technology

ERIC Educational Resources Information Center

Davis, Darrel R.; Abbitt, Jason T.

2013-01-01

This mixed-method pilot study investigated the impact of a custom Short Message Service (SMS) reminder system developed to help students reduce procrastination and increase performance on weekly content-related quizzes in a high-enrollment hybrid online course. Text message reminders were sent to three students with high procrastination and low…

The Use of Text Messaging to Improve the Hospital-to-Community Transition in Acute Coronary Syndrome Patients (Txt2Prevent): Intervention Development and Pilot Randomized Controlled Trial Protocol.

PubMed

Ross, Emily S; Sakakibara, Brodie M; Mackay, Martha H; Whitehurst, David Gt; Singer, Joel; Toma, Mustafa; Corbett, Kitty K; Van Spall, Harriette Gc; Rutherford, Kimberly; Gheorghiu, Bobby; Code, Jillianne; Lear, Scott A

2017-05-23

Acute coronary syndrome, including acute myocardial infarction (AMI), is one of the leading causes for hospitalization, with AMI 30-day readmission rates around 20%. Supporting patient information needs and increasing adherence to recommended self-management behaviors during transition from hospital to home has the potential to improve patient outcomes. Text messages have been effective in other interventions and may be suitable to provide support to patients during this transition period. The goal of this study is to pilot test a text messaging intervention program (Txt2Prevent) that supports acute coronary syndrome patients for 60 days postdischarge. The primary objective is to compare self-management, as measured by the Health Education Impact Questionnaire, between patients receiving only usual care versus those who receive usual care plus the Txt2Prevent intervention. The secondary objectives are to compare medication adherence, health-related quality of life, self-efficacy, health care resource use (and associated costs), all-cause and cardiovascular disease (CVD) readmission, and all-cause and CVD mortality rates between the 2 groups. The third objective is to assess acceptability of the text messaging intervention and feasibility of the study protocol. This is a randomized controlled trial with blinding of outcome assessors. The Txt2Prevent program includes automated text messages to patients about standard follow-up care, general self-management, and healthy living. The content of the text messages was informed by and developed based on interviews with patients, discharge materials, theoretical domains of behavior, and a clinical advisory group composed of patients, clinicians, and researchers. We will recruit 76 consecutive cardiac in-patients with acute coronary syndrome who are treated with either medical management or percutaneous coronary intervention from a hospital in Vancouver, Canada. Assessments at baseline will include measures for demographic information, self-management, health-related quality of life, and self-efficacy. Assessments at follow-up will include medication adherence, readmissions, health care resource use, and mortality in addition to the reassessment of baseline measures. Baseline assessments are done in-person while follow-up assessments are completed through a combination of mailed packages and phone calls. Semistructured interviews with participants will also be performed to better understand participant experiences managing their condition and with the text messages. This study will determine preliminary efficacy, feasibility, and acceptability of the Txt2Prevent program to support acute coronary syndrome patients in the transition to home following hospital discharge. The results of this study will be used to inform a larger trial. ClinicalTrials.gov NCT02336919; https://clinicaltrials.gov/ct2/show/NCT02336919 (Archived by WebCite at http://www.webcitation.org/6qMjEqo6O). ©Emily S Ross, Brodie M Sakakibara, Martha H Mackay, David GT Whitehurst, Joel Singer, Mustafa Toma, Kitty K Corbett, Harriette GC Van Spall, Kimberly Rutherford, Bobby Gheorghiu, Jillianne Code, Scott A Lear. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 23.05.2017.

Recruiting pregnant smokers from Text4baby for a randomized controlled trial of Quit4baby.

PubMed

Leavitt, Leah; Abroms, Lorien; Johnson, Pamela; Schindler-Ruwisch, Jennifer; Bushar, Jessica; Singh, Indira; Cleary, Sean D; McInvale, Whitney; Turner, Monique

2017-06-01

Recruiting pregnant smokers into clinical trials is challenging since this population tends to be disadvantaged, the behavior is stigmatized, and the intervention window is limited. The purpose of this study is to test the feasibility and effectiveness of recruiting pregnant smokers into a smoking cessation trial by sending recruitment text messages to an existing subscriber list. Recruitment messages were sent to subscribers flagged as pregnant in Text4baby, a national text messaging program for pregnant women and mothers. Four recruitment messages were rotated to test the effectiveness of different emotional frames and a financial incentive. Study staff called subscribers who expressed interest to screen for eligibility and enroll eligible women. Between October 6, 2015 and February 2, 2016, 10,194 recruitment messages were sent to Text4baby subscribers flagged as pregnant, and 10.18% (1038) responded indicating interest. No significant increase in cancellation was observed compared to subscribers who received other ad hoc messages. Of respondents, 54.05% (561) were reached by phone for follow-up, and 21.97% (228) were found to be eligible. Among the eligible, 87% (199) pregnant smokers enrolled. The recruitment message with a pride emotional appeal had a significantly higher response (p = 0.02) compared to the recruitment message with no emotional appeal, but enrollment did not significantly differ between recruitment messages with different emotional appeals. The recruitment messages with a reference to financial incentive yielded higher response (p < 0.01) and enrollment (p = 0.03) compared to a recruitment message without. This study demonstrates success recruiting pregnant smokers using text message. Future studies should consider building on this approach for recruiting high-risk populations.

Testing the effect of text messaging cues to promote physical activity habits: a worksite-based exploratory intervention.

PubMed

Fournier, M; d'Arripe-Longueville, F; Radel, R

2017-10-01

This study aims to test the efficacy of text messaging cues (SMS) to promote physical activity (PA) habit formation in the workplace. Employees (N = 49; 28 females and 21 males, Mage = 47.5 ± 8.29 years) were randomized into two parallel groups: a PA group enrolled in a 28-week supervised PA program and a PA+SMS group enrolled in the same PA program with text messaging cues received before their PA sessions. The exercise habit was assessed every week from self-reports on an online application. PA maintenance and several physical fitness measures were also assessed prior to and after the intervention to evaluate its general impact. Mixed model analysis of the 603 observations indicated a small but significant effect of the SMS cues on the speed at which participants engaged in PA behaviors, as the significant interaction effect revealed that the slope of the exercise habit over time was slightly steeper in the PA+SMS group (B = 0.0462, P = 0.0001) than in the PA group (B = 0.0216, P = 0.01). SMS delivery had a marginal effect on the maintenance of PA behaviors 1 year after the intervention. The results suggest that text messaging can help to form PA habits at the workplace and might facilitate long-term maintenance of PA behaviors. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Perceptions of successful cues to action and opportunities to augment behavioral triggers in diabetes self-management: qualitative analysis of a mobile intervention for low-income Latinos with diabetes.

PubMed

Burner, Elizabeth R; Menchine, Michael D; Kubicek, Katrina; Robles, Marisela; Arora, Sanjay

2014-01-29

The increasing prevalence of diabetes and the associated cost of managing this complicated disease have a significant impact on public health outcomes and health expenditures, especially among resource-poor Latino patients. Mobile health (mHealth) may be the solution to reaching this group and improving their health. In this qualitative study, we examined nuances of motivation, intention, and triggers to action effected by TExT-MED (Trial to Examine Text Messaging for Emergency Department patient with Diabetes), an mHealth intervention tailored to low-income, urban Latinos with diabetes. TExT-MED is a fully-automated, text message-based program designed to increase knowledge, self-efficacy, and subsequent disease management and glycemic control. We conducted 5 focus group interviews with 24 people who participated in TExT-MED. We employed a modified grounded theory analytic approach-an iterative process of coding and immersion in the data used to recognize the patterns and links between concepts voiced by the participants. We coded data to identify themes of participant experiences, motivations, and responses to the program. We organized themes into a theory of TExT-MED's action. Participants enjoyed their experience with TExT-MED and believed it improved their diabetes management. Through analysis of the transcripts, we identified that the strengths of the program were messages that cued specific behaviors such as medication reminders and challenge messages. Our analysis also revealed that increasing personalization of message delivery and content could augment these cues. This in-depth qualitative analysis of TExT-MED shows that low-income Latino patients will accept text messages as a behavioral intervention. This mHealth intervention acts as a behavioral trigger rather than an education platform. Personalization is an opportunity to enhance these cues to action and further research should be conducted on the ideal forms of personalization.

Perceptions of Successful Cues to Action and Opportunities to Augment Behavioral Triggers in Diabetes Self-Management: Qualitative Analysis of a Mobile Intervention for Low-Income Latinos With Diabetes

PubMed Central

Menchine, Michael D; Kubicek, Katrina; Robles, Marisela; Arora, Sanjay

2014-01-01

Background The increasing prevalence of diabetes and the associated cost of managing this complicated disease have a significant impact on public health outcomes and health expenditures, especially among resource-poor Latino patients. Mobile health (mHealth) may be the solution to reaching this group and improving their health. Objective In this qualitative study, we examined nuances of motivation, intention, and triggers to action effected by TExT-MED (Trial to Examine Text Messaging for Emergency Department patient with Diabetes), an mHealth intervention tailored to low-income, urban Latinos with diabetes. TExT-MED is a fully-automated, text message-based program designed to increase knowledge, self-efficacy, and subsequent disease management and glycemic control. Methods We conducted 5 focus group interviews with 24 people who participated in TExT-MED. We employed a modified grounded theory analytic approach—an iterative process of coding and immersion in the data used to recognize the patterns and links between concepts voiced by the participants. We coded data to identify themes of participant experiences, motivations, and responses to the program. We organized themes into a theory of TExT-MED’s action. Results Participants enjoyed their experience with TExT-MED and believed it improved their diabetes management. Through analysis of the transcripts, we identified that the strengths of the program were messages that cued specific behaviors such as medication reminders and challenge messages. Our analysis also revealed that increasing personalization of message delivery and content could augment these cues. Conclusions This in-depth qualitative analysis of TExT-MED shows that low-income Latino patients will accept text messages as a behavioral intervention. This mHealth intervention acts as a behavioral trigger rather than an education platform. Personalization is an opportunity to enhance these cues to action and further research should be conducted on the ideal forms of personalization. PMID:24476784

Pilot study of psychotherapeutic text messaging for depression.

PubMed

Pfeiffer, Paul N; Henry, Jennifer; Ganoczy, Dara; Piette, John D

2017-08-01

Background Text messaging services could increase access to psychotherapeutic content for individuals with depression by avoiding barriers to in-person psychotherapy such as cost, transportation, and therapist availability. Determining whether text messages reflecting different psychotherapeutic techniques exhibit differences in acceptability or effectiveness may help guide service development. Objectives We aimed to determine: (1) the feasibility of delivering a psychotherapy-based text messaging service to people with depression identified via the internet, (2) whether there is variation in satisfaction with messages according to the type of psychotherapeutic technique they represent, and (3) whether symptoms of depression vary according to receipt of each message type and participants' satisfaction with the messages they received. Methods For this study 190 US adults who screened positive for a major depressive episode (Patient Health Questionnaire (PHQ-9) score ≥10) were recruited from online advertisements. Participants received a daily psychotherapy-based text message 6 days per week for 12 weeks. Text messages were developed by a team of psychiatrists, psychologists, and social workers to reflect three psychotherapeutic approaches: acceptance and commitment therapy (ACT), behavioural activation, and cognitive restructuring. Each week the message type for the week was randomly assigned from one of the three types, allowing for repeats. Participants were asked daily to rate each message. On the 7th day of each week, participants completed a two-item depression screener (PHQ-2). Web-based surveys at baseline, 6, and 12 weeks were used as the primary measure of depressive symptoms (PHQ-9). Results Of the 190 participants enrolled, 85 (45%) completed the 6-week web survey and 67 (35%) completed the 12-week survey. The mean baseline PHQ-9 score was 19.4 (SD 4.2) and there was a statistically significant mean improvement in PHQ-9 scores of -2.9 (SD 6.0; p < 0.001) at 6 weeks and -4.8 (SD 6.6; p < 0.001) at 12 weeks. Mean satisfaction ratings did not vary across message types. There was generally no association between the number of weeks in which participants received a given message type and PHQ-9 scores at follow-up. However, among individuals with more severe depression at baseline (PHQ-9 ≥ 20; n = 30), the number of weeks of behavioural activation messages received was associated with less symptom improvement (ρ = 0.37; p = 0.04) at 12 weeks. Participants who gave higher satisfaction ratings to messages regardless of type had greater reductions in PHQ-9 scores at 6 weeks. Conclusions Study participants exhibited borderline clinically significant improvement in depressive symptoms at 12 weeks suggesting the effects of the intervention, if any, were small. Although there was no overall variation in changes in PHQ-9 according to users' exposure to the three message types, effectiveness among severely depressed participants could potentially be improved by tailoring towards fewer behavioural activation messages. Controlled studies to determine effectiveness of texting interventions such as this one are indicated considering that even small effects may be cost effective given the low cost of delivering text messages.

Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care.

PubMed

Schwartz, Sheree R; Clouse, Kate; Yende, Nompumelelo; Van Rie, Annelies; Bassett, Jean; Ratshefola, Mamothe; Pettifor, Audrey

2015-09-01

The objective of this study was to assess the acceptability and feasibility of a cell phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through 6 weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Fifty women were enrolled into the pilot from May to July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n = 50) and intervention (n = 50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0 vs. 63.3%, p < 0.01). Maternal support through a cell phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness.

Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial

PubMed Central

Khoo, Selina; Morris, Tony

2016-01-01

Background Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones. Objective The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants’ exercise frequency and the effects of the intervention on secondary outcomes. Methods The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity–related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24. Results In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study-unrelated injuries forced 4 participants to discontinue after a few weeks (they were not included in any analyses). Overall retention was 86% (37/43). After 12 weeks, SMS texting arm participants exercised significantly more than non-SMS texting arm participants (mean difference 1.21 times, bias-corrected and accelerated bootstrap [BCa] 95% CI 0.18-2.24). Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers. They described the SMS text messages as being encouraging, a push, and a reminder. After 24 weeks, there was no significant difference between the research arms (mean difference 0.74, BCa 95% CI –0.30 to 1.76). There were no significant effects for secondary outcomes. Conclusions This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country. Although the effects were not maintained when SMS text messaging ceased, the results are promising and warrant more research on behavioral mobile health interventions in other regions. Trial Registration Clinicaltrials.gov NCT02123342; http://clinicaltrials.gov/ct2/show/NCT02123342 (Archived by WebCite at http://www.webcitation.org/6eGSsu2EI). PMID:26742999

Text Messaging for Exercise Promotion in Older Adults From an Upper-Middle-Income Country: Randomized Controlled Trial.

PubMed

Müller, Andre Matthias; Khoo, Selina; Morris, Tony

2016-01-07

Mobile technology to promote exercise is effective; however, most evidence is from studies of younger groups in high-income countries. Investigating if short message service (SMS) texting can affect exercise participation in older adults from an upper-middle-income country is important considering the proliferation of mobile phones in developing regions and the increased interest of older adults in using mobile phones. The main objective was to examine the short- and long-term effects of SMS text messaging on exercise frequency in older adults. Secondary objectives were to investigate how SMS text messages impact study participants' exercise frequency and the effects of the intervention on secondary outcomes. The Malaysian Physical Activity for Health Study (myPAtHS) was a 24-week, 2-arm, parallel randomized controlled trial conducted in urban Malaysia. Participants were recruited via health talks in resident associations and religious facilities. Older Malaysians (aged 55-70 years) who used mobile phones and did not exercise regularly were eligible to participate in the study. Participants randomly allocated to the SMS texting arm received an exercise booklet and 5 weekly SMS text messages over 12 weeks. The content of the SMS text messages was derived from effective behavior change techniques. The non-SMS texting arm participants received only the exercise booklet. Home visits were conducted to collect outcome data: (1) exercise frequency at 12 and 24 weeks, (2) secondary outcome data (exercise self-efficacy, physical activity-related energy expenditure, sitting time, body mass index, grip and leg strength) at baseline and at 12 and 24 weeks. Intention-to-treat procedures were applied for data analysis. Semistructured interviews focusing primarily on the SMS text messages and their impact on exercise frequency were conducted at weeks 12 and 24. In total, 43 participants were randomized into the SMS texting arm (n=22) and the non-SMS texting arm (n=21). Study-unrelated injuries forced 4 participants to discontinue after a few weeks (they were not included in any analyses). Overall retention was 86% (37/43). After 12 weeks, SMS texting arm participants exercised significantly more than non-SMS texting arm participants (mean difference 1.21 times, bias-corrected and accelerated bootstrap [BCa] 95% CI 0.18-2.24). Interview analysis revealed that the SMS text messages positively influenced SMS texting arm participants who experienced exercise barriers. They described the SMS text messages as being encouraging, a push, and a reminder. After 24 weeks, there was no significant difference between the research arms (mean difference 0.74, BCa 95% CI -0.30 to 1.76). There were no significant effects for secondary outcomes. This study provides evidence that SMS text messaging is effective in promoting exercise in older adults from an upper-middle-income country. Although the effects were not maintained when SMS text messaging ceased, the results are promising and warrant more research on behavioral mobile health interventions in other regions. Clinicaltrials.gov NCT02123342; http://clinicaltrials.gov/ct2/show/NCT02123342 (Archived by WebCite at http://www.webcitation.org/6eGSsu2EI).

A Systematic Review of Interventions to Enhance Healthy Lifestyle Behaviors in Adolescents Delivered via Mobile Phone Text Messaging.

PubMed

Loescher, Lois J; Rains, Stephen A; Kramer, Sandra S; Akers, Chelsie; Moussa, Renee

2018-05-01

To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM). PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases. Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM. The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias. Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n = 8) reported more positive results than those for health behavior change (n = 19). Studies that only included message delivered via TM (n = 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies. Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.

Mobile phone text messaging for improving secondary prevention in cardiovascular diseases: A systematic review.

PubMed

Unal, Eda; Giakoumidakis, Konstantinos; Khan, Ehsan; Patelarou, Evridiki

2018-05-23

The aim of this study was to identify, retrieve, critically appraise and synthesize the existing mobile phone text messaging interventions that have been done for secondary prevention of cardiovascular disease (CVD). A systematic review was conducted. The searching was conducted by using the MEDLINE, EMBASE, PsychINFO, CINAHL, PubMed and ScienceDirect databases. Nine randomized controlled trials (RCTs) were eligible and included. The preventive factors measured among studies varied. While the majority of studies examined medication adherence as a main outcome (4), the other 3 studies focused of CVD risk factors combining blood pressure (BP), smoking, body mass index (BMI), physical activity and dietary habits, only 2 studies examined both medication adherence and risk factor modification of CVD. Even though mobile phone text messaging may be beneficial for the secondary prevention of CVD, reliable conclusions on the effects of text messaging cannot be drawn. Copyright © 2018 Elsevier Inc. All rights reserved.

Experiences of Older Adults With Mobile Phone Text Messaging as Reminders of Home Exercises After Specialized Manual Therapy for Recurrent Low Back Pain: A Qualitative Study.

PubMed

Lilje, Stina Charlotta; Olander, Ewy; Berglund, Johan; Skillgate, Eva; Anderberg, Peter

2017-03-30

Clinical experience of manual therapy for musculoskeletal pain is that patients often suffer from recurrent pain and disorders, but that they do not continue to perform their physical home exercises when they are free from symptoms. The chance of positive long-term effects of manual therapy would probably increase if patients were reminded that they are to continue to perform their exercises. Mobile phone text messaging (short messaging service, SMS) is increasingly used as an innovative intervention to remind patient to exercise. However, there are only a few studies on such interventions in the field of low back pain (LBP). Qualitative studies of patients' experiences of receiving text messages as reminders of home exercises after manual treatment for recurrent LBP have to the best of our knowledge never been published. The aim of this study was to explore older persons' common experiences of receiving reminders of home exercises through mobile phone text messaging after specialized manual therapy for recurrent LBP. A total of 7 men and 8 women (67-86 years), who had sought specialized manual therapy (Naprapathic manual therapy) for recurrent LBP were included in the study. Individual one-way text messages as reminders of home exercises (to be performed on a daily basis) were sent to each patient every third day for 3 weeks, then once a week for another 2 weeks. Semistructured interviews with 2 broad, open-ended questions were held and data were analyzed with systematic text condensation, based on Giorgi's principles of psychological phenomenological analysis. The participants appreciated the messages, which were perceived as timely and usable, and also stimulated memorizing. The messages made the participants reflect on the aim of the exercise, value of being reminded, and on their improvement in pain. During the interviews, the participants created their own routines for continued adherence to the exercises. It seems plausible that mobile phone text messaging may serve as a useful tool for patient empowerment with regard to recurrent LBP in older persons. Further studies are needed to explore whether future compliance with the exercises will be as large if the participants are not being interviewed. ©Stina Charlotta Lilje, Ewy Olander, Johan Berglund, Eva Skillgate, Peter Anderberg. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 30.03.2017.

Text messaging versus email for emergency medicine residents’ knowledge retention: a pilot comparison in the United States

PubMed Central

2016-01-01

We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required. PMID:27780350

Text messaging versus email for emergency medicine residents' knowledge retention: a pilot comparison in the United States.

PubMed

Hoonpongsimanont, Wirachin; Kulkarni, Miriam; Tomas-Domingo, Pedro; Anderson, Craig; McCormack, Denise; Tu, Khoa; Chakravarthy, Bharath; Lotfipour, Shahram

2016-01-01

We evaluated the effectiveness of text messaging versus email, as a delivery method to enhance knowledge retention of emergency medicine (EM) content in EM residents. We performed a multi-centered, prospective, randomized study consisting of postgraduate year (PGY) 1 to PGY 3 & 4 residents in three United States EM residency programs in 2014. Fifty eight residents were randomized into one delivery group: text message or email. Participants completed a 40 question pre- and post-intervention exam. Primary outcomes were the means of pre- and post-intervention exam score differences. Data were analyzed using descriptive statistics, paired t-test, and multiple linear regressions. No significant difference was found between the primary outcomes of the two groups (P=0.51). PGY 2 status had a significant negative effect (P=0.01) on predicted exam score difference. Neither delivery method enhanced resident knowledge retention. Further research on implementation of mobile technology in residency education is required.

Healthcare resource utilisation by patients with coronary heart disease receiving a lifestyle-focused text message support program: an analysis from the TEXT ME study.

PubMed

Thakkar, Jay; Redfern, Julie; Khan, Ehsan; Atkins, Emily; Ha, Jeffrey; Vo, Kha; Thiagalingam, Aravinda; Chow, Clara K

2018-05-23

The 'Tobacco, Exercise and Diet Messages' (TEXT ME) study was a 6-month, single-centre randomised clinical trial (RCT) that found a text message support program improved levels of cardiovascular risk factors in patients with coronary heart disease (CHD). The current analyses examined whether receipt of text messages influenced participants' engagement with conventional healthcare resources. The TEXT ME study database (N=710) was linked with routinely collected health department databases. Number of doctor consultations, investigations and cardiac medication prescriptions in the two study groups were compared. The most frequently accessed health service was consultations with a General Practitioner (mean 7.1, s.d. 5.4). The numbers of medical consultations, biochemical tests or cardiac-specific investigations were similar between the study groups. There was at least one prescription registered for statin, ACEI/ARBs and β-blockers in 79, 66 and 50% of patients respectively, with similar refill rates in both the study groups. The study identified TEXT ME text messaging program did not increase use of Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) captured healthcare services. The observed benefits of TEXT ME reflect direct effects of intervention independent of conventional healthcare resource engagement.

A randomised control crossover trial of a theory based intervention to improve sun-safe and healthy behaviours in construction workers: study protocol.

PubMed

Nioi, Amanda; Wendelboe-Nelson, Charlotte; Cowan, Sue; Cowie, Hilary; Rashid, Shahzad; Ritchie, Peter; Cherrie, Mark; Lansdown, Terry C; Cherrie, John W

2018-02-15

Exposure to sunlight can have both positive and negative health impacts. Excessive exposure to ultra-violet (UV) radiation from the sun can cause skin cancer, however insufficient exposure to sunlight has a detrimental effect on production of Vitamin D. In the construction industry there are onsite proactive behaviours for safety, but sun-safety remains a low priority. There is limited research on understanding the barriers to adopting sun-safe behaviours and the association this may have with Vitamin D production. This paper reports a protocol for an intervention study, using text messaging in combination with a supportive smartphone App. The intervention aims to both reduce UV exposure during months with higher UV levels and promote appropriate dietary changes to boost Vitamin D levels during months with low UV levels. Approximately 60 construction workers will be recruited across the United Kingdom. A randomised control crossover trial (RCCT) will be used to test the intervention, with randomisation at site level - i.e. participants will receive both the control (no text messages or supportive App support) and intervention (daily text messages and supportive App). Using the Theory of Planned Behaviour (TPB) the intervention focuses on supporting sun-safety and healthy dietary decisions in relation to Vitamin D intake. The intervention emphasises cultivating the perception of normative support in the workplace, increasing awareness of control and self-efficacy in taking sun-protective behaviours, making healthier eating choices to boost Vitamin D, and tackling stigmas attached to image and group norms. Each study epoch will last 21 days with intervention text messages delivered on workdays only. The supportive App will provide supplementary information about sun protective behaviours and healthy dietary choices. The primary outcome measure is 25-hydroxy-Vitamin D [25(OH)D] level (obtained using blood spot sampling), which will be taken pre and post control and intervention periods. Secondary outcome measures are two-fold, (1) using the TPB to detect changes in behaviour, and (2) quantifying UV exposure during the UK peak radiation season (April-September) using body-mounted UV sensors. This study will provide important information about the effectiveness of a technology-based intervention to promote sun-safety and healthy behaviours in outdoor construction workers. ISRCTN15888934 retrospectively registered 15.01.2018.

Design and rationale of the Cardiovascular Health and Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study: two randomised controlled trials of text messaging to improve secondary prevention for coronary heart disease and diabetes.

PubMed

Huo, Xiqian; Spatz, Erica S; Ding, Qinglan; Horak, Paul; Zheng, Xin; Masters, Claire; Zhang, Haibo; Irwin, Melinda L; Yan, Xiaofang; Guan, Wenchi; Li, Jing; Li, Xi; Spertus, John A; Masoudi, Frederick A; Krumholz, Harlan M; Jiang, Lixin

2017-12-21

Mobile health interventions have the potential to promote risk factor management and lifestyle modification, and are a particularly attractive approach for scaling across healthcare systems with limited resources. We are conducting two randomised trials to evaluate the efficacy of text message-based health messages in improving secondary coronary heart disease (CHD) prevention among patients with or without diabetes. The Cardiovascular Health And Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study are multicentre, single-blind, randomised controlled trials of text messaging versus standard treatment with 6 months of follow-up conducted in 37 hospitals throughout 17 provinces in China. The intervention group receives six text messages per week which target blood pressure control, medication adherence, physical activity, smoking cessation (when appropriate), glucose monitoring and lifestyle recommendations including diet (in CHAT-DM). The text messages were developed based on behavioural change techniques, using models such as the information-motivation-behavioural skills model, goal setting and provision of social support. A total sample size of 800 patients would be adequate for CHAT Study and sample size of 500 patients would be adequate for the CHAT-DM Study. In CHAT, the primary outcome is the change in systolic blood pressure (SBP) at 6 months. Secondary outcomes include a change in proportion of patients achieving a SBP <140 mm Hg, low-density lipoprotein cholesterol (LDL-C), physical activity, medication adherence, body mass index (BMI) and smoking cessation. In CHAT-DM, the primary outcome is the change in glycaemic haemoglobin (HbA 1C ) at 6 months. Secondary outcomes include a change in the proportion of patients achieving HbA 1C <7%, fasting blood glucose, SBP, LDL-C, BMI, physical activity and medication adherence. The central ethics committee at the China National Center for Cardiovascular Disease and the Yale University Institutional Review Board approved the CHAT and CHAT-DM studies. Results will be disseminated via usual scientific forums including peer-reviewed publications. CHAT (NCT02888769) and CHAT-DM (NCT02883842); Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Mobile Text Message Intervention to Reduce Repeat Suicidal Episodes: Design and Development of Reconnecting After a Suicide Attempt (RAFT).

PubMed

Larsen, Mark Erik; Shand, Fiona; Morley, Kirsten; Batterham, Philip J; Petrie, Katherine; Reda, Bill; Berrouiguet, Sofian; Haber, Paul S; Carter, Gregory; Christensen, Helen

2017-12-13

Suicide is a leading cause of death, particularly among young people. Continuity of care following discharge from hospital is critical, yet this is a time when individuals often lose contact with health care services. Offline brief contact interventions following a suicide attempt can reduce the number of repeat attempts, and text message (short message service, SMS) interventions are currently being evaluated. The aim of this study was to extend postattempt caring contacts by designing a brief Web-based intervention targeting proximal risk factors and the needs of this population during the postattempt period. This paper details the development process and describes the realized system. To inform the design of the intervention, a lived experience design group was established. Participants were asked about their experiences of support following their suicide attempt, their needs during this time, and how these could be addressed in a brief contact eHealth intervention. The intervention design was also informed by consultation with lived experience panels external to the project and a clinical design group. Prompt outreach following discharge, initial distraction activities with low cognitive demands, and ongoing support over an extended period were identified as structural requirements of the intervention. Key content areas identified included coping with distressing feelings, safety planning, emotional regulation and acceptance, coping with suicidal thoughts, connecting with others and interpersonal relationships, and managing alcohol consumption. The RAFT (Reconnecting AFTer a suicide attempt) text message brief contact intervention combines SMS contacts with additional Web-based brief therapeutic content targeting key risk factors. It has the potential to reduce the number of repeat suicidal episodes and to provide accessible, acceptable, and cost-effective support for individuals who may not otherwise seek face-to-face treatment. A pilot study to test the feasibility and acceptability of the RAFT intervention is underway. ©Mark Erik Larsen, Fiona Shand, Kirsten Morley, Philip J. Batterham, Katherine Petrie, Bill Reda, Sofian Berrouiguet, Paul S. Haber, Gregory Carter, Helen Christensen. Originally published in JMIR Mental Health (http://mental.jmir.org), 13.12.2017.

Mobile Phone Messaging During Unobserved "Home" Induction to Buprenorphine.

PubMed

Tofighi, Babak; Grossman, Ellie; Sherman, Scott; Nunes, Edward V; Lee, Joshua D

2016-01-01

The deployment of health information technologies promises to optimize clinical outcomes for populations with substance use disorders. Electronic health records, web-based counseling interventions, and mobile phone applications enhance the delivery of evidence-based behavioral and pharmacological treatments, with minimal burden to clinical personnel, infrastructure, and work flows. This clinical case shares a recent experience utilizing mobile phone text messaging between an office-based buprenorphine provider in a safety net ambulatory clinic and a patient seeking buprenorphine treatment for opioid use disorder. The case highlights the use of text message-based physician-patient communication to facilitate unobserved "home" induction onto buprenorphine.

Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students: A Randomized Clinical Trial.

PubMed

Müssener, Ulrika; Bendtsen, Marcus; Karlsson, Nadine; White, Ian R; McCambridge, Jim; Bendtsen, Preben

2016-03-01

Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people. To determine the effectiveness of a text-based smoking cessation intervention among young people. A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate. The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date). A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively, a mean (SD) of 3.9 (0.37) months after the quit date. The adjusted odds ratios (95% CIs) for these findings were 2.05 (1.57-2.67) and 1.56 (1.19-2.05), respectively. With the limitation of assessing only the short-term effect of the intervention, the effects observed in this trial are comparable with those for traditional smoking cessation interventions. The simple NEXit intervention has the potential to improve the uptake of effective smoking cessation interventions. isrctn.org Identifier: ISRCTN75766527.

Connecting Health and Technology (CHAT): protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults.

PubMed

Kerr, Deborah A; Pollard, Christina M; Howat, Peter; Delp, Edward J; Pickering, Mark; Kerr, Katherine R; Dhaliwal, Satvinder S; Pratt, Iain S; Wright, Janine; Boushey, Carol J

2012-06-22

Increasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults. The CHAT project will involve the development of the mobile device food record (MDFR), and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1) Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2) Intervention Group 2: MDFR + Dietary Feedback; (3) Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion. This trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT project will assess the impact of the intervention on behavioural intention to eat a more healthful diet. This innovative approach if successful may provide a means to deliver a low cost health promotion program that has the potential to reach large groups, particularly young adults. Australian and New Zealand Clinical Trials Registry ACTRN12612000250831.

Connecting Health and Technology (CHAT): protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults

PubMed Central

2012-01-01

Background Increasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults. Methods/design The CHAT project will involve the development of the mobile device food record (MDFR), and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1) Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2) Intervention Group 2: MDFR + Dietary Feedback; (3) Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion. Discussion This trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT project will assess the impact of the intervention on behavioural intention to eat a more healthful diet. This innovative approach if successful may provide a means to deliver a low cost health promotion program that has the potential to reach large groups, particularly young adults. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12612000250831 PMID:22726532

Smoking Cessation Following Text Message Intervention in Pregnant Women.

PubMed

Forinash, Alicia B; Yancey, Abigail; Chamness, Danielle; Koerner, Jamie; Inteso, Christina; Miller, Collin; Gross, Gilad; Mathews, Katherine

2018-06-01

Smoking during pregnancy has detrimental effects on mother and fetus. Text messaging has been utilized to improve patient care. To evaluate the impact of text messaging on smoking cessation rates among pregnant women in addition to standard of care (SOC) smoking cessation services. Our SOC includes pharmacist-driven education with or without nicotine patch or bupropion. This randomized, open-label, prospective trial was conducted at a maternal fetal care center from May 2014 to January 2016. Pregnant patients in the preparation stage of change were randomized to text messaging or SOC. The primary outcome was smoking cessation verified with exhaled carbon monoxide levels (eCO) 2 weeks from quit date. All received clinical pharmacist weekly calls for 3 weeks and biweekly visits until pharmacotherapy completion. The text messaging group also received predetermined motivational messages. Of 49 randomized patients, 13 withdrew, and 6 were lost to follow-up. The remaining included 14 texting and 16 SOC patients. eCO-verified cessation was achieved by 57.1% in the texting group versus 31.3% in the control ( P = 0.153). Overall, 64.3% of the texting group achieved an eCO below 8 ppm at ≥1 visit versus 37.5% in the control group ( P = 0.143). No difference was found in birth outcomes. The study was underpowered because of slow enrollment and high drop-out rates. Text messaging had minimal impact on improving smoking cessation rates in the obstetric population. However, further research is warranted because of the underpowered nature of this trial. Given the detrimental effects of smoking in pregnancy, more comprehensive cessation strategies are warranted.

A text messaging intervention to improve heart failure self-management after hospital discharge in a largely African-American population: before-after study.

PubMed

Nundy, Shantanu; Razi, Rabia R; Dick, Jonathan J; Smith, Bryan; Mayo, Ainoa; O'Connor, Anne; Meltzer, David O

2013-03-11

There is increasing interest in finding novel approaches to reduce health disparities in readmissions for acute decompensated heart failure (ADHF). Text messaging is a promising platform for improving chronic disease self-management in low-income populations, yet is largely unexplored in ADHF. The purpose of this pre-post study was to assess the feasibility and acceptability of a text message-based (SMS: short message service) intervention in a largely African American population with ADHF and explore its effects on self-management. Hospitalized patients with ADHF were enrolled in an automated text message-based heart failure program for 30 days following discharge. Messages provided self-care reminders and patient education on diet, symptom recognition, and health care navigation. Demographic and cell phone usage data were collected on enrollment, and an exit survey was administered on completion. The Self-Care of Heart Failure Index (SCHFI) was administered preintervention and postintervention and compared using sample t tests (composite) and Wilcoxon rank sum tests (individual). Clinical data were collected through chart abstraction. Of 51 patients approached for recruitment, 27 agreed to participate and 15 were enrolled (14 African-American, 1 White). Barriers to enrollment included not owning a personal cell phone (n=12), failing the Mini-Mental exam (n=3), needing a proxy (n=2), hard of hearing (n=1), and refusal (n=3). Another 3 participants left the study for health reasons and 3 others had technology issues. A total of 6 patients (5 African-American, 1 White) completed the postintervention surveys. The mean age was 50 years (range 23-69) and over half had Medicaid or were uninsured (60%, 9/15). The mean ejection fraction for those with systolic dysfunction was 22%, and at least two-thirds had a prior hospitalization in the past year. Participants strongly agreed that the program was easy to use (83%), reduced pills missed (66%), and decreased salt intake (66%). Maintenance (mean composite score 49 to 78, P=.003) and management (57 to 86, P=.002) improved at 4 weeks, whereas confidence did not change (57 to 75, P=.11). Of the 6 SCHFI items that showed a statistically significant improvement, 5 were specifically targeted by the texting intervention. Over half of ADHF patients in an urban, largely African American community were eligible and interested in participating in a text messaging program following discharge. Access to mobile phones was a significant barrier that should be addressed in future interventions. Among the participants who completed the study, we observed a high rate of satisfaction and preliminary evidence of improvements in heart failure self-management.

The effects of a lifestyle-focused text-messaging intervention on adherence to dietary guideline recommendations in patients with coronary heart disease: an analysis of the TEXT ME study.

PubMed

Santo, Karla; Hyun, Karice; de Keizer, Laura; Thiagalingam, Aravinda; Hillis, Graham S; Chalmers, John; Redfern, Julie; Chow, Clara K

2018-05-23

A healthy diet is an important component of secondary prevention of coronary heart disease (CHD). The TEXT ME study was a randomised clinical trial of people with CHD that were randomised into standard care or a text-message programme in addition to standard care. This analysis aimed to: 1) assess the effects of the intervention onadherence to the dietary guideline recommendations; 2) assess the consistency of effect across sub-groups; and 3) assess whether adherence to the dietary guideline recommendations mediated the improvements in objective clinical outcomes. Dietary data were collected using a self-report questionnaire to evaluate adherence to eight dietary guideline recommendations in Australia, including consumption of vegetables, fruits, fish, type of fat used for cooking and in spreads, takeaway food, salt and standard alcohol drinks. The primary outcome of this analysis was the proportion of patients adhering to ≥ 4 dietary guideline recommendations concomitantly and each recommendation was assessed individually as secondary outcomes. Data were analysed using log-binomial regression for categorical variables and analysis of covariance for continuous variables. Among 710 patients, 54% were adhering to ≥ 4 dietary guideline recommendations (intervention 53% vs control 56%, p = 0.376) at baseline. At six months, the intervention group had a significantly higher proportion of patients adhering to ≥ 4 recommendations (314, 93%) compared to the control group (264, 75%, RR 1.23, 95% CI 1.15-1.31, p < 0.001). In addition, the intervention patients reported consuming higher amounts of vegetables, fruits, and fish per week; less takeaway foods per week; and greater salt intake control. The intervention had a similar effect in all sub-groups tested. There were significant mediational effects of the increase in adherence to the recommendations for the association between the intervention and LDL-cholesterol (p < 0.001) and body mass index (BMI) at six months follow-up (p = 0.005). A lifestyle-focused text-message programme improved adherence to the dietary guideline recommendations, and specifically improved self-reported consumption of vegetables, fruits, fish, takeaway foods and salt intake. Importantly, these improvements partially mediated improvements in LDL-cholesterol and BMI. This simple and scalable text-messaging intervention could be used as a strategy to improve diet in people with CHD. Australia and New Zealand Clinical Trials Registry ACTRN12611000161921 . Registered on 10 February 2011.

A multimedia mobile phone-based youth smoking cessation intervention: findings from content development and piloting studies.

PubMed

Whittaker, Robyn; Maddison, Ralph; McRobbie, Hayden; Bullen, Chris; Denny, Simon; Dorey, Enid; Ellis-Pegler, Mary; van Rooyen, Jaco; Rodgers, Anthony

2008-11-25

While most young people who smoke want to quit, few access cessation support services. Mobile phone-based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention. The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone. Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention. Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting "real" and "honest" role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study. A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people.

A Multimedia Mobile Phone–Based Youth Smoking Cessation Intervention: Findings From Content Development and Piloting Studies

PubMed Central

Maddison, Ralph; McRobbie, Hayden; Bullen, Chris; Denny, Simon; Dorey, Enid; Ellis-Pegler, Mary; van Rooyen, Jaco; Rodgers, Anthony

2008-01-01

Background While most young people who smoke want to quit, few access cessation support services. Mobile phone–based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention. Objective The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone. Methods Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention. Results Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting “real” and “honest” role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study. Conclusions A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people. PMID:19033148

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Rodgers, Anthony; Gu, Yulong

2016-04-10

Access to mobile phones continues to increase exponentially globally, outstripping access to fixed telephone lines, fixed computers and the Internet. Mobile phones are an appropriate and effective option for the delivery of smoking cessation support in some contexts. This review updates the evidence on the effectiveness of mobile phone-based smoking cessation interventions. To determine whether mobile phone-based smoking cessation interventions increase smoking cessation in people who smoke and want to quit. For the most recent update, we searched the Cochrane Tobacco Addiction Group Specialised Register in April 2015. We also searched the UK Clinical Research Network Portfolio for current projects in the UK, and the ClinicalTrials.gov register for ongoing or recently completed studies. We searched through the reference lists of identified studies and attempted to contact the authors of ongoing studies. We applied no restrictions on language or publication date. We included randomised or quasi-randomised trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention for smoking cessation. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Review authors extracted information on risk of bias and methodological details using a standardised form. We considered participants who dropped out of the trials or were lost to follow-up to be smoking. We calculated risk ratios (RR) and 95% confidence intervals (CI) for each included study. Meta-analysis of the included studies used the Mantel-Haenszel fixed-effect method. Where meta-analysis was not possible, we presented a narrative summary and descriptive statistics. This updated search identified 12 studies with six-month smoking cessation outcomes, including seven studies completed since the previous review. The interventions were predominantly text messaging-based, although several paired text messaging with in-person visits or initial assessments. Two studies gave pre-paid mobile phones to low-income human immunodeficiency virus (HIV)-positive populations - one solely for phone counselling, the other also included text messaging. One study used text messages to link to video messages. Control programmes varied widely. Studies were pooled according to outcomes - some providing measures of continuous abstinence or repeated measures of point prevalence; others only providing 7-day point prevalence abstinence. All 12 studies pooled using their most rigorous 26-week measures of abstinence provided an RR of 1.67 (95% CI 1.46 to 1.90; I(2) = 59%). Six studies verified quitting biochemically at six months (RR 1.83; 95% CI 1.54 to 2.19). The current evidence supports a beneficial impact of mobile phone-based smoking cessation interventions on six-month cessation outcomes. While all studies were good quality, the fact that those studies with biochemical verification of quitting status demonstrated an even higher chance of quitting further supports the positive findings. However, it should be noted that most included studies were of text message interventions in high-income countries with good tobacco control policies. Therefore, caution should be taken in generalising these results outside of this type of intervention and context.

Mobile health for early retention in HIV care: a qualitative study in Kenya (WelTel Retain)

PubMed Central

Smillie, Kirsten; Van Borek, Natasha; van der Kop, Mia L; Lukhwaro, Abigael; Li, Neville; Karanja, Sarah; Patel, Anik R; Ojakaa, David; Lester, Richard T

2017-01-01

Many people newly diagnosed with HIV are lost to follow-up before timely initiation of antiretroviral therapy (ART). A randomised controlled trial (RCT), WelTel Kenya1, demonstrated the effectiveness of the WelTel text messaging intervention to improve clinical outcomes among patients initiating ART. In preparation for WelTel Retain, an RCT that will evaluate the effect of the intervention to retain patients in care immediately following HIV diagnosis, we conducted an informative qualitative study with people living with HIV (n = 15) and healthcare providers (HCP) (n = 5) in October 2012. Study objectives included exploring the experiences of people living with HIV who have attempted to engage in HIV care, the use of cell phones in everyday life, and perceptions of communicating via text message with HCP. Participants were recruited through convenience sampling. Semi-structured, qualitative interviews were conducted and recorded, transcribed verbatim and analysed using NVivo software. Analysis was guided by the Theory of Reasoned Action and the Technology Acceptance Model. Results indicate that while individuals have many motivators for engaging in care after diagnosis, structural and individual barriers including poverty, depression and fear of stigma prevent them from doing so. All participants had access to a mobile phone, and most were comfortable communicating through text messages, or were willing to learn. Both people living with HIV and HCP felt that increased communication via the text messaging intervention has the potential to enable early identification of problems, leading to timely problem solving that may improve retention and engagement in care during the first year after diagnosis. PMID:25555099

Mobile health for early retention in HIV care: a qualitative study in Kenya (WelTel Retain).

PubMed

Smillie, Kirsten; Van Borek, Natasha; van der Kop, Mia L; Lukhwaro, Abigael; Li, Neville; Karanja, Sarah; Patel, Anik R; Ojakaa, David; Lester, Richard T

2014-01-01

Many people newly diagnosed with HIV are lost to follow-up before timely initiation of antiretroviral therapy (ART). A randomised controlled trial (RCT), WelTel Kenya1, demonstrated the effectiveness of the WelTel text messaging intervention to improve clinical outcomes among patients initiating ART. In preparation for WelTel Retain, an RCT that will evaluate the effect of the intervention to retain patients in care immediately following HIV diagnosis, we conducted an informative qualitative study with people living with HIV (n = 15) and healthcare providers (HCP) (n = 5) in October 2012. Study objectives included exploring the experiences of people living with HIV who have attempted to engage in HIV care, the use of cell phones in everyday life, and perceptions of communicating via text message with HCP. Participants were recruited through convenience sampling. Semi-structured, qualitative interviews were conducted and recorded, transcribed verbatim and analysed using NVivo software. Analysis was guided by the Theory of Reasoned Action and the Technology Acceptance Model. Results indicate that while individuals have many motivators for engaging in care after diagnosis, structural and individual barriers including poverty, depression and fear of stigma prevent them from doing so. All participants had access to a mobile phone, and most were comfortable communicating through text messages, or were willing to learn. Both people living with HIV and HCP felt that increased communication via the text messaging intervention has the potential to enable early identification of problems, leading to timely problem solving that may improve retention and engagement in care during the first year after diagnosis.

mHealth Series: Measuring maternal newborn and child health coverage by text messaging – a county–level model for China

PubMed Central

Zhang, Yanfeng; Chen, Li; van Velthoven, Michelle H. M. M. T.; Wang, Wei; Liu, Li; Du, Xiaozhen; Wu, Qiong; Li, Ye; Car, Josip

2013-01-01

Background Effective interventions in maternal, newborn and child health (MNCH), if achieving high level of population coverage, could prevent most of deaths in children under five years of age. High–quality measurements of MNCH coverage are essential for tracking progress and making evidence–based decisions. Methods MNCH coverage data are mainly collected through fieldworkers’ interview with preselected households in standard programs of Demographic and Health Surveys (DHS) or Multiple Indicator Cluster Surveys (MICS) in most low– and middle–income countries. Household surveys will continue to be the major data source for MNCH coverage in the foreseeable future. However, face–to–face data collection broadly used in household surveys is labor–intensive, time–consuming and expensive. Mobile phones are drawing more and more interest in medical research with the rapid increase in usage and text messaging could be an innovative way of data collection, that is, we could collect DHS data through mHealth method. We refer to it as “mDHS”. Finding We propose in this paper a conceptual model for measuring MNCH coverage by text messaging in China. In developing this model, we considered resource constraints, sample representativeness, sample size and survey bias. The components of the model are text messaging platform, routine health information system, health facilities, communities and households. Conclusions Measuring MNCH interventions coverage by text messaging could be advantageous in many ways and establish a much larger evidence–base for MNCH health policies in China. Before mDHS could indeed be launched, research priorities would include a systematic assessment of routine health information systems and exploring feasibility to collect name lists, mobile phone numbers and general demographic and socio–economic data; qualitative interviews with health workers and caregivers; assessment of data validity of all indicators to be collected by text messaging; and exploring approaches to increase participation rate. PMID:24363920

The Uses of Text Messaging in Sexual Relationships Scale: Associations with risky sexual behavior among at-risk African American emerging adults

PubMed Central

Broaddus, Michelle; Dickson-Gomez, Julia

2017-01-01

Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication. PMID:27710089

Design and rationale of the Cardiovascular Health and Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study: two randomised controlled trials of text messaging to improve secondary prevention for coronary heart disease and diabetes

PubMed Central

Huo, Xiqian; Spatz, Erica S; Ding, Qinglan; Horak, Paul; Zheng, Xin; Masters, Claire; Zhang, Haibo; Irwin, Melinda L; Yan, Xiaofang; Guan, Wenchi; Li, Jing; Li, Xi; Spertus, John A; Masoudi, Frederick A; Krumholz, Harlan M; Jiang, Lixin

2017-01-01

Introduction Mobile health interventions have the potential to promote risk factor management and lifestyle modification, and are a particularly attractive approach for scaling across healthcare systems with limited resources. We are conducting two randomised trials to evaluate the efficacy of text message-based health messages in improving secondary coronary heart disease (CHD) prevention among patients with or without diabetes. Methods and analysis The Cardiovascular Health And Text Messaging (CHAT) Study and the CHAT-Diabetes Mellitus (CHAT-DM) Study are multicentre, single-blind, randomised controlled trials of text messaging versus standard treatment with 6 months of follow-up conducted in 37 hospitals throughout 17 provinces in China. The intervention group receives six text messages per week which target blood pressure control, medication adherence, physical activity, smoking cessation (when appropriate), glucose monitoring and lifestyle recommendations including diet (in CHAT-DM). The text messages were developed based on behavioural change techniques, using models such as the information-motivation-behavioural skills model, goal setting and provision of social support. A total sample size of 800 patients would be adequate for CHAT Study and sample size of 500 patients would be adequate for the CHAT-DM Study. In CHAT, the primary outcome is the change in systolic blood pressure (SBP) at 6 months. Secondary outcomes include a change in proportion of patients achieving a SBP <140 mm Hg, low-density lipoprotein cholesterol (LDL-C), physical activity, medication adherence, body mass index (BMI) and smoking cessation. In CHAT-DM, the primary outcome is the change in glycaemic haemoglobin (HbA1C) at 6 months. Secondary outcomes include a change in the proportion of patients achieving HbA1C<7%, fasting blood glucose, SBP, LDL-C, BMI, physical activity and medication adherence. Ethics and dissemination The central ethics committee at the China National Center for Cardiovascular Disease and the Yale University Institutional Review Board approved the CHAT and CHAT-DM studies. Results will be disseminated via usual scientific forums including peer-reviewed publications. Trial registration number CHAT (NCT02888769) and CHAT-DM (NCT02883842); Pre-results. PMID:29273661

MessageSpace: a messaging system for health research

NASA Astrophysics Data System (ADS)

Escobar, Rodrigo D.; Akopian, David; Parra-Medina, Deborah; Esparza, Laura

2013-03-01

Mobile Health (mHealth) has emerged as a promising direction for delivery of healthcare services via mobile communication devices such as cell phones. Examples include texting-based interventions for chronic disease monitoring, diabetes management, control of hypertension, smoking cessation, monitoring medication adherence, appointment keeping and medical test result delivery; as well as improving patient-provider communication, health information communication, data collection and access to health records. While existing messaging systems very well support bulk messaging and some polling applications, they are not designed for data collection and processing of health research oriented studies. For that reason known studies based on text-messaging campaigns have been constrained in participant numbers. In order to empower healthcare promotion and education research, this paper presents a system dedicated for healthcare research. It is designed for convenient communication with various study groups, feedback collection and automated processing.

Understanding Messaging Preferences to Inform Development of Mobile Goal-Directed Behavioral Interventions

PubMed Central

van Stolk-Cooke, Katherine; Morgenstern, Jon; Kuerbis, Alexis N; Markle, Kendra

2014-01-01

Background Mobile messaging interventions have been shown to improve outcomes across a number of mental health and health-related conditions, but there are still significant gaps in our knowledge of how to construct and deliver the most effective brief messaging interventions. Little is known about the ways in which subtle linguistic variations in message content can affect user receptivity and preferences. Objective The aim of this study was to determine whether any global messaging preferences existed for different types of language content, and how certain characteristics moderate those preferences, in an effort to inform the development of mobile messaging interventions. Methods This study examined user preferences for messages within 22 content groupings. Groupings were presented online in dyads of short messages that were identical in their subject matter, but structurally or linguistically varied. Participants were 277 individuals residing in the United States who were recruited and compensated through Amazon’s Mechanical Turk (MTurk) system. Participants were instructed to select the message in each dyad that they would prefer to receive to help them achieve a personal goal of their choosing. Results Results indicate global preferences of more than 75% of subjects for certain types of messages, such as those that were grammatically correct, free of textese, benefit-oriented, polite, nonaggressive, and directive as opposed to passive, among others. For several classes of messages, few or no clear global preferences were found. There were few personality- and trait-based moderators of message preferences, but subtle manipulations of message structure, such as changing “Try to…” to “You might want to try to…” affected message choice. Conclusions The results indicate that individuals are sensitive to variations in the linguistic content of text messages designed to help them achieve a personal goal and, in some cases, have clear preferences for one type of message over another. Global preferences were indicated for messages that contained accurate spelling and grammar, as well as messages that emphasize the positive over the negative. Research implications and a guide for developing short messages for goal-directed behaviors are presented in this paper. PMID:24500775

Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study.

PubMed

Evans, C; Turner, K; Suggs, L S; Occa, A; Juma, A; Blake, H

2016-07-28

HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the conditions. A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined. The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits. HIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities.

Text-messaging versus telephone reminders to reduce missed appointments in an academic primary care clinic: a randomized controlled trial

PubMed Central

2013-01-01

Background Telephone or text-message reminders have been shown to significantly reduce the rate of missed appointments in different medical settings. Since text-messaging is less resource-demanding, we tested the hypothesis that text-message reminders would be as effective as telephone reminders in an academic primary care clinic. Methods A randomized controlled non-inferiority trial was conducted in the academic primary care division of the Geneva University Hospitals between November 2010 and April 2011. Patients registered for an appointment at the clinic, and for whom a cell phone number was available, were randomly selected to receive a text-message or a telephone call reminder 24 hours before the planned appointment. Patients were included each time they had an appointment. The main outcome was the rate of unexplained missed appointments. Appointments were not missed if they were cancelled or re-scheduled before or independently from the intervention. We defined non-inferiority as a difference below 2% in the rate of missed appointments and powered the study accordingly. A satisfaction survey was conducted among a random sample of 900 patients (response rate 41%). Results 6450 patients were included, 3285 in the text-message group and 3165 in the telephone group. The rate of missed appointments was similar in the text-message group (11.7%, 95% CI: 10.6-12.8) and in the telephone group (10.2%, 95% CI: 9.2-11.3 p = 0.07). However, only text message reminders were cost-effective. No patient reported any disturbance by any type of reminder in the satisfaction survey. Three quarters of surveyed patients recommended its regular implementation in the clinic. Conclusions Text-message reminders are equivalent to telephone reminders in reducing the proportion of missed appointments in an academic primary care clinic and are more cost-effective. Both types of reminders are well accepted by patients. PMID:23557331

Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders.

PubMed

McInnes, D Keith; Petrakis, Beth Ann; Gifford, Allen L; Rao, Sowmya R; Houston, Thomas K; Asch, Steven M; O'Toole, Thomas P

2014-09-01

We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = -0.4, 6.4; P = .08). Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings.

Development of macaronic Hindi-English ‘Hinglish’ text message content for a coronary heart disease secondary prevention programme

PubMed Central

Thakkar, Jay; Karthikeyan, Ganesan; Purohit, Gaurav; Thakkar, Swetha; Sharma, Jitender; Verma, Sunilkumar; Parakh, Neeraj; Seth, Sandeep; Mishra, Sundeep; Yadav, Rakesh; Singh, Sandeep; Joshi, Rohina; Thiagalingam, Aravinda; Chow, Clara K; Redfern, Julie

2016-01-01

Background Coronary heart disease (CHD) is a leading cause of morbidity and mortality in India. Text message based prevention programs have demonstrated reduction in cardiovascular risk factors among patients with CHD in selected populations. Customisation is important as behaviour change is influenced by culture and linguistic context. Objectives To customise a mobile phone text message program supporting behaviour and treatment adherence in CHD for delivery in North India. Methods We used an iterative process with mixed methods involving three phases: (1) Initial translation, (2) Review and incorporation of feedback including review by cardiologists in India to assess alignment with local guidelines and by consumers on perceived utility and clarity and (3) Pilot testing of message management software. Results Messages were translated in three ways: symmetrical translation, asymmetrical translation and substitution. Feedback from cardiologists and 25 patients was incorporated to develop the final bank. Patients reported Hinglish messages were easy to understand (93%) and useful (78%). The software located in Australia successfully delivered messages to participants based in Delhi-surrounds (India). Conclusions Our process for customisation of a text message program considered cultural, linguistic and the medical context of potential participants. This is important in optimising intervention fidelity across populations enabling examination of the generalisability of text message programs across populations. We also demonstrated the customised program was acceptable to patients in India and that a centralised cross-country delivery model was feasible. This process could be used as a guide for other groups seeking to customise their programs. Trial registration number TEXTMEDS Australia (Parent study)—ACTRN 12613000793718. PMID:27752288

Collecting outcome data of a text messaging smoking cessation intervention with in-program text assessments: How reliable are the results?

PubMed

Thrul, Johannes; Mendel, Judith A; Simmens, Samuel J; Abroms, Lorien C

2018-05-18

Text messaging interventions have shown promise in helping people quit smoking. Texting programs periodically survey participants about their smoking status. This study examined the consistency of participant self-reported smoking between external surveys and internal program text message assessments. Participants in Text2Quit program were surveyed about their past 7-day smoking at one, three, and six months post-enrollment using different survey modes (external surveys and internal program text message assessments) and responses were compared for consistency. The first set of analyses was conducted for participants responding on both modes (n = 45 at one month; n = 50 at three months; n = 42 at six months). Additional analyses, assuming missing = smoking, were conducted with the full sample of 262 smokers (68.7% female, mean age = 35.8 years) and compared to saliva-confirmed abstinence rates. Participants responding to both modes consistently reported smoking status at one (88.9%), three (88.0%) and six (88.1%) months post-enrollment, with fair to substantial levels of agreement (one month: κ = 0.24; three months: κ = 0.63; six months: κ = 0.66). Participants responding to both modes reported high rates of abstinence. In missing = smoking analyses, significant differences in abstinence rates reported across modes were detected at each timepoint (one month: external = 30.5%, internal = 16.4%; three months: external = 33.2%, internal = 16.0%; six months: external = 31.7%, internal = 12.2%; all p < .001). Moderate levels of agreement were found between the two modes. At 6 months, abstinence rates obtained via internal data were closer to those biochemically verified (15.7%) compared to external surveys. Results provide initial support for the use of internal program assessments in text messaging programs with missing = smoking assumptions in order to gather outcome data on smoking behavior. Copyright © 2018 Elsevier Ltd. All rights reserved.

Short Text Messages to Encourage Adherence to Medication and Follow-up for People With Psychosis (Mobile.Net): Randomized Controlled Trial in Finland

PubMed Central

Kannisto, Kati Anneli; Vahlberg, Tero; Hätönen, Heli; Adams, Clive E

2017-01-01

Background A text messaging service (short message service [SMS]) has the potential to target large groups of people with long-term illnesses such as serious mental disorders, who may have difficulty with treatment adherence. Robust research on the impact of mobile technology interventions for these patients remains scarce. Objective The main objective of our study was to investigate the impact of individually tailored short text messages on the rate of psychiatric hospital readmissions, health care service use, and clinical outcomes. In addition, we analyzed treatment costs. Methods Between September 2011 and November 2012, we randomly assigned 1139 people to a tailored text message intervention (n=569) or usual care (n=570). Participants received semiautomated text messages for up to 12 months or usual care. The primary outcome, based on routinely collected health register data, was patient readmission into a psychiatric hospital during a 12-month follow-up period. Secondary outcomes were related to other service use, coercion, medication, adverse events, satisfaction, social functioning, quality of life, and economic factors (cost analysis). Results There was 98.24% (1119/1139) follow-up at 12 months. Tailored mobile telephone text messages did not reduce the rate of hospital admissions (242/563, 43.0% of the SMS group vs 216/556, 38.8% of the control group; relative risk 1.11; 95% CI 0.92-1.33; P=.28), time between hospitalizations (mean difference 7.0 days 95% CI –8.0 to 24.0; P=.37), time spent in a psychiatric hospital during the year (mean difference 2.0 days 95% CI –2.0 to 7.0; P=.35), or other service outcomes. People who received text messages were less disabled, based on Global Assessment Scale scores at the time of their readmission, than those who did not receive text messages (odds ratio 0.68; 95% CI 0.47-0.97; P=.04). The costs of treatment were higher for people in the SMS group than in the control group (mean €10,103 vs €9210, respectively, P<.001). Conclusions High-grade routinely collected data can provide clear outcomes for pragmatic randomized trials. SMS messaging tailored with the input of each individual patient did not decrease the rate of psychiatric hospital visits after the 12 months of follow-up. Although there may have been other, more subtle effects, the results of these were not evident in outcomes of agreed importance to clinicians, policymakers, and patients and their families. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6rVzZrbuz). PMID:28701292

Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+: an exploratory study

PubMed Central

Nachega, Jean B; Skinner, Donald; Jennings, Larissa; Magidson, Jessica F; Altice, Frederick L; Burke, Jessica G; Lester, Richard T; Uthman, Olalekan A; Knowlton, Amy R; Cotton, Mark F; Anderson, Jean R; Theron, Gerhard B

2016-01-01

Objective To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT). Design and methods A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters. Setting A community primary care clinic in Cape Town, South Africa. Participants HIV-infected pregnant women. Main outcomes Acceptability and feasibility of mHealth and cDOT interventions. Results Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed. Conclusion mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial. PMID:27175068

Recruiter Stress: An Experiment Using Text-messages as a Stress Intervention

DTIC Science & Technology

2013-02-01

messages covered a number of areas (e.g., physiological, cognitive , social) and were generally self-contained with 140 characters or less (to meet text...although most differences here are small and within margins of errors. The two most noticeable differences are for the impact of work stress on job...order to compute estimated hour and day losses. Using recruiter population estimates, over 4,500 man-hours were lost due to late arrivals and over 9,500

[Effectiveness of an intervention to provide information to patients with hypertension as short text messages and reminders sent to their mobile phone (HTA-Alert)].

PubMed

Márquez Contreras, E; de la Figuera von Wichmann, M; Gil Guillén, V; Ylla-Catalá, A; Figueras, M; Balaña, M; Naval, J

2004-11-15

To analyze the effect of an intervention to provide information with mobile phone text messages to patients with hypertension on compliance with therapy for hypertension. Comparative, controlled, multicenter, randomized cluster study. 26 primary care health centers in Spain. 26 researchers were randomized to a control group or an intervention group (52 patients each, for a total of 104 patients). All patients were receiving monotherapy for uncontrolled hypertension. Patients in the control group received their physician's usual interventions. Patients in the intervention group received messages and reminders sent to their mobile phones 2 days per week during 4 months. Tablets were counted and blood pressure was measured at the start of the study and 1, 3, and 6 months later. The percentage of compliers, mean percentage of compliance and degree of control of hypertension were compared. The reduction in absolute and relative risk was calculated, as was the number of individuals needed to treat to avoid noncompliance. The results were evaluated for a total of 67 individuals (34 in the intervention group and 33 in the control group). The rate of compliance was 85.1% (CI, 74.9%-95.3%) overall, 85.7% (CI, 70.5%-100.9%) in the control group and 84.4% in the intervention group (CI, 70.7%-95.3%) (P=NS). Mean percentage compliance was 90.2%+/-16.3% overall, 88.1%+/-20.8% in the control group and 91.9%+/-11.6% in the intervention group (P=NS). The percentage of patients whose hypertension was controlled at the end of the study was 51.5% (CI, 34.4%-68.6%) in the control group and 64.7% (CI, 48.6%-80.8%) in the intervention group (P=NS). The telephone messaging intervention with alerts and reminders sent to mobile phones did not improve compliance with therapy in patients with hypertension.

High or low intensity text-messaging combined with group treatment equally promote weight loss maintenance in obese adults.

PubMed

Zwickert, Kristy; Rieger, Elizabeth; Swinbourne, Jessica; Manns, Clare; McAulay, Claire; Gibson, Alice A; Sainsbury, Amanda; Caterson, Ian D

Text-message and e-mail are emerging as potential methods for improving weight outcomes among obese individuals. The optimal volume, frequency, and timing of such interventions are unknown. This study investigated the effect of adjunct technological support on weight and psychological variables after a 3-month cognitive-behaviour therapy (CBT) group intervention. Sixty obese adults were randomised to a CBT programme plus intensive (text-message and e-mail; CBT+ITS) or minimal (text-message only; CBT+MTS) technological support. Assessments occurred at baseline, 3-, 6-, 9-, and 15-months. Outcome variables included weight (kg), body mass index (kg/m 2 ), waist circumference (cm), binge-eating tendencies, weight self-efficacy, and weight control cognitions and behaviours. CBT+ITS (n=31) and CBT+MTS (n=29) participants lost 5.2% (±1.1) and 4.7% (±1.1) of their baseline weight by 3-months, 8.4% (±1.2) and 6.4% (±1.1) by 6-months, 9.6% (±1.3) and 6.4% (±1.3) by 9-months, and sustained a 7.5% (±1.3) and 5.1% (±1.3) loss at 15-months, respectively. There were no significant differences between intensive and minimal support, however, the CBT+ITS group showed a marginal advantage across all anthropometric measures. A low intensity text-message support programme is just as effective as higher intensity technological support for maintaining weight loss in obese adults. This represents a low-cost means of aiding weight loss maintenance without reliance on extended face-to-face treatment. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students: A Randomized Clinical Trial

PubMed Central

Müssener, Ulrika; Bendtsen, Marcus; Karlsson, Nadine; White, Ian R.; McCambridge, Jim; Bendtsen, Preben

2018-01-01

Importance Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people. Objective To determine the effectiveness of a text-based smoking cessation intervention among young people. Design, Setting, and Participants A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate. Interventions The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. Main Outcomes and Measures The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date). Results A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively, a mean (SD) of 3.9 (0.37) months after the quit date. The adjusted odds ratios (95% CIs) for these findings were 2.05 (1.57-2.67) and 1.56 (1.19-2.05), respectively. Conclusions and Relevance With the limitation of assessing only the short-term effect of the intervention, the effects observed in this trial are comparable with those for traditional smoking cessation interventions. The simple NEXit intervention has the potential to improve the uptake of effective smoking cessation interventions. Trial Registration isrctn.org Identifier: ISRCTN75766527 PMID:26903176

Adaptation and uptake evaluation of an SMS text message smoking cessation programme (MiQuit) for use in antenatal care

PubMed Central

Naughton, Felix; Cooper, Sue; Bowker, Katharine; Campbell, Katarzyna; Sutton, Stephen; Leonardi-Bee, Jo; Sloan, Melanie; Coleman, Tim

2015-01-01

Objectives To adapt a tailored short message service (SMS) text message smoking cessation intervention (MiQuit) for use without active health professional endorsement in routine antenatal care settings, to estimate ‘real-world’ uptake and test the feasibility of its use. Design Single-site service evaluation. Setting A Nottinghamshire (UK) antenatal clinic. Participants Pregnant women accessing the antenatal clinic (N=1750) over 6 months. Intervention A single-sheet A5 leaflet provided in the women's maternity notes folder describing the MiQuit text service. Similar materials were left on clinic desks and noticeboards. Outcome measures MiQuit activation requests and system interactions were logged for two time frames: 6 months (strict) and 8 months (extended). Local hospital data were used to estimate the denominator of pregnant smokers exposed to the materials. Results During the strict and extended time frames, 13 and 25 activation requests were received, representing 3% (95% CI 2% to 5%) and 4% (95% CI 3% to 6%) of estimated smokers, respectively. Only 11 (44%) of the 25 requesting activation sent a correctly formatted initiation text. Of those activating MiQuit, and invited to complete tailoring questions (used to tailor support), 6 (67%) completed all 12 questions by text or website and 5 (56%) texted a quit date to the system. Of the 11 activating MiQuit, 5 (45%, 95% CI 21% to 72%) stopped the programme prematurely. Conclusions A low-intensity, cheap cessation intervention promoted at very low cost, resulted in a small but potentially impactful uptake rate by pregnant smokers. PMID:26493459

Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging

PubMed Central

Rodgers, A; Corbett, T; Bramley, D; Riddell, T; Wills, M; Lin, R; Jones, M

2005-01-01

Objectives: To determine the effectiveness of a mobile phone text messaging smoking cessation programme. Design: Randomised controlled trial Setting: New Zealand Participants: 1705 smokers from throughout New Zealand who wanted to quit, were aged over 15 years, and owned a mobile phone were randomised to an intervention group that received regular, personalised text messages providing smoking cessation advice, support, and distraction, or to a control group. All participants received a free month of text messaging; starting for the intervention group on their quit day to assist with quitting, and starting for the control group at six months to encourage follow up. Follow up data were available for 1624 (95%) at six weeks and 1265 (74%) at six months. Main outcome measures: The main trial outcome was current non-smoking (that is, not smoking in the past week) six weeks after randomisation. Secondary outcomes included current non-smoking at 12 and 26 weeks. Results: More participants had quit at six weeks in the intervention compared to the control group: 239 (28%) v 109 (13%), relative risk 2.20 (95% confidence interval 1.79 to 2.70), p < 0.0001. This treatment effect was consistent across subgroups defined by age, sex, income level, or geographic location (p homogeneity > 0.2). The relative risk estimates were similar in sensitivity analyses adjusting for missing data and salivary cotinine verification tests. Reported quit rates remained high at six months, but there was some uncertainty about between group differences because of incomplete follow up. Conclusions: This programme offers potential for a new way to help young smokers to quit, being affordable, personalised, age appropriate, and not location dependent. Future research should test these findings in different settings, and provide further assessment of long term quit rates. PMID:16046689

Development of a Culturally Tailored Text Message Maternal Health Program: TextMATCH

PubMed Central

Whittaker, Robyn; Bartley, Hannah; Connor, Augusta; Chen, Ruyan; Ross, Mairead; McCool, Judith

2017-01-01

Background Mobile phones are increasingly being used to deliver health information and health services globally. Mobile health (mHealth) interventions may be well-suited for minority groups with greater barriers to accessing traditional health services. However, little has been written about the process of culturally adapting interventions for multiple ethnic and cultural minorities within a population. Objective This study describes the process of developing a culturally tailored text message-based maternal health program (TextMATCH: Text for MATernal and Child Health) for Māori, Pacific, Asian, and South Asian families living in New Zealand. We report on engagement and acceptability of the TextMATCH program. Methods Program data was examined to describe engagement with the program 18 months after implementation. Telephone interviews were conducted with a sample of participants who consented to provide feedback on acceptability and relevance of the program. Results A total of 1404 participants enrolled in TextMATCH over 18 months, with 18.52% (260) actively opting out at some point (after 0 to 17 months of messages). It was found that 356 (70.9%) of the 502 eligible participants actively switched from the initial pregnancy program to the baby program after delivery. Phone interviews were conducted with 29 participants including 6 who had withdrawn (duration of program from 3 to 16 months). Only 2 participants reported that the program was not useful, with the remainder rating the usefulness of messages positively (average 4.24 out of 5). All participants stated that the messages were relevant, culturally appropriate, and easy to understand. Most were happy with the specific advice and the language options provided. Conclusions We have demonstrated the importance of an intensive approach to the development of a culturally adapted and tailored mHealth program for multiple different cultural minority groups within our population. PMID:28428159

A feasibility pilot study on the use of text messages to track PTSD symptoms after a traumatic injury.

PubMed

Price, Matthew; Ruggiero, Kenneth J; Ferguson, Pamela L; Patel, Sachin K; Treiber, Frank; Couillard, Deborah; Fahkry, Samir M

2014-01-01

Monitoring posttraumatic stress disorder (PTSD) symptoms after a traumatic injury is beneficial for patients and providers. Text messages can be used to automatically monitor symptoms and impose minimal burden to patients and providers. The present study piloted such a strategy with traumatic injury patients. An automated daily text message was piloted to evaluate PTSD symptoms after discharge from the hospital. Twenty-nine patients who experienced a traumatic injury received 15 daily texts and were then followed up at 1-month and 3-months after discharge. 82.8% of the sample responded at least once and the average response rate per participant was 63.1%. Response rates were correlated with PTSD symptoms at baseline but not at any other time. Patient satisfaction with this approach was high. Text messages are a viable method to monitor PTSD symptoms after a traumatic injury. Such an approach should be evaluated on a larger scale as part of a more comprehensive early intervention for traumatic stress. Copyright © 2014 Elsevier Inc. All rights reserved.

Text message-based diabetes self-management support (SMS4BG): study protocol for a randomised controlled trial.

PubMed

Dobson, Rosie; Whittaker, Robyn; Jiang, Yannan; Shepherd, Matthew; Maddison, Ralph; Carter, Karen; Cutfield, Richard; McNamara, Catherine; Khanolkar, Manish; Murphy, Rinki

2016-04-02

Addressing the increasing prevalence, and associated disease burden, of diabetes is a priority of health services internationally. Interventions to support patients to effectively self-manage their condition have the potential to reduce the risk of costly and debilitating complications. The utilisation of mobile phones to deliver self-management support allows for patient-centred care at the frequency and intensity that patients desire from outside the clinic environment. Self-Management Support for Blood Glucose (SMS4BG) is a novel text message-based intervention for supporting people with diabetes to improve self-management behaviours and achieve better glycaemic control and is tailored to individual patient preferences, demographics, clinical characteristics, and culture. This study aims to assess whether SMS4BG can improve glycaemic control in adults with poorly controlled diabetes. This paper outlines the rationale and methods of the trial. A two-arm, parallel, randomised controlled trial will be conducted across New Zealand health districts. One thousand participants will be randomised at a 1:1 ratio to receive SMS4BG, a theoretically based and individually tailored automated text message-based diabetes self-management support programme (intervention) in addition to usual care, or usual care alone (control). The primary outcome is change in glycaemic control (HbA1c) at 9 months. Secondary outcomes include glycaemic control at 3 and 6 months, self-efficacy, self-care behaviours, diabetes distress, health-related quality of life, perceived social support, and illness perceptions. Cost information and healthcare utilisation will also be collected as well as intervention satisfaction and interaction. This study will provide information on the effectiveness of a text message-based self-management support tool for people with diabetes. If found to be effective it has the potential to provide individualised support to people with diabetes across New Zealand (and internationally), thus extending care outside the clinic environment. Australian New Zealand Clinical Trials Registry: ACTRN12614001232628 .

The effectiveness of telephone counselling and internet- and text-message-based support for smoking cessation: results from a randomized controlled trial.

PubMed

Skov-Ettrup, Lise S; Dalum, Peter; Bech, Mickael; Tolstrup, Janne S

2016-07-01

To compare the effectiveness of proactive telephone counselling, reactive telephone counselling and an internet- and text-message-based intervention with a self-help booklet for smoking cessation. A randomized controlled trial with equal allocation to four conditions: (1) proactive telephone counselling (n = 452), (2) reactive telephone counselling (n = 453), (3) internet- and text-message-based intervention (n = 453) and (4) self-help booklet (control) (n = 452). Denmark. Smokers who had participated previously in two national health surveys were invited. Eligibility criteria were daily cigarette smoking, age ≥ 16 years, having a mobile phone and e-mail address. Primary outcome was prolonged abstinence to 12 months from the end of the intervention period. At 12-month follow-up, higher prolonged abstinence was found in the proactive telephone counselling group compared with the booklet group [7.3 versus 3.6%, odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.2-4.0]. There was no clear evidence of a difference in prolonged abstinence between the reactive telephone counselling group or the internet-based smoking cessation program and the booklet group: 1.8 versus 3.6%, OR = 0.8, 95% CI = 0.6-1.2 and 5.3 versus 3.6%, OR = 1.6, 95% CI = 0.8-3.0, respectively. In the proactive telephone counselling group, the cost per additional 12-month quitter compared with the booklet group was £644. Proactive telephone counselling was more effective than a self-help booklet in achieving prolonged abstinence for 12 months. No clear evidence of an effect of reactive telephone counselling or the internet- and text-message-based intervention was found compared with the self-help booklet. © 2016 Society for the Study of Addiction.

Characterizing Periodic Messaging Interventions Across Health Behaviors and Media: Systematic Review

PubMed Central

Fuentes, Laura W; Cohen, Joanna E

2014-01-01

Background Periodic prompts serve as tools for health behavior interventions to encourage and maintain behavior changes. Past literature reviews have examined periodic messages targeting specific behaviors (smoking, physical activity, diet, etc) or media (telephone, email, face-to-face, newsletter, etc) and have found them to be effective in impacting health behavior in the short term. Objective Our goal was to review the literature related to periodic messaging and prompts in order to explore typical characteristics, assess the role of prompt timing, identify common theoretical models used, and identify characteristics associated with the effectiveness of periodic prompts. Methods Electronic searches of PubMed, PsycINFO, CINAHL, and Web of Science were conducted in October 2012 and May 2013. Database search terms included variant terms for periods, prompts, interventions, media, and health behaviors. Results Forty-two of the 55 included research articles found that prompts resulted in significant positive behavioral outcomes for participants. Prompts were delivered via text messages, email, mailed communications, and in a few instances via phone. Generally, the provision of feedback and specific strategies to accomplish behavior change appears to be important for the success of periodic prompts. Rationale for prompt timing was rarely provided, although some studies did organize message content around days of the week or times perceived to be high risk for particular behaviors. Smoking cessation interventions tended to be organized around quit date. Among studies using theoretical models to inform their interventions, the transtheoretical model was most common. Conclusions Periodic messaging interventions yield positive results for short-term health behavior changes. Interventions including feedback and prompts that included strategies were more likely to report significantly positive outcomes. Work remains to better understand elements that make periodic prompts successful and whether they are effective in producing long-term outcomes. PMID:24667840

Feasibility and user perception of a fully automated push-based multiple-session alcohol intervention for university students: randomized controlled trial.

PubMed

Bendtsen, Marcus; Bendtsen, Preben

2014-06-23

In recent years, many electronic health behavior interventions have been developed in order to reach individuals with unhealthy behaviors, such as risky drinking. This is especially relevant for university students, many of whom are risky drinkers. This study explored the acceptability and feasibility in a nontreatment-seeking group of university students (including both risk and nonrisk drinkers), of a fully automated, push-based, multiple-session, alcohol intervention, comparing two modes of delivery by randomizing participants to receive the intervention either by SMS text messaging (short message service, SMS) or by email. A total of 5499 students at Luleå University in northern Sweden were invited to participate in a single-session alcohol assessment and feedback intervention; 28.04% (1542/5499) students completed this part of the study. In total, 29.44% (454/1542) of those participating in the single-session intervention accepted to participate further in the extended multiple-session intervention lasting for 4 weeks. The students were randomized to receive the intervention messages via SMS or email. A follow-up questionnaire was sent immediately after the intervention and 52.9% (240/454) responded. No difference was seen regarding satisfaction with the length and frequency of the intervention, regardless of the mode of delivery. Approximately 15% in both the SMS (19/136) and email groups (15/104) would have preferred the other mode of delivery. On the other hand, more students in the SMS group (46/229, 20.1%) stopped participating in the intervention during the 4-week period compared with the email group (10/193, 5.2%). Most students in both groups expressed satisfaction with the content of the messages and would recommend the intervention to a fellow student in need of reducing drinking. A striking difference was seen regarding when a message was read; 88.2% (120/136) of the SMS group read the messages within 1 hour in contrast to 45.2% (47/104) in the email group. In addition, 83.1% (113/136) in the SMS group stated that they read all or almost all the messages, compared with only 63.5% (66/104) in the email group. Based on the feedback from the students, an extended, multiple-session, push-based intervention seems to be a feasible option for students interested in additional support after a single-session alcohol intervention. SMS as a mode of delivery seems to have some advantages over email regarding when a message is read and the proportion of messages read. However, more students in the SMS group stopped the intervention than in the email group. Based on these promising findings, further studies comparing the effectiveness of single-session interventions with extended multiple-session interventions delivered separately or in combination are warranted.

Improving patient health engagement with mobile texting: A pilot study in the head and neck postoperative setting.

PubMed

Sosa, Alan; Heineman, Nathan; Thomas, Kimberly; Tang, Kai; Feinstein, Marie; Martin, Michelle Y; Sumer, Baran; Schwartz, David L

2017-05-01

Cell phone ownership is nearly universal. Messaging is one of its most widely used features. Texting-based interventions may improve patient engagement in the postoperative setting, but remain understudied. Patients were recruited before discharge from the hospital and received automated daily texts for 1 week providing information about expected recovery. Patients were encouraged to text questions to providers, which were triaged for intervention. Web-based surveys solicited patient feedback about the platform. Thirty-two patients were approached, and 23 patients (72%) were enrolled in the study. All study patients texted their providers, although frequency (median, 7 texts; range, 2-44 texts) varied. Unmarried patients and those facing surgical complications used the platform more frequently. Mean patient satisfaction with the platform was high (mean, 3.8 on a 4-point Likert scale). Text messaging seems feasible in the acute postoperative setting and potentially improves engagement of patients with head and neck cancer. Further study is warranted to confirm scalability and impact. © 2017 Wiley Periodicals, Inc. Head Neck 39: 988-995, 2017. © 2017 Wiley Periodicals, Inc.

The effect of mobile phone short messaging system on healthy food choices among Iranian postmenopausal women.

PubMed

Vakili, Mahdis; Abedi, Parvin; Afshari, Poorandokht; Kaboli, Nayereh Esmael

2015-01-01

Central adiposity and metabolic syndrome are quite common among postmenopausal women. Dietary diversity and healthy food choices have essential role in health and also in prevention of obesity. The main objective of this study was to evaluate the impact of mobile phone short messaging system on healthy food choices among Iranian postmenopausal women. This was a randomized controlled trial in which 100 postmenopausal women aged 40-60 years were recruited and assigned to two groups (50 each in the intervention and control groups). Food frequency consumption was measured using a questionnaire. A total of 16 text messages including information about modification of food selection (healthy choices, benefits, methods, etc.,) were sent to participants in the intervention group during 4 months follow-up (1/week). The Chi-square and independent t-test used for data analysis. Ninety-two women completed the study. The consumption of Vitamin A rich fruits and vegetables significantly increased in the intervention group compared to the control group (P < 0.001). More women in the intervention group consumed fish after intervention (P = 0.02). The consumption of green leafy vegetables showed a nonsignificant increase in the intervention group. Using mobile phone short messaging system can improve the healthy food choices regarding Vitamin A rich fruits and vegetables and fish among postmenopausal women.

Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

PubMed

McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

2018-05-02

Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

Factors affecting adherence to appointment system in the clinic for non-communicable diseases in UNRWA's Khan Younis Health Centre and the role of mobile phone text messages to improve adherence: a descriptive cross-sectional study.

PubMed

Al Najjar, Sanaa; Al Shaer, Tamer

2018-02-21

To meet the emerging needs of the increasing numbers of patients with non-communicable diseases and to provide optimum care with optimum contact time and minimum waiting time, as stated in UNRWA guidelines, the mobile phone text messaging system was implemented in UNRWA centres to remind patients of upcoming appointments and to thereby improve the quality of care for vulnerable patients and regulate the work load in the clinics for non-communicable diseases. The aim of this study was to assess the causes for lack of adherence to the appointment system at UNRWA centres. This descriptive cross-sectional study was done in the UNRWA's Khan Younis Health Centre (KYHC), which serves the same refugee population as other UNRWA health centres and follows the same guidelines with minimal variation. Data were collected through interviewer-administered questionnaires, with ten medical staff members involved in the appointment process and 50 patients with non-communicable diseases selected randomly from patients attending the KYHC. The text-message reminder intervention targeted 1000 patients with non-communicable diseases and consisted of an electronic message technique that was developed to remind patients about the day and time of upcoming appointments. Administrative approval was obtained from the chief of UNRWA health programme. Verbal consent was obtained from participants. We followed the Modified International Code of Ethics Principles (1975), known as the Declaration of Helsinki. The main barrier to adherence to appointments in the clinic for non-communicable diseases was forgetting the appointment. Other factors were lack of awareness, clinic overcrowding, appointments that do not match the patient's preference, availability of other service providers, and financial issues. In March, 2016, after the completion of the intervention, the proportion of patients that adhered to their appointment by date and time was 76%, compared with about 45% in January and February, 2016 (p=0·013). The text messaging reminder is a successful way of improving patient's adherence to appointments in UNRWA clinics for non-communicable diseases. The intervention should be continued and integrated in daily work. More financial resources are needed to support the text messaging reminder system. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Randomized Controlled Trial of Personalized Text Message Reminders to Promote Medication Adherence Among HIV-Positive Adolescents and Young Adults.

PubMed

Garofalo, Robert; Kuhns, Lisa M; Hotton, Anna; Johnson, Amy; Muldoon, Abigail; Rice, Dion

2016-05-01

HIV-positive adolescents and young adults often experience suboptimal medication adherence, yet few interventions to improve adherence in this group have shown evidence of efficacy. We conducted a randomized trial of a two-way, personalized daily text messaging intervention to improve adherence to antiretroviral therapy (ART) among N = 105 poorly adherent HIV-positive adolescents and young adults, ages 16-29. Adherence to ART was assessed via self-reported visual analogue scale (VAS; 0-100 %) at 3 and 6-months for mean adherence level and proportion ≥90 % adherent. The average effect estimate over the 6-month intervention period was significant for ≥90 % adherence (OR = 2.12, 95 % CI 1.01-4.45, p < .05) and maintained at 12-months (6 months post-intervention). Satisfaction scores for the intervention were very high. These results suggest both feasibility and initial efficacy of this approach. Given study limitations, additional testing of this intervention as part of a larger clinical trial with objective and/or clinical outcome measures of adherence is warranted.

Efficacy of a web- and text messaging-based intervention to reduce problem drinking in adolescents: Results of a cluster-randomized controlled trial.

PubMed

Haug, Severin; Paz Castro, Raquel; Kowatsch, Tobias; Filler, Andreas; Dey, Michelle; Schaub, Michael P

2017-02-01

To test the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people compared to assessment only. Two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and 6-month follow up. The automated intervention included online feedback, based on the social norms approach, and individually tailored text messages addressing social norms, outcome expectations, motivation, self-efficacy, and planning processes, provided over 3 months. The main outcome criterion was the prevalence of risky single-occasion drinking (RSOD, defined as drinking at least 5 standard drinks on a single occasion in men and 4 in women) in the past 30 days. Irrespective of alcohol consumption, 1,355 students from 80 Swiss vocational and upper secondary school classes, all of whom owned a mobile phone, were invited to participate in the study. Of these, 1,041 (76.8%) students participated in the study. Based on intention-to-treat analyses, RSOD prevalence decreased by 5.9% in the intervention group and increased by 2.6% in the control group, relative to that of baseline assessment (odds ratio [OR] = 0.62, 95% confidence interval [CI] = 0.44-0.87). No significant group differences were observed for the following secondary outcomes: RSOD frequency, quantity of alcohol consumed, estimated peak blood alcohol concentration, and overestimation of peer drinking norms. The intervention program reduced RSOD, which is a major indicator of problem drinking in young people, effectively. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis.

PubMed

Saffari, Mohsen; Ghanizadeh, Ghader; Koenig, Harold G

2014-12-01

Diabetes type 2 is an increasing problem worldwide that may be managed through education. Text-messaging using a cell phone can assist with self-care. The aim of this study was to systematically review the impact of education through mobile text-messaging on glycemic control. The design was a systematic review with meta-analysis. Five electronic databases were searched to access English studies involving a randomized controlled trial design that used text-messaging educational interventions in patients with type 2 diabetes during an 11-year period (2003-2013). Studies were evaluated using a quality assessment scale adapted from Jadad scale and Cochrane handbook. Extraction of data was carried out by two reviewers. A random-effect model with a standardized mean difference and Hedges's g indices was used for conducting the meta-analysis. Subgroup analyses were conducted and a Funnel plot was used to examine publication bias. Ten studies overall were identified that fulfilled inclusion criteria, involving a total of 960 participants. The mean age of the sample was 52.8 years and majority were females. Data were heterogeneous (I(2)=67.6). Analyses suggested a publication bias based on Egger's regression (P<0.05). HbA1c was reduced significantly in experimental groups compared to control groups (P<0.001). The effect size for glycemic control in studies that used text-messaging only was 44%. For studies that used both text-messaging and Internet, the effect size was 86%. Mobile text-messaging for educating Type 2 diabetics appears to be effective on glycemic control. Further investigations on mobile applications to achieve educational goals involving other diseases are recommended. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Informing Active Play and Screen Time Behaviour Change Interventions for Low Socioeconomic Position Mothers of Young Children: What Do Mothers Want?

PubMed Central

Campbell, Karen J.; Hesketh, Kylie D.

2016-01-01

Introduction. This study investigated views of mothers from disadvantaged urban and regional areas (i.e., beyond major capital cities) as potential end users of child active play and screen time behaviour change interventions, with a focus on text messaging and web-based delivery platforms. Methods. Thirty-two mothers (22 urban; 10 regional) were interviewed. Purpose-designed questions covered topics regarding mothers' preferences for accessing and receiving information related to parenting and child active play and screen time. Data from transcribed interviews were analysed to identify responses and key themes. Results. Mothers reported frequently accessing parenting- and child-related information online. Regional mothers reported seeking information by talking with other people less frequently than urban mothers and seemed to have a stronger preference for receiving information online. There were few differences between responses from low and high educated mothers. The majority of mothers reported that they would be happy to receive text messages containing information about active play and screen time and that they would find a dedicated website with this information useful. Conclusions. Mothers in this study held favourable views on the potential of receiving information via new communication technologies. Future interventions targeting socioeconomically disadvantaged mothers may benefit from delivering intervention messages via these technologies. PMID:28053979

Retaining Homeless Veterans in Outpatient Care: A Pilot Study of Mobile Phone Text Message Appointment Reminders

PubMed Central

Petrakis, Beth Ann; Gifford, Allen L.; Rao, Sowmya R.; Houston, Thomas K.; Asch, Steven M.; O’Toole, Thomas P.

2014-01-01

Objectives. We examined the feasibility of using mobile phone text messaging with homeless veterans to increase their engagement in care and reduce appointment no-shows. Methods. We sent 2 text message reminders to participants (n = 20) before each of their outpatient appointments at an urban Veterans Affairs medical center. Evaluation included pre- and postsurvey questionnaires, open-ended questions, and review of medical records. We estimated costs and savings of large-scale implementation. Results. Participants were satisfied with the text-messaging intervention, had very few technical difficulties, and were interested in continuing. Patient-cancelled visits and no-shows trended downward from 53 to 37 and from 31 to 25, respectively. Participants also experienced a statistically significant reduction in emergency department visits, from 15 to 5 (difference of 10; 95% confidence interval [CI]  = 2.2, 17.8; P = .01), and a borderline significant reduction in hospitalizations, from 3 to 0 (difference of 3; 95% CI = −0.4, 6.4; P = .08). Conclusions. Text message reminders are a feasible means of reaching homeless veterans, and users consider it acceptable and useful. Implementation may reduce missed visits and emergency department use, and thus produce substantial cost savings. PMID:25100425

Perceptions of the Feasibility and Practicalities of Text Messaging-Based Infectious Disease Surveillance: A Questionnaire Survey.

PubMed

Dang, Linh Thuy; Vu, Nguyen Cong; Vu, Thiem Dinh; James, Spencer L; Katona, Peter; Katona, Lindsay; Rosen, Joseph M; Nguyen, Cuong Kieu

2016-05-25

In Vietnam, infectious disease surveillance data are collected via a paper-based system through four government tiers leading to a large delay. Meanwhile, mobile phones are abundant and very popular in the country, and known to be a useful tool in health care worldwide. Therefore, there is a great potential for the development of a timely disease surveillance system through the use of mobile phone short message service (SMS) text messages. This study aims to explore insights about the feasibility and practicalities of the utilization of SMS text messaging-based interventions in disease-reporting systems by identifying potential challenges and barriers in the text messaging process and looking at lessons learned. An SMS text messaging-based disease tracking system was set up in Vietnam with patient reports texted by clinic staff. Two 6-month trials utilizing this disease tracking system were designed and implemented in two northern provinces of Vietnam to report two infectious diseases: diarrhea and influenza-like illness. A structured self-reported questionnaire was developed to measure the feasibility and practicalities of the system from the participants. On the completion of the second trial in 2013, participating health staff from 40 commune health centers in the two pilot provinces were asked to complete the survey (N=80). Most participants were female (61%, 49/80) and nearly half (44%, 35/80) were heads of a commune health center. Approximately two-thirds (63%, 50/80) of participants retained the basic structure of the SMS text message report and there was a strong influence (OR 28.2, 95% CI 5.3-151.2) of those people on the time they spent texting the information. The majority (88%, 70/80) felt the information conveyed in the SMS text message report was not difficult to understand. Most (86%, 69/80) believed that they could report all 28 infectious diseases asked for by the Ministry of Health by using SMS text messaging. From a health center staff perspective, a disease-reporting system utilizing text messaging technology is easy to use and has great potential to be implemented and expanded nationwide. The survey showed positive perceptions and feedback from the participants and contributed to a promising practical solution to improve the surveillance system of infectious disease in Vietnam.

Technology Interventions to Manage Food Intake: Where Are We Now?

PubMed

Allman-Farinelli, Margaret; Gemming, Luke

2017-09-23

This review describes the state-of-the-art for dietary assessment using smartphone apps and digital technology and provides an update on the efficacy of technology-mediated interventions for dietary change. Technology has progressed from apps requiring entry of foods consumed, to digital imaging to provide food intake data. However, these methods rely on patients being active in data collection. The automated estimation of the volume and composition of every meal consumed globally is years away. The use of text messaging, apps, social media, and combinations of these for interventions is growing and proving effective for type 2 diabetes mellitus (T2DM). Effectiveness of text messaging for obesity management is improving and multicomponent interventions show promise. A stand-alone app is less likely to produce positive outcomes and social media is relatively unexplored. A concentrated effort will be needed to progress digital dietary assessment. Researcher-designed technology programs are producing positive outcomes for T2DM but further research is needed in the area of weight management.

Short Text Messages to Encourage Adherence to Medication and Follow-up for People With Psychosis (Mobile.Net): Randomized Controlled Trial in Finland.

PubMed

Välimäki, Maritta; Kannisto, Kati Anneli; Vahlberg, Tero; Hätönen, Heli; Adams, Clive E

2017-07-12

A text messaging service (short message service [SMS]) has the potential to target large groups of people with long-term illnesses such as serious mental disorders, who may have difficulty with treatment adherence. Robust research on the impact of mobile technology interventions for these patients remains scarce. The main objective of our study was to investigate the impact of individually tailored short text messages on the rate of psychiatric hospital readmissions, health care service use, and clinical outcomes. In addition, we analyzed treatment costs. Between September 2011 and November 2012, we randomly assigned 1139 people to a tailored text message intervention (n=569) or usual care (n=570). Participants received semiautomated text messages for up to 12 months or usual care. The primary outcome, based on routinely collected health register data, was patient readmission into a psychiatric hospital during a 12-month follow-up period. Secondary outcomes were related to other service use, coercion, medication, adverse events, satisfaction, social functioning, quality of life, and economic factors (cost analysis). There was 98.24% (1119/1139) follow-up at 12 months. Tailored mobile telephone text messages did not reduce the rate of hospital admissions (242/563, 43.0% of the SMS group vs 216/556, 38.8% of the control group; relative risk 1.11; 95% CI 0.92-1.33; P=.28), time between hospitalizations (mean difference 7.0 days 95% CI -8.0 to 24.0; P=.37), time spent in a psychiatric hospital during the year (mean difference 2.0 days 95% CI -2.0 to 7.0; P=.35), or other service outcomes. People who received text messages were less disabled, based on Global Assessment Scale scores at the time of their readmission, than those who did not receive text messages (odds ratio 0.68; 95% CI 0.47-0.97; P=.04). The costs of treatment were higher for people in the SMS group than in the control group (mean €10,103 vs €9210, respectively, P<.001). High-grade routinely collected data can provide clear outcomes for pragmatic randomized trials. SMS messaging tailored with the input of each individual patient did not decrease the rate of psychiatric hospital visits after the 12 months of follow-up. Although there may have been other, more subtle effects, the results of these were not evident in outcomes of agreed importance to clinicians, policymakers, and patients and their families. International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6rVzZrbuz). ©Maritta Välimäki, Kati Anneli Kannisto, Tero Vahlberg, Heli Hätönen, Clive E Adams. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.07.2017.

Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014.

PubMed

Haji, Adam; Lowther, S; Ngan'ga, Z; Gura, Z; Tabu, C; Sandhu, H; Arvelo, Wences

2016-02-16

Globally, vaccine preventable diseases are responsible for nearly 20% of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program. The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥ 2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose. We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31-99 days), and 574 (51%) were male. There were 136 (12%) dropouts. Thirteen (4%) children dropped out among those who received text messages, 60 (16%) among who received sticker reminders, and 63 (17%) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95% Confidence Interval (CI) 1.1-3.2], and residing >5 km from health facility (OR 1.6, CI 1.0-2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04-0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5-1.6). Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.

My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women.

PubMed

Griffin, Jamie B; Struempler, Barb; Funderburk, Katie; Parmer, Sondra M; Tran, Cecilia; Wadsworth, Danielle D

2018-01-01

To evaluate changes in dietary and physical activity behaviors and weight after implementation of a 12-week text messaging initiative (My Quest). The researchers conducted a 1-group, pre- to posttest study design to determine changes after implementation of a text messaging initiative developed using the tenets of the Social Cognitive Theory. A total of 55 Alabama counties (84% rural) with high rates of poverty, overweight/obesity, and chronic diseases. Convenience sample of low-income, primarily overweight/obese women (n = 104). Short texts (n = 2-3/d) provided health tips, reminders, and goal-setting prompts. Weekly electronic newsletters provided tips and recipes. Participant self-monitored body weight weekly. Outcomes included goal setting, self-efficacy, behavioral and environmental factors, self-monitoring, and body weight; data collection occurred through text message response and online surveys. Analyses were conducted using McNemar test (dichotomous data), Wilcoxon signed rank test (ordinal data), or paired t test (continuous data). Participants significantly (P < .05) improved dietary and physical activity behaviors and food environment; increased dietary and physical activity goal setting; and reduced body weight. A low-cost, text messaging initiative particularly targeting women residing in rural communities with high rates of poverty and obesity can promote weight loss and improve dietary and physical activity behaviors. Future studies may include a control group and social support component such as group text messaging. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Physical activity and adolescents: an exploratory randomized controlled trial investigating the influence of affective and instrumental text messages.

PubMed

Sirriyeh, Reema; Lawton, Rebecca; Ward, Jane

2010-11-01

The present study attempts to develop and pilot the feasibility and efficacy of a novel intervention using affective messages as a strategy to increase physical activity (PA) levels in adolescents. Design An exploratory pilot randomized control trial was used to compare behaviour change over 2 weeks. A modified form of the International Physical Activity Questionnaire was used to assess PA behaviour. A total of 120 adolescents (16-19 years) from 4 sixth forms in West Yorkshire completed the field-based study. Participants were randomly assigned to one of three experimental conditions, or the control condition (N=28). Participants in experimental conditions received 1 short messaging service (SMS) text message per day over the 2 weeks, which included manipulations of either affective beliefs (enjoyable/unenjoyable; N=31), instrumental beliefs (beneficial/harmful; N=30), or a combination of these (N=31). Control participants received one SMS text message per week. Outcomes were measured at baseline and at the end of the 2 week intervention. PA levels increased by the equivalent of 31.5  minutes of moderate (four metabolic equivalent) activity per week during the study. Main effects of condition (p=.049), and current physical activity level (p=.002) were identified, along with a significant interaction between condition and current activity level (p=.006). However, when the sample was split at baseline into active and inactive participants, a main effect of condition remained for inactive participants only (p=.001). Post hoc analysis revealed that inactive participants who received messages targeting affective beliefs increased their activity levels significantly more than the instrumental (p=.012), combined (p=.002), and control groups (p=.018). Strategies based on affective associations may be more effective for increasing PA levels in inactive individuals.

Texting to increase adolescent physical activity: Feasibility assessment

USDA-ARS?s Scientific Manuscript database

Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity. A 4-group ran...

Research in Brief: Using Mobile Phones to Collect Daily Experience Data from College Undergraduates

ERIC Educational Resources Information Center

Ravert, Russell D.; Calix, Shaun I.; Sullivan, Michael J.

2010-01-01

As mobile phone use and text messaging has continued to play a more central role in people's daily lives, some researchers and clinicians have sought to use the medium as a tool for interventions and data collection. Such efforts have included sending tailored health messages to college students who are trying to quit smoking. This research brief…

Factors Associated with Use of Automated Smoking Cessation Interventions: Findings from the eQuit Study

ERIC Educational Resources Information Center

Balmford, James; Borland, Ron; Benda, Peter; Howard, Steve

2013-01-01

The aim was to better understand structural factors associated with uptake of automated tailored interventions for smoking cessation. In a prospective randomized controlled trial with interventions only offered, not mandated, participants were randomized based on the following: web-based expert system (QuitCoach); text messaging program (onQ);…

Is there an app for that? Mobile phones and secondary prevention of cardiovascular disease.

PubMed

Neubeck, Lis; Cartledge, Susie; Dawkes, Susan; Gallagher, Robyn

2017-09-01

Advances in technology coupled with increased penetration of mobile phones and smart devices are rapidly changing healthcare delivery. Mobile phone applications ('apps'), text messages, and Internet platforms used alone or in combination are now providing interventions targeting people with multiple cardiovascular risk factors. The present article will review the emerging evidence regarding apps and discuss their potential role in providing secondary prevention interventions via mobile phones. Seven recent randomized controlled trials used text messages or apps for six to 12 months, with or without differing combinations of other technology platforms. All studies, involved cardiac and diabetes populations, and demonstrated at least one positive improvement to cardiovascular risk factor profiles. When measured, acceptability of the intervention was high. Mobile apps and technology can deliver positive outcomes in the management of cardiovascular risk factors. However, because of the complexity of combination interventions, it is difficult to determine the 'active' ingredient. A future challenge for researchers and clinicians will be to respond quickly to these rapidly evolving interventions in order to ensure the delivery of effective, evidence-based outcomes.

Text messaging for addiction: a review.

PubMed

Keoleian, Victoria; Polcin, Douglas; Galloway, Gantt P

2015-01-01

Individuals seeking treatment for addiction often experience barriers due to cost, lack of local treatment resources, or either school or work schedule conflicts. Text-messaging-based addiction treatment is inexpensive and has the potential to be widely accessible in real time. We conducted a comprehensive literature review identifying 11 published, randomized controlled trials (RCTs) evaluating text-messaging-based interventions for tobacco smoking, four studies for reducing alcohol consumption, one pilot study in former methamphetamine (MA) users, and one study based on qualitative interviews with cannabis users. Abstinence outcome results in RCTs of smokers willing to make a quit attempt have been positive overall in the short term and as far out as at six and 12 months. Studies aimed at reducing alcohol consumption have been promising. More data are needed to evaluate the feasibility, acceptability, and efficacy of this approach for other substance use problems.

Feasibility and User Perception of a Fully Automated Push-Based Multiple-Session Alcohol Intervention for University Students: Randomized Controlled Trial

PubMed Central

2014-01-01

Background In recent years, many electronic health behavior interventions have been developed in order to reach individuals with unhealthy behaviors, such as risky drinking. This is especially relevant for university students, many of whom are risky drinkers. Objective This study explored the acceptability and feasibility in a nontreatment-seeking group of university students (including both risk and nonrisk drinkers), of a fully automated, push-based, multiple-session, alcohol intervention, comparing two modes of delivery by randomizing participants to receive the intervention either by SMS text messaging (short message service, SMS) or by email. Methods A total of 5499 students at Luleå University in northern Sweden were invited to participate in a single-session alcohol assessment and feedback intervention; 28.04% (1542/5499) students completed this part of the study. In total, 29.44% (454/1542) of those participating in the single-session intervention accepted to participate further in the extended multiple-session intervention lasting for 4 weeks. The students were randomized to receive the intervention messages via SMS or email. A follow-up questionnaire was sent immediately after the intervention and 52.9% (240/454) responded. Results No difference was seen regarding satisfaction with the length and frequency of the intervention, regardless of the mode of delivery. Approximately 15% in both the SMS (19/136) and email groups (15/104) would have preferred the other mode of delivery. On the other hand, more students in the SMS group (46/229, 20.1%) stopped participating in the intervention during the 4-week period compared with the email group (10/193, 5.2%). Most students in both groups expressed satisfaction with the content of the messages and would recommend the intervention to a fellow student in need of reducing drinking. A striking difference was seen regarding when a message was read; 88.2% (120/136) of the SMS group read the messages within 1 hour in contrast to 45.2% (47/104) in the email group. In addition, 83.1% (113/136) in the SMS group stated that they read all or almost all the messages, compared with only 63.5% (66/104) in the email group. Conclusions Based on the feedback from the students, an extended, multiple-session, push-based intervention seems to be a feasible option for students interested in additional support after a single-session alcohol intervention. SMS as a mode of delivery seems to have some advantages over email regarding when a message is read and the proportion of messages read. However, more students in the SMS group stopped the intervention than in the email group. Based on these promising findings, further studies comparing the effectiveness of single-session interventions with extended multiple-session interventions delivered separately or in combination are warranted. PMID:25098296

Patient Perspectives on a Text Messaging Program to Support Asthma Management: A Qualitative Study.

PubMed

Doyle, Reina; Albright, Karen; Hurley, Laura P; Chávez, Catia; Stowell, Melanie; Dircksen, Suzanne; Havranek, Edward P; Anderson, Mark

2018-05-01

This study investigated participants' acceptance of a short messaging service (SMS) intervention designed to support asthma management, including suggestions regarding program delivery and message content. Individual and group interviews were conducted with patients from a safety-net health care system in Denver, Colorado. Eligible participants were English or Spanish speakers between the ages of 13 and 40 years, with diagnosed persistent asthma. All individual and group interviews were digitally recorded, transcribed, translated from Spanish to English (where applicable), and analyzed for thematic content by experienced analysts using established qualitative content techniques. The qualitative software package ATLAS.ti was used for data analysis and management. This study included a total of 43 participants. In general, participants were receptive toward the SMS program and supported the use of tailored and interactive messages. Adolescents supported the idea of enhancing care by sending messages to a support person, such as a parent or guardian. However, adults were less receptive toward this idea. Participants also preferred directive educational messages and cues to action, while general messages reminding them of their asthma diagnosis were viewed less favorably. The results from this study will inform a randomized control trial evaluating the efficacy of the SMS intervention.

Initial Outcomes From a 4-Week Follow-Up Study of the Text4baby Program in the Military Women’s Population: Randomized Controlled Trial

PubMed Central

Wallace Bihm, Jasmine; Szekely, Daniel; Nielsen, Peter; Murray, Elizabeth; Abroms, Lorien; Snider, Jeremy

2014-01-01

Background The use of mobile phone technologies for health promotion and disease prevention has advanced rapidly in recent years. Text4baby is a theory-based mobile health (mHealth) program in which text messages are delivered to pregnant women and new mothers to improve their health care beliefs and behaviors and improve health status and clinical outcomes. Recent evaluations of Text4baby have found that it improves targeted health attitudes and beliefs, but effects on behavior have not yet been determined. Objective In this study, investigators aimed to evaluate Text4baby in the military women’s population. Methods Investigators conducted a randomized controlled trial at Madigan Army Medical Center in Tacoma, Washington, from December 2011 through September 2013. All participants were pregnant women first presenting for care at Madigan. Investigators conducted a baseline assessment using a 24-item, self-administered online survey of attitudes and behaviors related to Text4baby message content. Participants were randomized to Text4baby plus usual care (intervention) or usual care alone (control). Investigators analyzed treatment effects of Text4baby on short-term targeted outcomes 4 weeks post enrollment. Results For this study, 943 patients were randomized and completed a baseline assessment. The average patient age was 28 years and nearly 70% self-identified as Caucasian. 48.7% of enrollees (459/943) completed the first follow-up assessment. Higher rates of single and working/in-school patients dropped out of the intervention arm of the study, and we adjusted for this finding in subsequent models. However, while investigators were unable to re-survey these participants, only 1.9% of Text4baby enrollees (18/943) dropped the service during the study period. Adjusted and unadjusted logistic generalized estimating equation models were developed to assess intervention effects on measured outcomes. In the model adjusting for age, marital status, having had a previous baby, and race/ethnicity, there was a significant effect of Text4baby intervention exposure on increased agreement with belief in the importance of taking prenatal vitamins (OR 1.91, 95% CI 1.08-3.34, P=.024). All of these attitudes had been targeted by at least one text message during the 4-week evaluation period examined in this study. In unadjusted models, there was a significant effect of intervention exposure on belief in the importance of visiting a health care provider to be a healthy new mother (OR 1.52, 95% CI 1.01-2.31, P=.046) and in the health risks of alcohol during pregnancy (OR 2.06, 95% CI 1.00-4.31, P=.05). No behavioral effects of the intervention were observed in this analysis. Conclusions Text4baby is a promising program that offers lessons for future mHealth activities. This large-scale study demonstrated initial effects of the program on attitudes and beliefs targeted by the messages received by women during the study period. Results confirm previous findings from Text4baby studies and other mHealth research. Future analyses will examine dosage effects of the intervention on behaviors and clinical outcomes. PMID:24846909

"You Shouldn't Be Making People Feel Bad about Having Sex": Exploring Young Adults' Perceptions of a Sex-Positive Sexual Health Text Message Intervention

ERIC Educational Resources Information Center

Brickman, Jared; Willoughby, Jessica Fitts

2017-01-01

Young adults are disproportionately affected by negative sexual health outcomes, such as sexually transmitted infections. One strategy for reducing such negative outcomes involves the use of comprehensive sexual health education. As comprehensive sexual health education programmes are adopted, there is a need to evaluate the messaging approaches…

A Randomised Controlled Trial Using Mobile Advertising to Promote Safer Sex and Sun Safety to Young People

ERIC Educational Resources Information Center

Gold, J.; Aitken, C. K.; Dixon, H. G.; Lim, M. S. C.; Gouillou, M.; Spelman, T.; Wakefield, M.; Hellard, M. E.

2011-01-01

Mobile phone text messages (SMS) are a promising method of health promotion, but a simple and low cost way to obtain phone numbers is required to reach a wide population. We conducted a randomised controlled trial with simultaneous brief interventions to (i) evaluate effectiveness of messages related to safer sex and sun safety and (ii) pilot the…

Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

PubMed

Joseph, Rodney P; Keller, Colleen; Adams, Marc A; Ainsworth, Barbara E

2015-03-27

African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women. Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction. All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend. A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women. ClinicalTrials.gov NCT02372565 . Registered 25 February 2015.

Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone.

PubMed

Crombie, Iain K; Irvine, Linda; Falconer, Donald W; Williams, Brian; Ricketts, Ian W; Jones, Claire; Humphris, Gerry; Norrie, John; Slane, Peter; Rice, Peter

2017-07-01

Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Disadvantaged men aged 25-44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. The study recruited 67 disadvantaged men at high risk of alcohol-related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post-study evaluation showed high levels of satisfaction with the study. This study has shown that disadvantaged men can be recruited and follow-up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol-related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway. [Crombie IK, Irvine L, Falconer DW, Williams B, Ricketts IW, Jones C, Humphris G, Norrie J, Slane P, Rice P. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone. Drug Alcohol Rev 2017;36:468-476]. © 2017 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone

PubMed Central

Irvine, Linda; Falconer, Donald W.; Williams, Brian; Ricketts, Ian W.; Jones, Claire; Humphris, Gerry; Norrie, John; Slane, Peter; Rice, Peter

2017-01-01

Abstract Introduction and Aims Disadvantaged men suffer substantial harm from heavy drinking. This feasibility study developed and evaluated the methods for a trial of a brief intervention delivered by text messages to disadvantaged men. It aimed to test the methods for recruitment and retention, to monitor engagement with the intervention and assess the overall acceptability of study methods. Design and Methods Disadvantaged men aged 25–44 years who had ≥2 episodes of binge drinking (≥8 units in one session) in the preceding month were recruited. Two recruitment strategies were assessed: recruitment from general practice registers and by a community outreach strategy. Theoretically and empirically based text messages were tailored to the target group. Results The study recruited 67 disadvantaged men at high risk of alcohol‐related harm, exceeding the target of 60. Evaluation showed that 95% of text messages were delivered, and the men engaged enthusiastically with the intervention. Retention at follow up was 96%. Outcomes were successfully measured on all men followed up. This provided data for the sample size calculation for the full trial. Post‐study evaluation showed high levels of satisfaction with the study. Discussion and Conclusions This study has shown that disadvantaged men can be recruited and follow‐up data obtained in an alcohol intervention study. The study methods were acceptable to the participants. The men recruited were at high risk of alcohol‐related harms. It also clarified ways in which the recruitment strategy, the baseline questionnaire and the intervention could be improved. The full trial is currently underway. [Crombie IK, Irvine L, Falconer DW, Williams B, Ricketts IW, Jones C, Humphris G, Norrie J, Slane P, Rice P. Alcohol and disadvantaged men: A feasibility trial of an intervention delivered by mobile phone. Drug Alcohol Rev 2017;36:468‐476] PMID:28295794

Text Messaging Improves Participation in Laboratory Testing in Adolescent Liver Transplant Patients.

PubMed

McKenzie, Rebecca B; Berquist, William E; Foley, Megan A; Park, K T; Windsheimer, Jered E; Litt, Iris F

In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients. AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention. Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (P<.001). This rate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM. TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.

Acceptability of delivering and accessing health information through text messaging among community health advisors.

PubMed

Schoenberger, Yu-Mei; Phillips, Janice; Mohiuddin, Mohammed Omar; McNees, Patrick; Scarinci, Isabel

2013-09-09

Communication technologies can play a significant role in decreasing communication inequalities and cancer disparities by promoting cancer control and enhancing population and individual health. Studies have shown that technology, such as the mobile phone short message service (SMS) or text messaging, can be an effective health communication strategy that influences individuals' health-related decisions, behaviors, and outcomes. The purpose of this study was to explore usage of communication technologies, assess the acceptability of mobile technology for delivery and access of health information, and identify cancer and health information needs among Deep South Network for Cancer Control trained Community Health Advisors as Research Partners (CHARPs). A mixed-method design was used, and a triangulation protocol was followed to combine quantitative and qualitative data. Focus groups (4 focus groups; n=37) and self-administered surveys (n=77) were conducted to determine CHARPs mobile phone and text message usage. The objective was to include identification of barriers and facilitators to a mobile phone intervention. All participants were African American (37/37, 100%), 11/37 (89%) were women, and the mean age was 53.4 (SD 13.9; focus groups) and 59.9 (SD 8.7; survey). Nearly all (33/37, 89%) of focus group participants reported owning a mobile phone. Of those, 8/33 (24%) owned a smartphone, 22/33 (67%) had a text messaging plan, and 18/33 (55%) and 11/33 (33%) received and sent text messages several times a week or day, respectively. Similar responses were seen among the survey participants, with 75/77 (97%) reporting owning a mobile phone, and of those, 22/75 (30%) owned a smartphone, 39/75 (53%) had a text messaging plan, and 37/75 (50%) received and 27/75 (37%) sent text messages several times a week or day. The benefits of a text messaging system mentioned by focus group participants included alternative form of communication, quick method for disseminating information, and privacy of communication. The main barriers reported by both groups to using mobile technology to receive health information were cost and not knowing how to text message. Ways to overcome barriers were explored with focus group participants, and education was the most proposed solution. Majority of CHARPs were in favor of receiving a weekly text message that would provide cancer/health information. The findings from this study indicate that CHARPs are receptive to receiving text messages focusing on cancer/health information and would be likely to engage in mobile health research. These findings represent the first step in the development of an interactive mobile health program designed to provide cancer/health information and a support network for the Deep South Network Community Health Advisors as Research Partners (DSN CHARPs).

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study

PubMed Central

2017-01-01

Background Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. Objective The aim of our study was to investigate care coordinators’ perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Methods Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. Results The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients’ agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship. Conclusions Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations. PMID:28325711

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

PubMed

Sigler, Brittany Erika

2017-03-21

Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship. Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations. ©Brittany Erika Sigler. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 21.03.2017.

Cross-sectional survey evaluating Text4Mood: mobile health program to reduce psychological treatment gap in mental healthcare in Alberta through daily supportive text messages.

PubMed

Agyapong, Vincent I O; Mrklas, Kelly; Juhás, Michal; Omeje, Joy; Ohinmaa, Arto; Dursun, Serdar M; Greenshaw, Andrew J

2016-11-08

To complement the oversubscribed counselling services in Alberta, the Text4Mood program which delivers daily supportive text messages to subscribers was launched on the 18th of January, 2016. This report presents an evaluation of self-reports of the impact of the program on the mental wellbeing of subscribers. An online link to a survey questionnaire was created by an expert group and delivered via text messages to mobile phones of all 4111 active subscribers of the Text4Mood program as of April 11, 2016. Overall, 894 subscribers answered the survey (overall response rate 21.7 %). The response rate for individual questions varied and is reported alongside the results. Most respondents were female (83 %, n = 668), Caucasian (83 %, n = 679), and diagnosed with a psychiatric disorder (38 %, n = 307), including Depression (25.4 %, n = 227) and Anxiety (20 %, n = 177). Overall, 52 % (n = 461) signed up for Text4Mood to help elevate their mood and 24.5 % (n = 219) signed up to help them worry less. Most respondents felt the text messages made them more hopeful about managing issues in their lives (81.7 %, n = 588), feel in charge of managing depression and anxiety (76.7 %, n = 552), and feel connected to a support system (75.2 %, n = 542). The majority of respondents felt Text4Mood improved their overall mental well-being (83.1 %, n = 598). Supportive text messages are a feasible and acceptable way of delivering adjunctive psychological interventions to the general public with mental health problems. Given that text messages are affordable, readily available, and can be delivered to thousands of people simultaneously, they present an opportunity to help close the psychological treatment gap for mental health patients in Alberta and elsewhere.

A block randomized controlled trial of a brief smoking cessation counselling and advice through short message service on participants who joined the Quit to Win Contest in Hong Kong.

PubMed

Chan, Sophia S C; Wong, David C N; Cheung, Yee Tak Derek; Leung, Doris Y P; Lau, Lisa; Lai, Vienna; Lam, Tai-Hing

2015-08-01

The present trial examined the effectiveness of brief interventions for smokers who joined the Hong Kong Quit to Win Contest to quit smoking. A block randomized controlled trial allocated 1003 adult daily smokers to three groups: (i) The TEL group (n = 338) received a 5-min nurse-led telephone counselling; (ii) The SMS group (n = 335) received eight text messages through mobile phone and (iii) The CONTROL group (n = 330) did not receive the above interventions. Participants with biochemically verified abstinence at 6-month follow-up could receive cash incentive. The primary outcome was the self-reported 7-day point prevalence (PP) of tobacco abstinence at 6-month follow-up. The abstinence rate in the TEL, SMS and CONTROL group was 22.2, 20.6 and 20.3%, respectively (P for TEL versus CONTROL = 0.32; P for SMS versus CONTROL = 0.40). When abstinence at 2-, 6- and 12-month follow-up was modelled simultaneously, the TEL group had a higher abstinence than the CONTROL group (Adjusted OR = 1.38, 95% CI = 1.01-1.88, P = 0 .04). In the Quit to Win Contest, the brief telephone counselling might have increased abstinence, but the text messages had no significant effect. Further studies on intensive intervention and interactive messaging services are warranted. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Diabetes buddies: peer support through a mobile phone buddy system.

PubMed

Rotheram-Borus, Mary Jane; Tomlinson, Mark; Gwegwe, Margaret; Comulada, W Scott; Kaufman, Neal; Keim, Marion

2012-01-01

The purpose of this study is to test the feasibility and acceptability of a mobile phone-based peer support intervention among women in resource-poor settings to self-manage their diabetes. Secondary goals were to evaluate the intervention's effectiveness to motivate diabetes-related health choices. Women with diabetes (n = 22) in Cape Town, South Africa, participated in a 12-week program focused on providing and applying knowledge of health routines to manage diabetes. Women were linked with a buddy via a mobile phone for support and were questioned daily about a health behavior via text message. Women were assessed at recruitment and then 3 and 6 months later by a trained interviewer using a mobile phone for data collection. The women were evaluated on technology uptake, reduction of body mass index, blood glucose levels, and increases in positive coping and general health-seeking behaviors. Women exchanged 16 739 text messages to buddies and received 3144 texts from the project. Women responded to 29% of texted questions (n = 1321/14 582). Women attended at least 9 of 12 possible intervention sessions; a third attended all 12 sessions (n = 8/22). Between baseline and 3 months, women increased their sleep and reported a higher level of positive action and social support coping, yet blood glucose increased by 3.3 points. From 3 to 6 months, spiritual hope decreased and diastolic blood pressure increased. One year later, the 22 women continue to attend meetings. Mobile phones are an easy and reliable way to provide peer support and disseminate health messages. Both positive and negative changes were observed in this pilot study.

Can skin cancer prevention be improved through mobile technology interventions? A systematic review.

PubMed

Finch, Linda; Janda, Monika; Loescher, Lois J; Hacker, Elke

2016-09-01

Print-based health promotion interventions are being phased out to bring forth more appealing and assessable new technology applications. This review aimed to evaluate the current literature on the use of mobile text messaging and similar electronic technology interventions in the area of skin cancer prevention. A search of studies guided by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was conducted on mobile technology interventions for improving skin cancer prevention in the electronic databases PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Overall, 136 articles were screened for eligibility between 2001 (earliest relevant article found) and November 2015. Eight studies fulfilled the inclusion criteria and were reviewed according to the PRISMA guidelines. Of these, five were randomised controlled trials (RCTs), two were controlled clinical trials, and one was a cohort study. Five studies used text messages as an intervention, two used mobile phone applications, and another used electronic messages via email. All studies resulted in self-reported behaviour change in at least one of their outcome measures (e.g., sunscreen application, seeking shade). While the behaviour change outcomes are promising, the lack of change in more objective measures such as sunburn indicates a need to further improve mobile phone technology-delivered interventions in order to have a greater impact on skin cancer prevention. Future studies may consider the use of objective outcome measures (e.g., sunscreen weight), electronic diaries, or behavioural outcomes in social networks. Copyright © 2016 Elsevier Inc. All rights reserved.

Text Messaging for Addiction: A Review

PubMed Central

Keoleian, Victoria; Polcin, Douglas; Galloway, Gantt P.

2015-01-01

Individuals seeking treatment for addiction often experience barriers due to cost, lack of local treatment resources, or either school or work schedule conflicts. Text messaging-based addiction treatment is inexpensive and has the potential to be widely accessible in real time. We conducted a comprehensive literature review identifying 11 published randomized controlled trials (RCTs) evaluating text messaging-based interventions for tobacco smoking, 4 studies for reducing alcohol consumption, 1 pilot study in former methamphetamine (MA) users, and 1 study based on qualitative interviews with cannabis users. Abstinence outcome results in RCTs of smokers willing to make a quit attempt have been positive overall in the short term and as far out as at 6 and 12 months. Studies aimed at reducing alcohol consumption have been promising. More data are needed to evaluate the feasibility, acceptability, and efficacy of this approach for other substance use problems. PMID:25950596

Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial.

PubMed

Pfaeffli Dale, Leila; Whittaker, Robyn; Jiang, Yannan; Stewart, Ralph; Rolleston, Anna; Maddison, Ralph

2015-10-21

Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial

PubMed Central

Whittaker, Robyn; Jiang, Yannan; Stewart, Ralph; Rolleston, Anna; Maddison, Ralph

2015-01-01

Background Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. Objective The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). Methods A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. Results Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. Conclusions A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. Trial Registration ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt) PMID:26490012

Feasibility and effectiveness of an automated bilingual text message intervention for weight loss: pilot study.

PubMed

Kolodziejczyk, Julia K; Norman, Gregory J; Barrera-Ng, Angelica; Dillon, Lindsay; Marshall, Simon; Arredondo, Elva; Rock, Cheryl L; Raab, Fred; Griswold, William G; Sullivan, Mark; Patrick, Kevin

2013-11-06

Little is known about the feasibility and acceptability of tailored text message based weight loss programs for English and Spanish-language speakers. This pilot study evaluated the feasibility, acceptability, and estimated impact of a tailored text message based weight loss program for English and Spanish-language speakers. The purpose of this pilot study was to inform the development of a full-scale randomized trial. There were 20 overweight or obese participants (mean age 40.10, SD 8.05; 8/20, 40% male; 9/20, 45% Spanish-speakers) that were recruited in San Diego, California, from March to May 2011 and evaluated in a one-group pre/post clinical trial. For 8 weeks, participants received and responded to 3-5 text messages daily sent from a fully automated text messaging system. They also received printed weight loss materials and brief 10-15 minute weekly counseling calls. To estimate the impact of the program, the primary outcome was weight (kg) measured during face-to-face measurement visits by trained research staff. Pre and post differences in weight were analyzed with a one-way repeated measures analysis of variance. Differences by language preference at both time points were analyzed with t tests. Body mass index and weight management behaviors also were examined. Feasibility and acceptability were determined by recruitment success, adherence (ie, percentage of replies to interactive text messages and attrition), and participant satisfaction. Participants who completed the final assessment (N=18) decreased body weight by 1.85 kg (F1,17=10.80, P=.004, CI∆ 0.66-3.03, η(2)=0.39). At both time points, there were no differences in weight by language preference. Participants responded to 88.04% (986/1120) of interactive text messages, attrition rate was 10% (2/20), and 94% (19/20) of participants reported satisfaction with the program. This fully automated text message based weight program was feasible with English and Spanish-speakers and may have promoted modest weight loss over an 8-week period. Clinicaltrials.gov NCT01171586; http://clinicaltrials.gov/ct2/show/NCT01171586 (Archived by WebCite at http://www.webcitation.org/6Ksr6dl7n).

Mobile phone messaging for communicating results of medical investigations.

PubMed

Gurol-Urganci, Ipek; de Jongh, Thyra; Vodopivec-Jamsek, Vlasta; Car, Josip; Atun, Rifat

2012-06-13

Mobile phone messaging, such as Short Message Service (SMS) and Multimedia Message Service (MMS), has rapidly grown into a mode of communication with a wide range of applications, including communicating the results from medical investigations to patients. Alternative modes of communication of results include face-to-face communication, postal messages, calls to landlines or mobile phones, through web-based health records and email. Possible advantages of mobile phone messaging include convenience to both patients and healthcare providers, reduced waiting times for health services and healthcare costs. To assess the effects of mobile phone messaging for communicating results of medical investigations, on people's healthcare-seeking behaviour and health outcomes. Secondary objectives include assessment of participants' evaluation of the intervention, direct and indirect healthcare costs and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009). We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We included studies assessing mobile phone messaging for communicating results of medical tests, between a healthcare provider or 'treatment buddy' and patient. We only included studies in which it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions.   Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by a third. Primary outcomes of interest were health outcomes and healthcare utilisation as a result of the intervention. We also considered patients' and providers' evaluation of the intervention, perceptions of safety, costs and potential harms or adverse effects of the intervention. We included one randomised controlled trial involving 2782 participants. The study investigated the effects of mobile phone messaging in alleviating anxiety in women waiting for prenatal biochemical screening results for Down syndrome, by providing fast reporting of results before a follow-up appointment. The study measured health outcomes using the Spielberger State-Trait Anxiety Inventory (STAI), which includes a scale (20 to 80 points, higher score indicates higher anxiety) to describe how the respondent feels at a particular moment in time (state anxiety). The study, which was at high risk of bias, found that women who had received their test result early by text message had a mean anxiety score 2.48 points lower than women who had not yet received their result (95% CI - 8.79 to 3.84). Women with a serum-negative test result receiving their result early had a mean anxiety score 5.3 points lower (95% CI - 5.99 to -4.61) than women in the control group. Women with a serum-positive test result receiving their result early by text message had a mean anxiety score 1.2 points higher (95% CI - 3.48 to 5.88) than women in the control group.The evidence was of low quality due to high risk of bias in the included study, and the fact that the evidence comes from one study only. The study did not report on other outcomes of interest, such as patient satisfaction, adverse events or cost. We found very limited evidence of low quality that communicating results of medical investigations by mobile phone messaging may make little or no difference to women's anxiety overall or in women with positive test results, but may reduce anxiety in women with negative test results. However, with only one study included in this review, this evidence is insufficient to inform recommendations at this time. More research is needed on the effectiveness and user evaluation of these interventions. In particular, more research should be conducted into the potential risks and limitations of these interventions.

Improving Family Communication.

PubMed

Medrano, Vilma; Bonilla, Gladys; Hernández, Ericka; Romanjek, Mariana Harnecker; Gómez, Adriana; Hernández, Jasón; Reyes, Marcela Ríos; Lindenberg, Cathy Strachan

2017-03-01

TeenSmart International harnesses the power and flexibility of technology to empower youth to take personal responsibility for their health and lifestyle choices. Access to the Internet via mobile phones is often cheaper than paying to connect to a wired broadband service, and in rural areas, mobile networks may be the only means of accessing the Internet. This study assessed the feasibility, acceptability, and impact of "cues to action" or brief motivating cell phone text messages to improve adolescent family communication and relationships. A quasi-experimental design using a voluntary sample of 100 Nicaraguan youth at high risk for poor family communication participated. Pre- and posttest quantitative measures using Student t statistical analysis, a focus group, and a participant testimony provided the evaluation evidence. Findings suggest that there are economic and motivational barriers to the use of text messages, but when barriers are eliminated, the behavioral results are positive. Youth who received two weekly text messages over a 6-month period demonstrated statistically significant improvements in family communication perceptions, attitudes, and behaviors, strengthening their family communications and relationships. Brief and personalized text messaging "cues to action" may be a cost-effective intervention to improve adolescent healthy lifestyle behaviors.

The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes.

PubMed

Mayberry, Lindsay Satterwhite; Berg, Cynthia A; Harper, Kryseana J; Osborn, Chandra Y

2016-01-01

Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs ( n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP.

The Design, Usability, and Feasibility of a Family-Focused Diabetes Self-Care Support mHealth Intervention for Diverse, Low-Income Adults with Type 2 Diabetes

PubMed Central

Berg, Cynthia A.; Harper, Kryseana J.; Osborn, Chandra Y.

2016-01-01

Family members' helpful and harmful actions affect adherence to self-care and glycemic control among adults with type 2 diabetes (T2D) and low socioeconomic status. Few family interventions for adults with T2D address harmful actions or use text messages to reach family members. Through user-centered design and iterative usability/feasibility testing, we developed a mHealth intervention for disadvantaged adults with T2D called FAMS. FAMS delivers phone coaching to set self-care goals and improve patient participant's (PP) ability to identify and address family actions that support/impede self-care. PPs receive text message support and can choose to invite a support person (SP) to receive text messages. We recruited 19 adults with T2D from three Federally Qualified Health Centers to use FAMS for two weeks and complete a feedback interview. Coach-reported data captured coaching success, technical data captured user engagement, and PP/SP interviews captured the FAMS experience. PPs were predominantly African American, 83% had incomes <$35,000, and 26% were married. Most SPs (n = 7) were spouses/partners or adult children. PPs reported FAMS increased self-care and both PPs and SPs reported FAMS improved support for and communication about diabetes. FAMS is usable and feasible and appears to help patients manage self-care support, although some PPs may not have a SP. PMID:27891524

The Detroit Young Adult Asthma Project: Pilot of a Technology-Based Medication Adherence Intervention for African-American Emerging Adults.

PubMed

Kolmodin MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Lam, Phebe; Secord, Elizabeth

2016-10-01

To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions. Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1, and 3 months. Ecological Momentary Assessment via two-way text messaging was also used to collect "real-time" data on medication use and asthma control. The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to postintervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen's d = .071). Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Stepwise strategy to improve Cervical Cancer Screening Adherence (SCAN-CC): automated text messages, phone calls and face-to-face interviews: protocol of a population-based randomised controlled trial.

PubMed

Firmino-Machado, João; Mendes, Romeu; Moreira, Amélia; Lunet, Nuno

2017-10-05

Screening is highly effective for cervical cancer prevention and control. Population-based screening programmes are widely implemented in high-income countries, although adherence is often low. In Portugal, just over half of the women adhere to cervical cancer screening, contributing for greater mortality rates than in other European countries. The most effective adherence raising strategies are based on patient reminders, small/mass media and face-to-face educational programmes, but sequential interventions targeting the general population have seldom been evaluated. The aim of this study is to assess the effectiveness of a stepwise approach, with increasing complexity and cost, to improve adherence to organised cervical cancer screening: step 1a-customised text message invitation; step 1b-customised automated phone call invitation; step 2-secretary phone call; step 3-family health professional phone call and face-to-face appointment. A population-based randomised controlled trial will be implemented in Portuguese urban and rural areas. Women eligible for cervical cancer screening will be randomised (1:1) to intervention and control. In the intervention group, women will be invited for screening through text messages, automated phone calls, manual phone calls and health professional appointments, to be applied sequentially to participants remaining non-adherent after each step. Control will be the standard of care (written letter). The primary outcome is the proportion of women adherent to screening after step 1 or sequences of steps from 1 to 3. The secondary outcomes are: proportion of women screened after each step (1a, 2 and 3); proportion of text messages/phone calls delivered; proportion of women previously screened in a private health institution who change to organised screening. The intervention and control groups will be compared based on intention-to-treat and per-protocol analyses. The study was approved by the Ethics Committee of the Northern Health Region Administration and National Data Protection Committee. Results will be disseminated through communications in scientific meetings and peer-reviewed journals. NCT03122275. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The use of telehealth (text messaging and video communications) in patients with cystic fibrosis: A pilot study.

PubMed

Gur, Michal; Nir, Vered; Teleshov, Anna; Bar-Yoseph, Ronen; Manor, Eynav; Diab, Gizelle; Bentur, Lea

2017-05-01

Background Poor communications between cystic fibrosis (CF) patients and health-care providers may result in gaps in knowledge and misconceptions about medication usage, and can lead to poor adherence. We aimed to assess the feasibility of using WhatsApp and Skype to improve communications. Methods This single-centre pilot study included CF patients who were older than eight years of age assigned to two groups: one without intervention (control group), and one with intervention. Each patient from the intervention group received Skype-based online video chats and WhatsApp messages from members of the multidisciplinary CF team. CF questionnaires, revised (CFQ-R) scores, knowledge and adherence based on CF My Way and patients satisfaction were evaluated before and after three months. Feasibility was assessed by session attendance, acceptability and satisfaction survey. Descriptive analysis and paired and non-paired t-tests were used as applicable. Results Eighteen patients were recruited to this feasibility study (nine in each group). Each intervention group participant had between four and six Skype video chats and received 22-45 WhatsApp messages. In this small study, CFQ-R scores, knowledge, adherence and patient satisfaction were similar in both groups before and after the three-month intervention. Conclusions A telehealth-based approach, using Skype video chats and WhatsApp messages, was feasible and acceptable in this pilot study. A larger and longer multi-centre study is warranted to examine the efficacy of these interventions to improve knowledge, adherence and communication.

Connect-Text: Leveraging Text-Message Communication to Mitigate Chronic Absenteeism and Improve Parental Engagement in the Earliest Years of Schooling

ERIC Educational Resources Information Center

Smythe-Leistico, Kenneth; Page, Lindsay C.

2018-01-01

Poor school attendance in the early grades is predictive of poor subsequent educational outcomes. We report on a pilot intervention aiming to reduce chronic absenteeism in kindergarten. We designed and implemented a two-way, text-based parent-school communication system to encourage daily attendance, provide parents with personalized feedback on…

Supporting Parenting through Differentiated and Personalized Text-Messaging: Testing Effects on Learning during Kindergarten. CEPA Working Paper No. 16-18

ERIC Educational Resources Information Center

Doss, Christopher; Fahle, Erin M.; Loeb, Susanna; York, Benjamin N.

2017-01-01

Recent studies show that texting-based interventions can produce educational benefits in children across a range of ages. We study the effects of a text-based program for kindergarten parents, distinguishing a general program from one that adds differentiation and personalization based on the child's developmental level. Children in the…

Text Messaging, Teen Outreach Program, and Sexual Health Behavior: A Cluster Randomized Trial.

PubMed

Bull, Sheana; Devine, Sharon; Schmiege, Sarah J; Pickard, Leslie; Campbell, Jon; Shlay, Judith C

2016-09-01

To consider whether Youth All Engaged! (a text message intervention) intensified the effects of the adolescent pregnancy prevention Teen Outreach Program (control) for youths. In this trial performed in Denver, Colorado, from 2011 to 2014, we randomized 8 Boys & Girls Clubs each of 4 years into 32 clubs per year combinations to ensure each club would serve as a treatment site for 2 years and a control site for 2 years. Control intervention consisted of the Teen Outreach Program only. We enrolled 852 youths (aged 14-18 years), and 632 were retained at follow-up, with analytic samples ranging from 50 to 624 across outcomes. We examined program costs, and whether the intervention increased condom and contraceptive use, access to care, and pregnancy prevention. Control program costs were $1184 per participant, and intervention costs were an additional $126 per participant (+10.6%). There were no statistically significant differences in primary outcomes for the full sample. Hispanic participants in the intervention condition had fewer pregnancies at follow-up (1.79%) than did those in the control group (6.72%; P = .02). Youth All Engaged is feasible, low cost, and could have potential benefits for Hispanic youths.

Cell Phone Utilization among Foreign-born Latinos: a Promising Tool for Dissemination of Health and HIV Information

PubMed Central

Leite, Lorena; Buresh, Megan; Rios, Naomi; Conley, Anna; Flys, Tamara; Page, Kathleen R.

2013-01-01

Latinos in the U.S. are disproportionately affected by HIV and are at risk for late presentation to care. Between June 2011 and January 2012, we conducted a cross-sectional survey of 209 Baltimore Latinos at community-based venues to evaluate the feasibility of using communication technology (ICT)-based interventions to improve access to HIV testing and education within the Spanish-speaking community in Baltimore. Participants had a median age of 33 years (IQR 28-42), 51.7% were male, and 95.7% were foreign-born. Approximately two-thirds (63.2%) had been in the U.S. less than 10 years and 70.1% had been previously tested for HIV. Cell phone (92.3%) and text messaging (74.2%) was used more than Internet (52.2%) or e-mail (42.8%) (p<0.01). In multivariate analysis, older age and lower education were associated with less utilization of Internet, e-mail and text messaging, but not cell phones. Interest was high for receiving health education (73.1%), HIV education (70.2%), and test results (68.8%) via text messaging. Innovative cell phone-based communication interventions have the potential to link Latino migrants to HIV prevention, testing and treatment services. PMID:23440452

Cell phone utilization among foreign-born Latinos: a promising tool for dissemination of health and HIV information.

PubMed

Leite, Lorena; Buresh, Megan; Rios, Naomi; Conley, Anna; Flys, Tamara; Page, Kathleen R

2014-08-01

Latinos in the US are disproportionately affected by HIV and are at risk for late presentation to care. Between June 2011 and January 2012, we conducted a cross-sectional survey of 209 Baltimore Latinos at community-based venues to evaluate the feasibility of using information communication technology-based interventions to improve access to HIV testing and education within the Spanish-speaking community in Baltimore. Participants had a median age of 33 years interquartile range (IQR) (IQR 28-42), 51.7 % were male, and 95.7 % were foreign-born. Approximately two-thirds (63.2 %) had been in the US less than 10 years and 70.1 % had been previously tested for HIV. Cell phone (92.3 %) and text messaging (74.2 %) was used more than Internet (52.2 %) or e-mail (42.8 %) (p < 0.01). In multivariate analysis, older age and lower education were associated with less utilization of Internet, e-mail and text messaging, but not cell phones. Interest was high for receiving health education (73.1 %), HIV education (70.2 %), and test results (68.8 %) via text messaging. Innovative cell phone-based communication interventions have the potential to link Latino migrants to HIV prevention, testing and treatment services.

Applications of Text Messaging, and Bibliotherapy for Treatment of Patients Affected by Depressive Symptoms.

PubMed

Taleban, Roya; Zamani, Ahmadreza; Moafi, Mohammad; Jiryaee, Nasrin; Khadivi, Reza

2016-01-01

Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging, which aimed at amelioration of patient's behavior and consciousness, which could lead to suicide prevention. This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, <18 years, and cell phone accessibility. Mental retardation, drug and alcohol abuse, visual disability, dementia, suicide attempt history, electrotherapy, and receiving psychological interventions were our not met criteria. Our patient outcomes comprised intensity of depressive symptom and treatment compliance. The first two trials were requested to study instructive booklets in 30 days while the second cohort was demanded to study the booklet in accordance with the daily delivered text messaging. Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction (F = 12.30, P < 0.001). Based on treatment compliance, the interactive effect of group factor and the time factor was statistically significant. It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary methodology aiming depression treatment.

MEMO--a mobile phone depression prevention intervention for adolescents: development process and postprogram findings on acceptability from a randomized controlled trial.

PubMed

Whittaker, Robyn; Merry, Sally; Stasiak, Karolina; McDowell, Heather; Doherty, Iain; Shepherd, Matthew; Dorey, Enid; Parag, Varsha; Ameratunga, Shanthi; Rodgers, Anthony

2012-01-24

Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations. To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants' self-reported satisfaction with the intervention. The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011. A total of 1348 students (13-17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)--significantly higher than proportions in the control group. Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage. CLINICALTRIAL: Australia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb).

Weight-loss intervention using implementation intentions and mental imagery: a randomised control trial study protocol.

PubMed

Hattar, Anne; Hagger, Martin S; Pal, Sebely

2015-02-27

Overweight and obesity are major health problems worldwide. This protocol describes the HEALTHI (Healthy Eating and Active LifesTyle Health Intervention) Program, a 12-week randomised-controlled weight-loss intervention that adopts two theory-based intervention techniques, mental imagery and implementation intentions, a behaviour-change technique based on planning that have been shown to be effective in promoting health-behaviour change in previous research. The effectiveness of goal-reminder text messages to augment intervention effects will also be tested. The trial will determine the effects of a brief, low cost, theory-based weight-loss intervention to improve dietary intake and physical activity behaviour and facilitate weight-loss in overweight and obese individuals. Overweight or obese participants will be randomly allocated to one of three conditions: (1) a psycho-education plus an implementation intentions and mental imagery condition; (2) a psycho-education plus an implementation intentions and mental imagery condition with text messages; or (3) a psycho-education control condition. The intervention will be delivered via video presentation to increase the intervention's applicability in multiple contexts and keep costs low. We hypothesise that the intervention conditions will lead to statistically-significant changes in the primary and secondary outcome variables measured at 6 and 12 weeks post-intervention relative to the psycho-education control condition after controlling for baseline values. The primary outcome variable will be body weight and secondary outcome variables will be biomedical (body mass, body fat percentage, muscle mass, waist-hip circumference ratio, systolic and diastolic blood pressure, low-density lipoprotein, high-density lipoprotein, total cholesterol, triglycerides, blood glucose and insulin levels), psychological (quality of life, motivation, risk perception, outcome expectancy, intention, action self-efficacy, maintenance self-efficacy, goal setting and planning), and behavioural (self-reported diet intake, and physical activity involvement) measures. We also expect the intervention condition augmented with text messages to lead to statistically significant differences in the primary and secondary outcome variables at the follow up periods after controlling for baseline values. The planned trial will test the effectiveness of the theory-based HEALTHI program intervention to reduce weight and salient psychological, biomedical, and behavioural outcomes in overweight and obese adults. The study has been designed to maximise applicability to real world settings and could be integrated into existing weight management practices. ACTRN: ACTRN12613001274763. Registration date 19/11/2013.

Google glass: a driver distraction cause or cure?

PubMed

Sawyer, Ben D; Finomore, Victor S; Calvo, Andres A; Hancock, P A

2014-11-01

We assess the driving distraction potential of texting with Google Glass (Glass), a mobile wearable platform capable of receiving and sending short-message-service and other messaging formats. A known roadway danger, texting while driving has been targeted by legislation and widely banned. Supporters of Glass claim the head-mounted wearable computer is designed to deliver information without concurrent distraction. Existing literature supports the supposition that design decisions incorporated in Glass might facilitate messaging for drivers. We asked drivers in a simulator to drive and use either Glass or a smartphone-based messaging interface, then interrupted them with an emergency brake event. Both the response event and subsequent recovery were analyzed. Glass-delivered messages served to moderate but did not eliminate distracting cognitive demands. A potential passive cost to drivers merely wearing Glass was also observed. Messaging using either device impaired driving as compared to driving without multitasking. Glass in not a panacea as some supporters claim, but it does point the way to design interventions that effect reduced load in multitasking. Discussions of these identified benefits are framed within the potential of new in-vehicle systems that bring both novel forms of distraction and tools for mitigation into the driver's seat.

Mobile Phone Text Messaging Intervention for Cervical Cancer Screening: Changes in Knowledge and Behavior Pre-Post Intervention

PubMed Central

2014-01-01

Background Cervical cancer poses a significant threat to Korean American women, who are reported to have one of the highest cervical cancer mortality rates in the United States. Studies consistently report that Korean American women have the lowest Pap test screening rates across US ethnic groups. Objective In response to the need to enhance cervical cancer screening in this vulnerable population, we developed and tested a 7-day mobile phone text message-based cervical cancer Screening (mScreening) intervention designed to promote the receipt of Pap tests by young Korean American women. Methods We developed and assessed the acceptability and feasibility of a 1-week mScreening intervention to increase knowledge of cervical cancer screening, intent to receive screening, and the receipt of a Pap test. Fogg’s Behavior Model was the conceptual framework that guided the development of the mScreening intervention. A series of focus groups were conducted to inform the development of the intervention. The messages were individually tailored for each participant and delivered to them for a 7-day period at each participant’s preferred time. A quasi-experimental research design of 30 Korean American women aged 21 to 29 years was utilized with baseline, post (1 week after the completion of mScreening), and follow-up (3 months after the completion of mScreening) testing. Results Findings revealed a significant increase in participants’ knowledge of cervical cancer (P<.001) and guidelines for cervical cancer screening (P=.006). A total of 23% (7/30) (95% CI 9.9-42.3) of the mScreening participants received a Pap test; 83% (25/30) of the participants expressed satisfaction with the intervention and 97% (29/30) reported that they would recommend the program to their friends, indicating excellent acceptability and feasibility of the intervention. Conclusions This study provides evidence of the effectiveness and feasibility of the mScreening intervention. Mobile technology is a promising tool to increase both knowledge and receipt of cervical cancer screening. Given the widespread usage of mobile phones among young adults, a mobile phone-based health intervention could be a low-cost and effective method of reaching populations with low cervical cancer screening rates, using individually tailored messages that cover broad content areas and overcome restrictions to place and time of delivery. PMID:25164545

Mobile phone text messaging intervention for cervical cancer screening: changes in knowledge and behavior pre-post intervention.

PubMed

Lee, Hee Yun; Koopmeiners, Joseph S; Rhee, Taeho Greg; Raveis, Victoria H; Ahluwalia, Jasjit S

2014-08-27

Cervical cancer poses a significant threat to Korean American women, who are reported to have one of the highest cervical cancer mortality rates in the United States. Studies consistently report that Korean American women have the lowest Pap test screening rates across US ethnic groups. In response to the need to enhance cervical cancer screening in this vulnerable population, we developed and tested a 7-day mobile phone text message-based cervical cancer Screening (mScreening) intervention designed to promote the receipt of Pap tests by young Korean American women. We developed and assessed the acceptability and feasibility of a 1-week mScreening intervention to increase knowledge of cervical cancer screening, intent to receive screening, and the receipt of a Pap test. Fogg's Behavior Model was the conceptual framework that guided the development of the mScreening intervention. A series of focus groups were conducted to inform the development of the intervention. The messages were individually tailored for each participant and delivered to them for a 7-day period at each participant's preferred time. A quasi-experimental research design of 30 Korean American women aged 21 to 29 years was utilized with baseline, post (1 week after the completion of mScreening), and follow-up (3 months after the completion of mScreening) testing. Findings revealed a significant increase in participants' knowledge of cervical cancer (P<.001) and guidelines for cervical cancer screening (P=.006). A total of 23% (7/30) (95% CI 9.9-42.3) of the mScreening participants received a Pap test; 83% (25/30) of the participants expressed satisfaction with the intervention and 97% (29/30) reported that they would recommend the program to their friends, indicating excellent acceptability and feasibility of the intervention. This study provides evidence of the effectiveness and feasibility of the mScreening intervention. Mobile technology is a promising tool to increase both knowledge and receipt of cervical cancer screening. Given the widespread usage of mobile phones among young adults, a mobile phone-based health intervention could be a low-cost and effective method of reaching populations with low cervical cancer screening rates, using individually tailored messages that cover broad content areas and overcome restrictions to place and time of delivery.

Designing a Knowledge Representation Approach for the Generation of Pedagogical Interventions by MTTs

ERIC Educational Resources Information Center

Paquette, Luc; Lebeau, Jean-François; Beaulieu, Gabriel; Mayers, André

2015-01-01

Model-tracing tutors (MTTs) have proven effective for the tutoring of well-defined tasks, but the pedagogical interventions they produce are limited and usually require the inclusion of pedagogical content, such as text message templates, in the model of the task. The capability to generate pedagogical content would be beneficial to MTT…

Effectiveness of a theory-based mobile phone text message intervention for improving protective behaviors of pregnant women against air pollution: a randomized controlled trial.

PubMed

Jasemzadeh, Mehrnoosh; Khafaie, Morteza Abdullatif; Jaafarzadeh, Nematallah; Araban, Marzieh

2018-03-01

Health impact of exposure to air pollution is a public health concern. The aim of this study was to investigate an extended parallel process model (EPPM)-based mobile phone text message intervention for improving protective behaviors against air pollution among pregnant women. In this randomized controlled trial (IRCT2016102810804N8), 130 pregnant women were randomly assigned into either experimental or control groups. A valid and reliable questionnaire was used to collect data. Experimental group received mobile phone intervention on a daily basis for 2 months. Control group received usual care, only. Data were analyzed using SPSS 15 applying t test, chi-square, and Wilcoxon and Mann-Whitney U test. Although before intervention, there were no significant differences between different structures of EPPM (P > 0.05), after intervention, there were statistically significant differences between perceived severity, response efficacy, self-efficacy, and protective behaviors between two groups (P < 0.05). Implementing EPPM based-mobile phone intervention could promote protective behaviors against air pollution among pregnant women. The present study might be used as a framework for evidence-based health promotion regarding air pollution risk communication and self-care behaviors. IRCT2016102810804N8.

Comparison of reminder methods in selected adolescents with records in an immunization registry.

PubMed

Morris, Jessica; Wang, Wendy; Wang, Lawrence; Peddecord, K Michael; Sawyer, Mark H

2015-05-01

The aim of this study was to assess the effectiveness and cost efficiency of three reminder/recall methods for improving adolescent vaccination rates using the San Diego Immunization Registry. Parents of 5,050 adolescents whose records indicated they lacked one or more adolescent vaccines were identified from the San Diego Immunization Registry and contacted by telephone. Based on their preference, consenting participants were enrolled to receive either postal mail (n = 282), e-mail (n = 963), or text (n = 552) reminders for vaccination. The intervention groups were sent a series of up to three reminders. The vaccination completion rate was compared between the intervention groups and two control groups-the enrollment phone call-only group who declined to participate and a no contact group-using logistic regression. The participants who received any reminder were more likely (24.6% vs. 12.4%; p < .001) to become up-to-date (UTD) than those in the enrollment phone call-only group. At the conclusion of the study observation, UTD status was reached by 32.1% of text message recipients, 23.0% of postcard recipients, and 20.8% of e-mail recipients compared to 12.4% for the enrollment phone call recipients. Only 9.7% of nonintervention adolescents became UTD. All three reminder interventions were effective in improving adolescent vaccination rates. Although postal mail reminders were preferred by most participants, text messaging and e-mail were the more effective reminder methods. Text messaging and e-mail as reminder methods for receiving vaccinations should be considered for use to boost vaccination completion among adolescents. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

How people with serious mental illness use smartphones, mobile apps, and social media.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Bartels, Stephen J

2016-12-01

Research shows that people with serious mental illness are increasingly using mobile devices. Less is known about how these individuals use their mobile devices or whether they access social media. We surveyed individuals with serious mental illness to explore their use of these technologies. Individuals with serious mental illness engaged in lifestyle interventions through community mental health centers completed a survey about their use of mobile and online technologies. Responses were compared with data from the general population. Among respondents (n = 70), 93% owned cellphones, 78% used text messaging, 50% owned smartphones, and 71% used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media. Technology use was comparable to the general population, though smartphone ownership was lower. These findings can inform future interventions that fully leverage this group's use of popular digital technologies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

How People with Serious Mental Illness Use Smartphones, Mobile Apps, and Social Media

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Bartels, Stephen J.

2016-01-01

Objective Research shows that people with serious mental illness are increasingly using mobile devices. Less is known about how these individuals use their mobile devices or whether they access social media. We surveyed individuals with serious mental illness to explore their use of these technologies. Methods Individuals with serious mental illness engaged in lifestyle interventions through community mental health centers completed a survey about their use of mobile and online technologies. Responses were compared to data from the general population. Results Among respondents (n=70), 93% owned cellphones, 78% used text messaging, 50% owned smartphones, and 71% used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media. Technology use was comparable to the general population, though smartphone ownership was lower. Conclusions and Implications for Practice These findings can inform future interventions that fully leverage this group’s use of popular digital technologies. PMID:27845533

The Uses of Texting in Sexual Relationships Scale: Associations With Risky Sexual Behavior Among At-Risk African American Emerging Adults.

PubMed

Broaddus, Michelle; Dickson-Gomez, Julia

2016-10-01

Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication.

Preferred Tone of Nutrition Text Messages for Young Adults: Focus Group Testing

PubMed Central

2016-01-01

Background Young adults are a particularly hard to reach group using conventional health promotion practices as they do not see nutrition messages as personally relevant to them. Text messaging (short message service, SMS) offers an innovative approach to reaching young adults to support and promote dietary behavior change. Objective The aim of this study was to develop and test tonal preferences for nutrition text messages among young adults using focus groups. Methods A total of 39 young adults aged 18-30 years residing in Perth, Western Australia participated in four focus groups. Participants briefly discussed their perception of healthy eating and their responses to messages about increasing fruit and vegetables, and reducing “junk food” and alcohol intake. They ranked their preference for 15 nutrition messages across 3 dietary behaviors (fruit and vegetables, junk food, and alcohol) with 5 different message tones (authoritative, empathetic, generation Y, solutions, and substitutions) and identified the messages most likely to persuade young adults to change their diet. A 5-point ranking of the nutrition messages was from the most likely to least likely to persuade (1-5). The focus groups were conducted by a trained facilitator and observer and were recorded. Data driven content analysis was used to explore themes. Tonal preferences and potential motivators were collated and frequencies presented. Results Participants ranked offering substitutes (29%, 11/39) and using empathy (22%, 9/39) as the most persuasive message techniques in improving diets of young adults, with low responses for Generation Y (17%, 7/39), solutions (17%, 7/39), and authoritative (15%, 6/39) tones. Females were more likely to consider substitution messages persuasive (35%, 7/20) compared with males (22%, 4/19). A greater proportion of males compared with females considered authoritative messages persuasive: (22%, 4/19) compared with (7%, 1/20). There is a strong preference for a substitution tone for fruit and vegetable messages (52%, 20/39), and no overall message tone preference for junk food and alcohol messages. Substitutions were viewed as helpful and practical. Empathy was liked as it acknowledged previous efforts. Responses to authoritative tone were mixed with some feeling guilt while others found them informative. Acceptability of the solutions depended on the behavioral change and acceptability of the solution proposed. Generation Y tone had some support for junk food and alcohol messages, and if favored, was considered casual, humorous, catchy, and motivational. Conclusions Substitutions and tone of empathy were favored as the most likely execution styles to motivate nutrition behavior change across all participants. There is no “one size fits all” with different tones preferred by individuals for different dietary behaviors. Although text messaging provides instant message delivery direct to the individual, these results demonstrate the complexity of developing motivational nutrition message for young adults. These findings reveal the importance of considering the tone and content and pretesting messages for health promotion text message interventions. PMID:26787115

Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

PubMed Central

2013-01-01

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

e-Monitoring of Asthma Therapy to Improve Compliance in children using a real-time medication monitoring system (RTMM): the e-MATIC study protocol.

PubMed

Vasbinder, Erwin C; Janssens, Hettie M; Rutten-van Mölken, Maureen P M H; van Dijk, Liset; de Winter, Brenda C M; de Groot, Ruben C A; Vulto, Arnold G; van den Bemt, Patricia M L A

2013-03-21

Many children with asthma do not have sufficient asthma control, which leads to increased healthcare costs and productivity loss of parents. One of the causative factors are adherence problems. Effective interventions improving medication adherence may therefore improve asthma control and reduce costs. A promising solution is sending real time text-messages via the mobile phone network, when a medicine is about to be forgotten. As the effect of real time text-messages in children with asthma is unknown, the primary aim of this study is to determine the effect of a Real Time Medication Monitoring system (RTMM) with text-messages on adherence to inhaled corticosteroids (ICS). The secondary objective is to study the effects of RTMM on asthma control, quality of life and cost-effectiveness of treatment. A multicenter, randomized controlled trial involving 220 children (4-11 years) using ICS for asthma. All children receive an RTMM-device for one year, which registers time and date of ICS doses. Children in the intervention group also receive tailored text-messages, sent only when a dose is at risk of omission. Primary outcome measure is the proportion of ICS dosages taken within the individually predefined time-interval. Secondary outcome measures include asthma control (monthly Asthma Control Tests), asthma exacerbations, healthcare use (collected from hospital records, patient reports and pharmacy record data), and disease-specific quality of life (PAQLQ questionnaire). Parental and children's acceptance of RTMM is evaluated with online focus groups and patient questionnaires. An economic evaluation is performed adopting a societal perspective, including relevant healthcare costs and parental productivity loss. Furthermore, a decision-analytic model is developed in which different levels of adherence are associated with clinical and financial outcomes. Also, sensitivity analyses are carried out on different price levels for RTMM. If RTMM with tailored text-message reminders proves to be effective, this technique can be used in daily practice, which would support children with suboptimal adherence in their asthma (self)management and in achieving better asthma control and better quality of life. Netherlands Trial Register NTR2583.

Mobile phone text messaging to improve knowledge and practice of diabetic foot care in a developing country: Feasibility and outcomes.

PubMed

Hassan, Zeinab M

2017-06-01

To test the feasibility and effectiveness of using mobile phone text messaging to reinforce learning and the practice of diabetic foot care in a developing country. Ongoing learning reinforcement (2-3 times weekly) by text messaging followed an informal class on diabetic foot care in a community clinic setting. Subjects with cell phone access and no history of diabetic foot wounds or current wounds were recruited for participation (N = 225). Foot examinations and pretesting by survey occurred just before patients departed the clinic; the posttest survey and a final foot examination occurred 12 weeks later. The survey included basic demographic items along with items to measure knowledge and current foot care practices. One sample t tests (raw scores) and Wilcoxon signed-rank tests compared knowledge and practice before and after intervention. Initially, a majority of the sample (76%) reported poor levels of foot care. After 12 weeks <1% reported poor foot care practices. Statistical testing showed significant gains in knowledge (by score and level) and nearly unanimous compliance with daily foot examination. Mobile phone text messaging is an economical, feasible, and effective method for educators to improve diabetic self-care, even in a developing country. © 2017 John Wiley & Sons Australia, Ltd.

[Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction].

PubMed

Kong, Jung-Hyeon; Ha, Yeongmi

2013-08-01

This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001). The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

Can you hear me now?

PubMed Central

Shacham, Enbal; Stamm, Kate E.; Overton, Edgar T.

2013-01-01

Recent studies support technology-based behavioral interventions for individuals with HIV. This study focused on the use of cell phone and internet technologies among a cohort of 515 HIV-infected individuals. Socio-demographic and clinic data were collected among individuals presenting at an urban Midwestern university HIV clinic in 2007. Regular internet usage occurred more often with males, Caucasians, those who were employed, had higher salaries, and were more educated. Higher levels of education and salary >$10,000 predicted regular usage when controlling for race, employment, and gender. Cell phone ownership was associated with being Caucasian, employed, more educated, and salary > $10,000. Employment was the only predictor of owning a cell phone when controlling for income, race, and education. Individuals who were <40 years of age, employed, and more educated were more likely to know how to text message. Employment and post-high school education predicted knowledge of text messaging, when controlling for age. Disparities among internet, cell phone, and text messaging usage exist among HIV-infected individuals. PMID:20024756

The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review.

PubMed

Free, Caroline; Phillips, Gemma; Galli, Leandro; Watson, Louise; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy

2013-01-01

Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes.

Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes.

PubMed

Nelson, Lyndsay A; Mulvaney, Shelagh A; Gebretsadik, Tebeb; Ho, Yun-Xian; Johnson, Kevin B; Osborn, Chandra Y

2016-01-01

Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants' baseline characteristics and the probability of engaging with texts and calls. On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age (Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Behavioural intervention to increase physical activity among patients with coronary heart disease: protocol for a randomised controlled trial.

PubMed

Alsaleh, Eman; Blake, Holly; Windle, Richard

2012-12-01

Although physical activity has significant health benefits in the treatment of patients with coronary heart disease, patients often do not follow prescribed physical activity recommendations. Behavioural strategies have been shown to be efficacious in increasing physical activity among those patients with coronary heart disease who are attending structured cardiac rehabilitation programmes. Research has also shown that tailoring consultation according to patients' needs and sending motivational reminders are successful ways of motivating patients to be physically active. However, there is a lack of evidence for the efficacy of behavioural interventions based on individualised consultation in promoting physical activity among those patients with coronary heart disease who are not attending structured physical activity programmes. This paper outlines the study protocol for a trial which is currently underway, to examine the effect of a behavioural change intervention delivered through individualised consultation calls and motivational reminder text messages on the level of physical activity among patients with coronary heart disease. Two large hospitals in Jordan. Eligible patients aged between 18 and 70 years, who are clinically stable, are able to perform physical activity and who have access to a mobile telephone have been randomly allocated to control or intervention group. Two-group randomised controlled trial. Behavioural intervention will be compared with usual care in increasing physical activity levels among patients with coronary heart disease. The control group (n=85) will receive advice from their doctors about physical activity as they would in usual practice. The intervention group (n=71) will receive the same advice, but will also receive behavioural change intervention (goal-setting, feed-back, self-monitoring) that will be delivered over a period of six months. Intervention will be delivered through individually tailored face-to-face and telephone consultations, supported by motivational SMS text messages to encourage and remind patients to attain these goals. The participants and the researcher delivering the intervention are not blinded to group assignment. Recruitment started in February 2012 and preliminary findings are expected in November 2012. It is hypothesised that behavioural intervention delivered through tailored individualised consultation supported by motivational SMS text message reminders will help CHD patients to increase their level of PA. The study is registered as a clinical trial at ISRCTN register (ISRCTN48570595). Copyright © 2012 Elsevier Ltd. All rights reserved.

Mobile phone text messaging for improving the uptake of vaccinations: a systematic review protocol.

PubMed

Kalan, Robyn; Wiysonge, Charles S; Ramafuthole, Tshepiso; Allie, Kurt; Ebrahim, Fatima; Engel, Mark Emmanuel

2014-08-04

Low vaccine coverage is a major public health concern, the consequences of which contribute to around 1.5 million child deaths from vaccine-preventable diseases. Thus, innovative strategies to rapidly increase coverage and recall rates for vaccinations are urgently required. Mobile text messaging (or short messaging service, SMS) has the potential to help increase vaccination coverage and therefore we propose to conduct a review of the current best evidence for the use of SMS as an intervention to promote vaccination coverage. This article describes the protocol for a systematic review of the effectiveness of SMS in improving the uptake of vaccination. Primary and secondary outcomes of interest are prespecified. We will preferably include randomised controlled trials (RCTs). However, non-randomised studies (NRS) will be considered if there is an inadequate number of RCTs. We will search several bibliographic databases (eg,PubMed, EMBASE, CINAHL, CENTRAL, Science Citation Index, Africa-Wide Information and WHOLIS electronic databases and search sources for grey literature. Following data extraction and assessment of risk of bias, we will meta-analyse studies and conduct subgroup analyses, according to intervention subtypes. We will assess clinical heterogeneity and statistical heterogeneity. For outcomes without quantitative data, a descriptive analysis will be used. This review protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number 2014:CRD42014007531 ETHICS AND DISSEMINATION: Ethics is not required for this study, given that this is a protocol for a systematic review, which uses published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations. We anticipate that the results could be used by researchers and policymakers to help inform them of the efficacy of mobile phone text messaging interventions to promote increased vaccination coverage. PROSPERO registration number 2014:CRD42014007531. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

PubMed

Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-11-24

We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs. © 2015 American Heart Association, Inc.

Factors Associated With Dropout During Recruitment and Follow-Up Periods of a mHealth-Based Randomized Controlled Trial for Mobile.Net to Encourage Treatment Adherence for People With Serious Mental Health Problems.

PubMed

Kannisto, Kati Anneli; Korhonen, Joonas; Adams, Clive E; Koivunen, Marita Hannele; Vahlberg, Tero; Välimäki, Maritta Anneli

2017-02-21

Clinical trials are the gold standard of evidence-based practice. Still many papers inadequately report methodology in randomized controlled trials (RCTs), particularly for mHealth interventions for people with serious mental health problems. To ensure robust enough evidence, it is important to understand which study phases are the most vulnerable in the field of mental health care. We mapped the recruitment and the trial follow-up periods of participants to provide a picture of the dropout predictors from a mHealth-based trial. As an example, we used a mHealth-based multicenter RCT, titled "Mobile.Net," targeted at people with serious mental health problems. Recruitment and follow-up processes of the Mobile.Net trial were monitored and analyzed. Recruitment outcomes were recorded as screened, eligible, consent not asked, refused, and enrolled. Patient engagement was recorded as follow-up outcomes: (1) attrition during short message service (SMS) text message intervention and (2) attrition during the 12-month follow-up period. Multiple regression analysis was used to identify which demographic factors were related to recruitment and retention. We recruited 1139 patients during a 15-month period. Of 11,530 people screened, 36.31% (n=4186) were eligible. This eligible group tended to be significantly younger (mean 39.2, SD 13.2 years, P<.001) and more often women (2103/4181, 50.30%) than those who were not eligible (age: mean 43.7, SD 14.6 years; women: 3633/6514, 55.78%). At the point when potential participants were asked to give consent, a further 2278 refused. Those who refused were a little older (mean 40.2, SD 13.9 years) than those who agreed to participate (mean 38.3, SD 12.5 years; t1842=3.2, P<.001). We measured the outcomes after 12 months of the SMS text message intervention. Attrition from the SMS text message intervention was 4.8% (27/563). The patient dropout rate after 12 months was 0.36% (4/1123), as discovered from the register data. In all, 3.12% (35/1123) of the participants withdrew from the trial. However, dropout rates from the patient survey (either by paper or telephone interview) were 52.45% (589/1123) and 27.8% (155/558), respectively. Almost all participants (536/563, 95.2%) tolerated the intervention, but those who discontinued were more often women (21/27, 78%; P=.009). Finally, participants' age (P<.001), gender (P<.001), vocational education (P=.04), and employment status (P<.001) seemed to predict their risk of dropping out from the postal survey. Patient recruitment and engagement in the 12-month follow-up conducted with a postal survey were the most vulnerable phases in the SMS text message-based trial. People with serious mental health problems may need extra support during the recruitment process and in engaging them in SMS text message-based trials to ensure robust enough evidence for mental health care. International Standard Randomized Controlled Trial Number (ISRCTN): 27704027; http://www.isrctn.com/ISRCTN27704027 (Archived by WebCite at http://www.webcitation.org/6oHcU2SFp). ©Kati Anneli Kannisto, Joonas Korhonen, Clive E Adams, Marita Hannele Koivunen, Tero Vahlberg, Maritta Anneli Välimäki. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.02.2017.

The carbon footprint of behavioural support services for smoking cessation.

PubMed

Smith, Anna Jo Bodurtha; Tennison, Imogen; Roberts, Ian; Cairns, John; Free, Caroline

2013-09-01

To estimate the carbon footprint of behavioural support services for smoking cessation: text message support, telephone counselling, group counselling and individual counselling. Carbon footprint analysis. Publicly available data on National Health Service Stop Smoking Services and per unit carbon emissions; published effectiveness data from the txt2stop trial and systematic reviews of smoking cessation services. Carbon dioxide equivalents (CO2e) per 1000 smokers, per lifetime quitter, and per quality-adjusted life year gained, and cost-effectiveness, including social cost of carbon, of smoking cessation services. Emissions per 1000 participants were 8143 kg CO2e for text message support, 8619 kg CO2e for telephone counselling, 16 114 kg CO2e for group counselling and 16 372 kg CO2e for individual counselling. Emissions per intervention lifetime quitter were 636 (95% CI 455 to 958) kg CO2e for text message support, 1051 (95% CI 560 to 2873) kg CO2e for telephone counselling, 1143 (95% CI 695 to 2270) kg CO2e for group counselling and 2823 (95% CI 1688 to 6549) kg CO2e for individual counselling. Text message, telephone and group counselling remained cost-effective when cost-effectiveness analysis was revised to include the environmental and economic cost of damage from carbon emissions. All smoking cessation services had low emissions compared to the health gains produced. Text message support had the lowest emissions of the services evaluated. Smoking cessation services have small carbon footprints and were cost-effective after accounting for the societal costs of greenhouse gas emissions.

The Effects of Tonsillectomy Education Using Smartphone Text Message for Mothers and Children Undergoing Tonsillectomy: A Randomized Controlled Trial.

PubMed

Yang, Ji Yeon; Lee, Hanna; Zhang, Yongai; Lee, Ji Uhn; Park, Jun Hee; Yun, Eun Kyoung

2016-11-01

Tonsillectomy is the most common type of surgical procedure performed in preschool children. Due to short period of hospitalization, mothers are expected to manage their children's care at home. However, they are rarely provided with sufficient information about postoperative management. This study aims to determine the effectiveness of providing caregivers with information on tonsillectomy care by smartphone text messaging in increasing their mothers' knowledge, reducing the anxiety, and improving the sick-role behavior of pediatric tonsillectomy patients. A sample of 61 pediatric patients and their mothers was recruited. Participants were randomly assigned into either the experimental group (n = 27) or the control group (n = 34). The control group was given information about the tonsillectomy by conventional textual and verbal means, whereas the experimental group received the same information in the form of 10 text messages during the period from hospitalization to their first follow-up visits. Results of mixed design, two-way analysis of variance indicated significant interaction effects between time points and groups for mothers' knowledge (F = 4.26, p = 0.043) and children's anxiety (F = 3.32; p = 0.037). Thus, the results do support the effectiveness of tonsillectomy education using smartphone text messaging in increasing mothers' knowledge and reducing children's anxiety. These results can be applied to preoperative and postoperative interventions for children not only for tonsillectomy but also for many other operations. The development of various educational programs using smartphone text messaging for postoperative patient management would also be valuable.

Applications of Text Messaging, and Bibliotherapy for Treatment of Patients Affected by Depressive Symptoms

PubMed Central

Taleban, Roya; Zamani, Ahmadreza; Moafi, Mohammad; Jiryaee, Nasrin; Khadivi, Reza

2016-01-01

Background: Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging, which aimed at amelioration of patient's behavior and consciousness, which could lead to suicide prevention. Methods: This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, <18 years, and cell phone accessibility. Mental retardation, drug and alcohol abuse, visual disability, dementia, suicide attempt history, electrotherapy, and receiving psychological interventions were our not met criteria. Our patient outcomes comprised intensity of depressive symptom and treatment compliance. The first two trials were requested to study instructive booklets in 30 days while the second cohort was demanded to study the booklet in accordance with the daily delivered text messaging. Results: Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction (F = 12.30, P < 0.001). Based on treatment compliance, the interactive effect of group factor and the time factor was statistically significant. Conclusions: It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary methodology aiming depression treatment. PMID:27076884

Mobile phone text messaging improves antihypertensive drug adherence in the community.

PubMed

Varleta, Paola; Acevedo, Mónica; Akel, Carlos; Salinas, Claudia; Navarrete, Carlos; García, Ana; Echegoyen, Carolina; Rodriguez, Daniel; Gramusset, Lissette; Leon, Sandra; Cofré, Pedro; Retamal, Raquel; Romero, Katerine

2017-12-01

Antihypertensive drug adherence (ADA) is a mainstay in blood pressure control. Education through mobile phone short message system (SMS) text messaging could improve ADA. The authors conducted a randomized study involving 314 patients with hypertension with <6 months of antihypertensive treatment from the Preventive Health Program of 12 different primary care centers in Santiago, Chile. Patients were randomly assigned to receive or not receive SMS related to ADA and healthy lifestyle. Adherence was assessed by the self-reported four-item scale Morisky-Green-Levine questionnaire at baseline and after 6 months of follow-up, with four of four positive questions classified as good adherence. Group comparison for adherence was performed by means of a logistic regression model, adjusting by baseline adherence, age older than 60 years, and sex. A total of 163 patients were randomized to receive and 151 to not receive SMS. After 6 months of follow-up, ADA in the non-SMS group decreased from 59.3% to 51.4% (P=.1). By contrast, adherence increased from 49% to 62.3% (P=.01) in the SMS group. Text messaging intervention improved ADA (risk ratio, 1.3; 95% confidence interval, 1.0-1.6 [P<.05]). At 6-month follow-up, text messaging resulted in an increase in reporting ADA in this hypertensive Latino population. This approach could become an effective tool to overcome poor medication adherence in the community. ©2017 Wiley Periodicals, Inc.

Text Messaging, Teen Outreach Program, and Sexual Health Behavior: A Cluster Randomized Trial

PubMed Central

Devine, Sharon; Schmiege, Sara J.; Pickard, Leslie; Campbell, Jon; Shlay, Judith C.

2016-01-01

Objectives. To consider whether Youth All Engaged! (a text message intervention) intensified the effects of the adolescent pregnancy prevention Teen Outreach Program (control) for youths. Methods. In this trial performed in Denver, Colorado, from 2011 to 2014, we randomized 8 Boys & Girls Clubs each of 4 years into 32 clubs per year combinations to ensure each club would serve as a treatment site for 2 years and a control site for 2 years. Control intervention consisted of the Teen Outreach Program only. We enrolled 852 youths (aged 14–18 years), and 632 were retained at follow-up, with analytic samples ranging from 50 to 624 across outcomes. We examined program costs, and whether the intervention increased condom and contraceptive use, access to care, and pregnancy prevention. Results. Control program costs were $1184 per participant, and intervention costs were an additional $126 per participant (+10.6%). There were no statistically significant differences in primary outcomes for the full sample. Hispanic participants in the intervention condition had fewer pregnancies at follow-up (1.79%) than did those in the control group (6.72%; P = .02). Conclusions. Youth All Engaged is feasible, low cost, and could have potential benefits for Hispanic youths. PMID:27689478

Designing text-messaging (SMS) in HIV programs: ethics-framed recommendations from the field

PubMed Central

Pérez, Guillermo Martínez; Hwang, Bella; Bygrave, Helen; Venables, Emilie

2015-01-01

Text messages (SMS) are being increasingly integrated into HIV programs across Southern Africa to improve patient adherence, linkage to care and provide psycho-social support. Careful attention needs to be paid to the design of SMS-based interventions for clients of HIV-care services to ensure that any potential harm, such as unwanted disclosure of HIV status, is minimized. In this article we propose a set of best practice recommendations to ensure that any SMS-based intervention considers ethical principles to safeguard safety, autonomy and confidentiality of its targeted HIV-positive beneficiaries. This analysis draws from our operational experience in Southern Africa in the design and conduct of mHealth interventions in the frame of HIV projects. The recommendations, framed in the context of the Belmont Report's three ethical pillars, may contribute to more safely operationalize any SMS service integrated into an HIV program if adopted by mHealth planners and implementers. We encourage actors to report on the ethical and methodological pathways followed when conducting SMS-based innovations to improve the wellbeing and quality provision of HIV-care for their targeted clients. PMID:26421096

Understanding the usage of content in a mental health intervention for depression: an analysis of log data.

PubMed

Van Gemert-Pijnen, Julia Ewc; Kelders, Saskia M; Bohlmeijer, Ernst T

2014-01-31

Web-based interventions for the early treatment of depressive symptoms can be considered effective in reducing mental complaints. However, there is a limited understanding of which elements in an intervention contribute to effectiveness. For efficiency and effectiveness of interventions, insight is needed into the use of content and persuasive features. The aims of this study were (1) to illustrate how log data can be used to understand the uptake of the content of a Web-based intervention that is based on the acceptance and commitment therapy (ACT) and (2) to discover how log data can be of value for improving the incorporation of content in Web-based interventions. Data from 206 participants (out of the 239) who started the first nine lessons of the Web-based intervention, Living to the Full, were used for a secondary analysis of a subset of the log data of the parent study about adherence to the intervention. The log files used in this study were per lesson: login, start mindfulness, download mindfulness, view success story, view feedback message, start multimedia, turn on text-message coach, turn off text-message coach, and view text message. Differences in usage between lessons were explored with repeated measures ANOVAs (analysis of variance). Differences between groups were explored with one-way ANOVAs. To explore the possible predictive value of the login per lesson quartiles on the outcome measures, four linear regressions were used with login quartiles as predictor and with the outcome measures (Center for Epidemiologic Studies-Depression [CES-D] and the Hospital Anxiety and Depression Scale-Anxiety [HADS-A] on post-intervention and follow-up) as dependent variables. A significant decrease in logins and in the use of content and persuasive features over time was observed. The usage of features varied significantly during the treatment process. The usage of persuasive features increased during the third part of the ACT (commitment to value-based living), which might indicate that at that stage motivational support was relevant. Higher logins over time (9 weeks) corresponded with a higher usage of features (in most cases significant); when predicting depressive symptoms at post-intervention, the linear regression yielded a significant model with login quartile as a significant predictor (explained variance is 2.7%). A better integration of content and persuasive features in the design of the intervention and a better intra-usability of features within the system are needed to identify which combination of features works best for whom. Pattern recognition can be used to tailor the intervention based on usage patterns from the earlier lessons and to support the uptake of content essential for therapy. An adaptable interface for a modular composition of therapy features supposes a dynamic approach for Web-based treatment; not a predefined path for all, but a flexible way to go through all features that have to be used.

Understanding the Usage of Content in a Mental Health Intervention for Depression: An Analysis of Log Data

PubMed Central

2014-01-01

Background Web-based interventions for the early treatment of depressive symptoms can be considered effective in reducing mental complaints. However, there is a limited understanding of which elements in an intervention contribute to effectiveness. For efficiency and effectiveness of interventions, insight is needed into the use of content and persuasive features. Objective The aims of this study were (1) to illustrate how log data can be used to understand the uptake of the content of a Web-based intervention that is based on the acceptance and commitment therapy (ACT) and (2) to discover how log data can be of value for improving the incorporation of content in Web-based interventions. Methods Data from 206 participants (out of the 239) who started the first nine lessons of the Web-based intervention, Living to the Full, were used for a secondary analysis of a subset of the log data of the parent study about adherence to the intervention. The log files used in this study were per lesson: login, start mindfulness, download mindfulness, view success story, view feedback message, start multimedia, turn on text-message coach, turn off text-message coach, and view text message. Differences in usage between lessons were explored with repeated measures ANOVAs (analysis of variance). Differences between groups were explored with one-way ANOVAs. To explore the possible predictive value of the login per lesson quartiles on the outcome measures, four linear regressions were used with login quartiles as predictor and with the outcome measures (Center for Epidemiologic Studies—Depression [CES-D] and the Hospital Anxiety and Depression Scale—Anxiety [HADS-A] on post-intervention and follow-up) as dependent variables. Results A significant decrease in logins and in the use of content and persuasive features over time was observed. The usage of features varied significantly during the treatment process. The usage of persuasive features increased during the third part of the ACT (commitment to value-based living), which might indicate that at that stage motivational support was relevant. Higher logins over time (9 weeks) corresponded with a higher usage of features (in most cases significant); when predicting depressive symptoms at post-intervention, the linear regression yielded a significant model with login quartile as a significant predictor (explained variance is 2.7%). Conclusions A better integration of content and persuasive features in the design of the intervention and a better intra-usability of features within the system are needed to identify which combination of features works best for whom. Pattern recognition can be used to tailor the intervention based on usage patterns from the earlier lessons and to support the uptake of content essential for therapy. An adaptable interface for a modular composition of therapy features supposes a dynamic approach for Web-based treatment; not a predefined path for all, but a flexible way to go through all features that have to be used. PMID:24486914

Improving sexually transmitted infection results notification via mobile phone technology.

PubMed

Reed, Jennifer L; Huppert, Jill S; Taylor, Regina G; Gillespie, Gordon L; Byczkowski, Terri L; Kahn, Jessica A; Alessandrini, Evaline A

2014-11-01

To improve adolescent notification of positive sexually transmitted infection (STI) tests using mobile phone technology and STI information cards. A randomized intervention among 14- to 21-year olds in a pediatric emergency department (PED). A 2 × 3 factorial design with replication was used to evaluate the effectiveness of six combinations of two factors on the proportion of STI-positive adolescents notified within 7 days of testing. Independent factors included method of notification (call, text message, or call + text message) and provision of an STI information card with or without a phone number to obtain results. Covariates for logistic regression included age, empiric STI treatment, days until first attempted notification, and documentation of confidential phone number. Approximately half of the 383 females and 201 males enrolled were ≥18 years of age. Texting only or type of card was not significantly associated with patient notification rates, and there was no significant interaction between card and notification method. For females, successful notification was significantly greater for call + text message (odds ratio, 3.2; 95% confidence interval, 1.4-6.9), and documenting a confidential phone number was independently associated with successful notification (odds ratio, 3.6; 95% confidence interval, 1.7-7.5). We found no significant predictors of successful notification for males. Of patients with a documented confidential phone number who received a call + text message, 94% of females and 83% of males were successfully notified. Obtaining a confidential phone number and using call + text message improved STI notification rates among female but not male adolescents in a pediatric emergency department. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Developing a Behavioral Model for Mobile Phone-Based Diabetes Interventions

PubMed Central

Nundy, Shantanu; Dick, Jonathan J.; Solomon, Marla C.; Peek, Monica E.

2013-01-01

Objectives Behavioral models for mobile phone-based diabetes interventions are lacking. This study explores the potential mechanisms by which a text message-based diabetes program affected self-management among African-Americans. Methods We conducted in-depth, individual interviews among 18 African-American patients with type 2 diabetes who completed a 4-week text message-based diabetes program. Each interview was audio- taped, transcribed verbatim, and imported into Atlas.ti software. Coding was done iteratively. Emergent themes were mapped onto existing behavioral constructs and then used to develop a novel behavioral model for mobile phone-based diabetes self-management programs. Results The effects of the text message-based program went beyond automated reminders. The constant, daily communications reduced denial of diabetes and reinforced the importance of self-management (Rosenstock Health Belief Model). Responding positively to questions about self-management increased mastery experience (Bandura Self-Efficacy). Most surprisingly, participants perceived the automated program as a “friend” and “support group” that monitored and supported their self-management behaviors (Barrera Social Support). Conclusions A mobile phone-based diabetes program affected self-management through multiple behavioral constructs including health beliefs, self-efficacy, and social support. Practice implications: Disease management programs that utilize mobile technologies should be designed to leverage existing models of behavior change and can address barriers to self-management associated with health disparities. PMID:23063349

Mobile phone use among female entertainment workers in Cambodia: an observation study.

PubMed

Brody, Carinne; Tatomir, Brent; Sovannary, Tuot; Pal, Khuondyla; Mengsrun, Song; Dionosio, Jennifer; Luong, Minh-Anh; Yi, Siyan

2017-01-01

Text or voice messages containing health behavior change content may be an inexpensive, discreet, sustainable and scalable way to reach populations at high risk for HIV. In Cambodia, one of the important high-risk populations is female entertainment workers (FEWs). This ethnographic study aims to explore typical phone use, examining patterns and behaviors that may influence the design of future mHealth interventions. The study consisted of one 8-hour non-participant observation session for 15 randomly sampled FEWs. Observations focused on capturing normal daily use of mobile devices. Observation checklists were populated by observers during the observations and a post-observation survey was conducted. Findings were discussed with Cambodian HIV outreach workers and HIV research fellows and their interpretations are summarized below. In this ethnographic study, all 15 participants made calls, checked the time and received research-related texts. More than half (n=8) of the participants engaged in texting to a non-research recipient. About half (n=7) went on Facebook (FB) and some (n=5) listened to music and looked at their FB newsfeed. Fewer played a mobile game, posted a photo to FB, went on YouTube, used FB chat/messenger, watched a video on FB, played a game on FB, used FB call/voice chat, looked at their phone's background or used the LINE app. Fewer still shared their phones, left them unattended, added airtime or changed their SIM cards. When participants received a research text message, most did not share the text message with anyone, did not ask for help deciphering the message and did not receive help composing a response. Notable themes from observer notes, HIV outreach workers and researchers include reasons why phone calls were the most frequent mode of communication, examples of how cell phone company text messages are used as a form of behavior change, literacy as a persistent barrier for some FEWs, and FEWs' high interest in receiving health-related messages and less concern about privacy and phone-sharing issues than expected. This study suggests texting is a part of normal phone use although not as frequently used as voice calls or Facebook. Despite the less frequent use, FEWs were able to send and receive messages, were interested in health messages and were not overly concerned about privacy issues. Texting and voice messaging may be useful tools for health behavior change within the FEW population in Cambodia.

Mobile phone use among female entertainment workers in Cambodia: an observation study

PubMed Central

Tatomir, Brent; Sovannary, Tuot; Pal, Khuondyla; Mengsrun, Song; Dionosio, Jennifer; Luong, Minh-Anh; Yi, Siyan

2017-01-01

Background Text or voice messages containing health behavior change content may be an inexpensive, discreet, sustainable and scalable way to reach populations at high risk for HIV. In Cambodia, one of the important high-risk populations is female entertainment workers (FEWs). This ethnographic study aims to explore typical phone use, examining patterns and behaviors that may influence the design of future mHealth interventions. Methods The study consisted of one 8-hour non-participant observation session for 15 randomly sampled FEWs. Observations focused on capturing normal daily use of mobile devices. Observation checklists were populated by observers during the observations and a post-observation survey was conducted. Findings were discussed with Cambodian HIV outreach workers and HIV research fellows and their interpretations are summarized below. Results In this ethnographic study, all 15 participants made calls, checked the time and received research-related texts. More than half (n=8) of the participants engaged in texting to a non-research recipient. About half (n=7) went on Facebook (FB) and some (n=5) listened to music and looked at their FB newsfeed. Fewer played a mobile game, posted a photo to FB, went on YouTube, used FB chat/messenger, watched a video on FB, played a game on FB, used FB call/voice chat, looked at their phone’s background or used the LINE app. Fewer still shared their phones, left them unattended, added airtime or changed their SIM cards. When participants received a research text message, most did not share the text message with anyone, did not ask for help deciphering the message and did not receive help composing a response. Notable themes from observer notes, HIV outreach workers and researchers include reasons why phone calls were the most frequent mode of communication, examples of how cell phone company text messages are used as a form of behavior change, literacy as a persistent barrier for some FEWs, and FEWs’ high interest in receiving health-related messages and less concern about privacy and phone-sharing issues than expected. Conclusions This study suggests texting is a part of normal phone use although not as frequently used as voice calls or Facebook. Despite the less frequent use, FEWs were able to send and receive messages, were interested in health messages and were not overly concerned about privacy issues. Texting and voice messaging may be useful tools for health behavior change within the FEW population in Cambodia. PMID:28293620

Modeling and testing maternal and newborn care mHealth interventions: a pilot impact evaluation and follow-up qualitative study in Guatemala

PubMed Central

Zuleta, Clara; Rodríguez, Jorge Tulio

2017-01-01

Objective: To develop a descriptive model of structural characteristics of mHealth in the context of newborn nutrition, and to assess the effects of illustrative interventions through a mixed-methods study consisting of an impact evaluation and a qualitative assessment. Materials and Methods: We conducted a 23-week intervention with 100 mothers in rural Guatemala in 2013 and 2014. In group 1 (n = 24), participants received health-promoting text messages. In group 2 (n = 32), peer-to-peer groups were formed. In group 3 (n = 30), peer-to-peer groups were formed, a health professional participated in the discussions, and participants received health-promoting messages. In the control group (n = 14), participants were simply given a mobile phone. We measured changes in knowledge and self-reported behavior. Four focus groups in 2015 showed the perceptions of 44 additional women and the potential of the previously tested interventions in other marginalized areas. Results: Significant relationships were found between group membership and changes in knowledge (P < .001), and between changes in knowledge and self-reported behavior (P = .010). Within peer-to-peer groups, 3665 text messages were shared; discussions covered topics such as breastfeeding practices, health concerns, and emotional issues. Focus groups revealed a deficit of support for mothers, a precariousness of public services, different cultural barriers affecting access to care, and the potential for scaling up. Discussion: The complementarity of structural arrangements of mHealth interventions can play an important role in helping to encourage recommended breastfeeding attitudes along with providing rich information about challenges in rural areas. Conclusion: A mixed-methods study was appropriate to compare the effects and assess the potential of mHealth strategies in a complex rural setting. PMID:27474102

A randomised trial to demonstrate the effectiveness of electronic messages on sun protection behaviours.

PubMed

Szabó, Csanád; Ócsai, Henriette; Csabai, Márta; Kemény, Lajos

2015-08-01

Message exposure is effective at changing a variety of health behaviours. Our aim was to improve sun protection habits of a volunteer sample. We conducted a randomised, non-blinded, investigator-initiated trial (from 1st June to 31st August in 2011) on the effect of an electronic text-message system on sun protection behaviours. The assessments of 149 healthy volunteer participants took place at the Clinical Department of Dermatology and Allergology at the University of Szeged in Hungary. Psychological and medical assessments were also made. Total motivation scores for adherence to sunscreen use improved at a nearly significant level (t=-1.954, p=0.054). The intervention group used sunscreens more often than the other groups according to their sun exposure diaries (F=8.173, p<0.05) and their interview results (F=3.44, p<0.05). Using electronic messages offers an effective method to improve sun protection behaviours. Our intervention is a cost-effective method and it can easily be implemented at worksites. Copyright © 2015 Elsevier B.V. All rights reserved.

Feasibility and Effectiveness of mHealth for Mobilizing Households for Indoor Residual Spraying to Prevent Malaria: A Case Study in Mali

PubMed Central

Mangam, Keith; Fiekowsky, Elana; Bagayoko, Moussa; Norris, Laura; Belemvire, Allison; Longhany, Rebecca; Fornadel, Christen; George, Kristen

2016-01-01

ABSTRACT Components of mHealth are increasingly being added to development interventions worldwide. A particular case of interest is in Mali where the U.S. President’s Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project piloted a mobile mass-messaging service in Koulikoro District in August 2014 to determine whether voice and/or text messages received on cell phones could effectively replace door-to-door mobilization for an indoor residual spraying (IRS) campaign. To measure the pilot’s effectiveness, we evaluated structure preparedness (all household and food items removed) in 3 pilot intervention villages compared with 3 villages prepared for spray through door-to-door mobilization that was modified by incorporating town hall meetings and radio spots. Structure preparedness was significantly lower in households mobilized through the mobile-messaging approach compared with the door-to-door approach (49% vs. 75%, respectively; P = .03). Spray coverage of targeted households also was significantly lower among the mobile-messaging villages than the door-to-door mobilization villages (86% vs. 96%, respectively; P = .02). The mobile-messaging approach, at US$8.62 per structure prepared, was both more costly and less effective than the door-to-door approach at US$1.08 per structure prepared. While literacy and familiarity with technology were major obstacles, it also became clear that by removing the face-to-face interactions between mobilizers and household residents, individuals were not as trusting or understanding of the mobilization messages. These residents felt it was easier to ignore a text or voice message than to ignore a mobilizer who could provide reassurances and preparation support. In addition, men often received the mobile messages, as they typically owned the mobile phones, while women—who were more likely to be at home at the time of spray—usually interacted with the door-to-door mobilizers. Future attempts at using mHealth approaches for similar IRS mobilization efforts in Mali should be done in a way that combines mHealth tools with more common human-based interventions, rather than as a stand-alone approach, and should be designed with a gender lens in mind. The choice of software used for mass messaging should also be considered to find a local option that is both less expensive and perhaps more attuned to the local context than a U.S.-based software solution. PMID:27353616

Feasibility and Effectiveness of mHealth for Mobilizing Households for Indoor Residual Spraying to Prevent Malaria: A Case Study in Mali.

PubMed

Mangam, Keith; Fiekowsky, Elana; Bagayoko, Moussa; Norris, Laura; Belemvire, Allison; Longhany, Rebecca; Fornadel, Christen; George, Kristen

2016-06-20

Components of mHealth are increasingly being added to development interventions worldwide. A particular case of interest is in Mali where the U.S. President's Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project piloted a mobile mass-messaging service in Koulikoro District in August 2014 to determine whether voice and/or text messages received on cell phones could effectively replace door-to-door mobilization for an indoor residual spraying (IRS) campaign. To measure the pilot's effectiveness, we evaluated structure preparedness (all household and food items removed) in 3 pilot intervention villages compared with 3 villages prepared for spray through door-to-door mobilization that was modified by incorporating town hall meetings and radio spots. Structure preparedness was significantly lower in households mobilized through the mobile-messaging approach compared with the door-to-door approach (49% vs. 75%, respectively; P = .03). Spray coverage of targeted households also was significantly lower among the mobile-messaging villages than the door-to-door mobilization villages (86% vs. 96%, respectively; P = .02). The mobile-messaging approach, at US$8.62 per structure prepared, was both more costly and less effective than the door-to-door approach at US$1.08 per structure prepared. While literacy and familiarity with technology were major obstacles, it also became clear that by removing the face-to-face interactions between mobilizers and household residents, individuals were not as trusting or understanding of the mobilization messages. These residents felt it was easier to ignore a text or voice message than to ignore a mobilizer who could provide reassurances and preparation support. In addition, men often received the mobile messages, as they typically owned the mobile phones, while women-who were more likely to be at home at the time of spray-usually interacted with the door-to-door mobilizers. Future attempts at using mHealth approaches for similar IRS mobilization efforts in Mali should be done in a way that combines mHealth tools with more common human-based interventions, rather than as a stand-alone approach, and should be designed with a gender lens in mind. The choice of software used for mass messaging should also be considered to find a local option that is both less expensive and perhaps more attuned to the local context than a U.S.-based software solution. © Mangam et al.

One-way versus two-way text messaging on improving medication adherence: meta-analysis of randomized trials.

PubMed

Wald, David S; Butt, Shahena; Bestwick, Jonathan P

2015-10-01

Mobile telephone text messaging is a simple potential solution to the failure to take medications as directed. There is uncertainty over the effectiveness of 1-way text messaging (sending text message reminders only) compared with 2-way text messaging (sending reminders and receiving replies confirming whether medication has been taken) as a means of improving medication adherence. A meta-analysis of 8 randomized trials (1994 patients) that tested the effectiveness of text messaging on medication adherence was performed. The trials were divided into 2 groups: trials using 1-way text messaging versus no text messaging and trials using 2-way text messaging versus no text messaging. The summary estimates of the effect of the 2 methods of text messaging (1-way or 2-way) were compared. The summary relative risk estimate was 1.04 (95% confidence interval, 0.97-1.11) for 1-way text messaging and 1.23 (95% confidence interval, 1.13-1.35) for 2-way text messaging. The difference in effect between the 2 methods was statistically significant (P = .007). Two-way text messaging is associated with substantially improved medication adherence compared with 1-way text messaging. This has important implications in the provision of mobile-based messaging in the management of patients taking medication for the prevention of chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Systematic development of a text-driven and a video-driven web-based computer-tailored obesity prevention intervention

PubMed Central

2013-01-01

Background This paper describes the systematic development of a text-driven and a video-driven web-based computer-tailored intervention aimed to prevent obesity among normal weight and overweight adults. We hypothesize that the video-driven intervention will be more effective and appealing for individuals with a low level of education. Methods and Design The Intervention Mapping protocol was used to develop the interventions, which have exactly the same educational content but differ in the format in which the information is delivered. One intervention is fully text-based, while in the other intervention in addition to text-based feedback, the core messages are provided by means of videos. The aim of the interventions is to prevent weight gain or achieve modest weight loss by making small changes in dietary intake or physical activity. The content of the interventions is based on the I-Change Model and self-regulation theories and includes behavior change methods such as consciousness raising, tailored feedback on behavior and cognitions, goal setting, action and coping planning, and evaluation of goal pursuit. The interventions consist of six sessions. In the first two sessions, participants will set weight and behavioral change goals and form plans for specific actions to achieve the desired goals. In the remaining four sessions, participants’ will evaluate their progress toward achievement of the behavioral and weight goals. They will also receive personalized feedback on how to deal with difficulties they may encounter, including the opportunity to make coping plans and the possibility to learn from experiences of others. The efficacy and appreciation of the interventions will be examined by means of a three-group randomized controlled trial using a waiting list control group. Measurements will take place at baseline and six and twelve months after baseline. Primary outcome measures are body mass index, physical activity, and dietary intake. Discussion The present paper provides insight into how web-based computer-tailored obesity prevention interventions consisting of self-regulation concepts and text-driven and video-driven messages can be developed systematically. The evaluation of the interventions will provide insight into their efficacy and will result in recommendations for future web-based computer-tailored interventions and the additional value of using video tailoring. Trial registration NTR3501. PMID:24138937

The effect of need supportive text messages on motivation and physical activity behaviour.

PubMed

Kinnafick, Florence-Emilie; Thøgersen-Ntoumani, Cecilie; Duda, Joan

2016-08-01

Few short messaging service (SMS) studies to support behaviour change have used a theoretical underpinning. Using a self-determination theory perspective, we explored the effects of need supportive (NS) SMS on physical activity in 65 (BMI = 24.06 kg/m(2), SD = 5.49; M = 25.76 years, SD = 10.23) insufficiently active individuals embarking on an existing exercise programme. For 10 weeks participants were randomised to an intervention group (NS) or control group (neutral). SMS were sent twice weekly, randomly, via an online SMS service. Mixed design ANCOVA and MANCOVA analyses of measures taken at baseline, mid and post intervention revealed increased levels of perceived autonomy support and psychological need satisfaction in the intervention group post intervention. Both groups reported increases in intrinsic motivation from pre to post intervention. Moderate intensity physical activity was greater in the intervention than the control group at 4-month post intervention with control group returning to baseline levels. Findings provide preliminary causal evidence to support the use of NS SMS to optimise physical activity behaviour change in individuals who are insufficiently active.

Ten Texts to College: Can Text Messages Mitigate Summer Attrition among College-Intending Low-Income High School Graduates?

ERIC Educational Resources Information Center

Castleman, Benjamin L.; Page, Lindsay C.

2013-01-01

Despite decades of policy intervention to increase college entry among low-income students, considerable gaps by socioeconomic status remain. To date, policy makers have largely overlooked the summer after high school as an important time period in students' transition to college. In Summer 2012, the authors designed a randomized trial to…

How Do Mobile Phone Diabetes Programs Drive Behavior Change?

PubMed Central

Nundy, Shantanu; Mishra, Anjuli; Hogan, Patrick; Lee, Sang Mee; Solomon, Marla C.; Peek, Monica E.

2015-01-01

Purpose The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. Methods This was a mixed methods observational cohort study. Study participants were members of the University of Chicago Health Plan (UCHP) who largely reside in a working-class, urban African American community. Surveys were conducted at baseline, 3 months (mid-intervention), and 6 months (postintervention) to test the hypothesis that the intervention would be associated with improvements in self-efficacy, social support, health beliefs, and self-care. In addition, in-depth individual interviews were conducted with 14 participants and then analyzed using the constant comparative method to identify new behavioral constructs affected by the intervention. Results The intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating) and improvements in 1 or more measures of self-efficacy, social support, and health beliefs (perceived control). Qualitatively, participants reported that knowledge, attitudes, and ownership were also affected by the program. Together these findings were used to construct a new behavioral model. Conclusions This study’s findings challenge the prevailing assumption that mobile phones largely affect behavior change through reminders and support the idea that behaviorally driven mobile health interventions can address multiple behavioral pathways associated with sustained behavior change. PMID:25278512

Post-coma persons with multiple disabilities use assistive technology for their leisure engagement and communication.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Buonocunto, Francesca; Sacco, Valentina; D'Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa

2014-01-01

Interventions for post-coma persons, who have emerged from a minimally conscious state but present with extensive neuro-motor impairment and lack of or minimal verbal skills, need to promote occupation and communication through the use of assistive technology. These two studies were aimed at assessing two technology-aided programs to promote leisure engagement and communication for three post-coma participants with multiple disabilities. Study I assessed a program to allow a woman and a man with extensive neuro-motor impairment and lack of speech to switch on music and videos, make requests to caregivers, and send messages to (communicate with) relevant partners and receive messages from those partners. Study II assessed a program to allow a post-coma woman with extensive motor impairment and reduced verbal behavior to activate music, videos and requests, send and receive messages, and make telephone calls. Data showed that both programs were successful. The participants of Study I managed leisure engagement, requests, as well as text messaging. The participant of Study II showed consistent leisure engagement, text messaging, and telephone calls. Assistive technology can be profitably used to provide post-coma persons with multiple disabilities relevant leisure and communication opportunities.

A Web-based, computer-tailored smoking prevention program to prevent children from starting to smoke after transferring to secondary school: randomized controlled trial.

PubMed

Cremers, Henricus-Paul; Mercken, Liesbeth; Candel, Math; de Vries, Hein; Oenema, Anke

2015-03-09

Smoking prevalence rates among Dutch children increase rapidly after they transit to secondary school, in particular among children with a low socioeconomic status (SES). Web-based, computer-tailored programs supplemented with prompt messages may be able to empower children to prevent them from starting to smoke when they transit to secondary school. The main aim of this study is to evaluate whether computer-tailored feedback messages, with and without prompt messages, are effective in decreasing children's smoking intentions and smoking behavior after 12 and 25 months of follow-up. Data were gathered at baseline (T0), and after 12 months (T1) and 25 months (T2) of follow-up of a smoking prevention intervention program called Fun without Smokes. A total of 162 schools were randomly allocated to a no-intervention control group, an intervention prompt group, or an intervention no-prompt group. A total of 3213 children aged 10 to 12 years old participated in the study and completed a Web-based questionnaire assessing their smoking intention, smoking behavior, and sociocognitive factors, such as attitude, social influence, and self-efficacy, related to smoking. After completion, children in the intervention groups received computer-tailored feedback messages in their own email inbox and those messages could be accessed on the intervention website. Children in the prompt group received prompt messages, via email and short message service (SMS) text messaging, to stimulate them to reuse the intervention website with nonsmoking content. Multilevel logistic regression analyses were performed using multiple imputations to assess the program effects on smoking intention and smoking behavior at T1 and T2. A total of 3213 children participated in the Fun without Smokes study at T0. Between T0 and T1 a total of 1067 children out of the original 3213 (33.21%) dropped out of the study. Between T0 and T2 the number of children that did not participate in the final measurement was 1730 out of the original 3213 (53.84%). No significant program effects were observed for any of the intervention groups compared to the control group at T1 for the intention to engage in smoking-prompt, OR 0.67 (95% CI 0.30-1.50), no-prompt, OR 0.76 (95% CI 0.34-1.67)-or for smoking behavior-prompt, OR 1.13 (95% CI 0.13-9.98), no-prompt, OR 0.50 (95% CI 0.04-5.59). Similar nonsignificant program effects were found at T2 for the intention to start smoking-prompt, OR 0.78 (95% CI 0.26-2.32), no-prompt, OR 1.31 (95% CI 0.45-3.82)-and smoking behavior-prompt, OR 0.53 (95% CI 0.12-2.47), no-prompt, OR 1.01 (95% CI 0.24-4.21). This study showed that the Web-based, computer-tailored feedback messages with and without prompt messages were not effective in modifying children's smoking intentions and smoking behavior as compared to no information. Future smoking prevention interventions are recommended to start closer to the age of actual smoking uptake. Furthermore, future studies on Web-based, computer-tailored smoking prevention programs should focus on assessing and controlling exposure to the educational content and the response to the prompt messages. Netherlands Trial Register NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI).

eHealth interventions for HIV prevention

PubMed Central

Noar, Seth M.; Willoughby, Jessica Fitts

2015-01-01

The rapidly changing media landscape and proliferation of new technologies creates vast new opportunities for HIV prevention. The fast growth of the relatively new eHealth field is a testament to the excitement and promise of these new technologies. eHealth interventions in HIV prevention tested to date include computer- and Internet-based interventions; chat room interventions; text messaging interventions; and social media. The current article provides a brief review of these types of interventions in HIV prevention, including their unique advantages and evidence of efficacy. Implications for future research in the eHealth HIV prevention field are discussed. PMID:22519523

A systematic review of mHealth-based heart failure interventions

PubMed Central

Cajita, Maan Isabella; Gleason, Kelly T.; Han, Hae-Ra

2015-01-01

Background The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. Purpose This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to: (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. Methods PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Conclusions Ten articles, representing nine studies, were included in this review. Majority of the studies utilized mobile health technology as part of a HF monitoring system, which typically included a blood pressure measuring device, weighing scale, and an ECG recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, NYHA functional class, LVEF, quality of life, and self-care were inconsistent at best. Implications Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (e.g. inadequate sample size, quasi-experimental design, use of older mobile phone models, etc.) should be taken into account when designing future studies. PMID:26544175

A Systematic Review of mHealth-Based Heart Failure Interventions.

PubMed

Cajita, Maan Isabella; Gleason, Kelly T; Han, Hae-Ra

2016-01-01

The popularity of mobile phones and similar mobile devices makes it an ideal medium for delivering interventions. This is especially true with heart failure (HF) interventions, in which mHealth-based HF interventions are rapidly replacing their telephone-based predecessors. This systematic review examined the impact of mHealth-based HF management interventions on HF outcomes. The specific aims of the systematic review are to (1) describe current mHealth-based HF interventions and (2) discuss the impact of these interventions on HF outcomes. PubMed, CINAHL Plus, EMBASE, PsycINFO, and Scopus were systematically searched for randomized controlled trials or quasi-experimental studies that tested mHealth interventions in people with HF using the terms Heart Failure, Mobile Health, mHealth, Telemedicine, Text Messaging, Texting, Short Message Service, Mobile Applications, and Mobile Apps. Ten articles, representing 9 studies, were included in this review. The majority of the studies utilized mobile health technology as part of an HF monitoring system, which typically included a blood pressure-measuring device, weighing scale, and an electrocardiogram recorder. The impact of the mHealth interventions on all-cause mortality, cardiovascular mortality, HF-related hospitalizations, length of stay, New York Heart Association functional class, left ventricular ejection fraction, quality of life, and self-care were inconsistent at best. Further research is needed to conclusively determine the impact of mHealth interventions on HF outcomes. The limitations of the current studies (eg, inadequate sample size, quasi-experimental design, use of older mobile phone models, etc) should be taken into account when designing future studies.

Improving Medical Care With Electronic Interventions Based on Automated Text and Phone Messages

ClinicalTrials.gov

2017-09-21

General Medicine; Maternal Health; Pediatric Health; Neurology; Psychiatry; Emergency Medicine; Internal Medicine; Nephrology; Wellness; Mobile Health; Surgery; Mental Health; Chronic Obstructive Pulmonary Disease; Diabetes Mellitus; CHF; Depression; Breast Feeding; PostPartum Depression; Perinatal Mood and Anxiety Disorder

Remote “Hovering” with Individuals with Psychotic Disorders and Substance Use: Feasibility, Engagement, and Therapeutic Alliance with a Text-Messaging Mobile Interventionist

PubMed Central

Ben-Zeev, Dror; Kaiser, Susan M.; Krzos, Izabela

2014-01-01

Objective People with serious mental illnesses and substance abuse problems (i.e., dual diagnosis) constitute a particularly challenging and costly clinical group. This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use. Methods Seventeen participants with dual diagnosis were enrolled in a twelve-week single-arm trial. A clinical social worker served as the mobile interventionist and sent daily text-messages to participants’ privately-owned mobile phones to assess their medication adherence and clinical status. The mobile interventionist provided text-message feedback and support, and suggested various coping strategies flexibly, in response to participants’ replies to prompts. At the end of the trial, participants completed a usability and satisfaction measure and two self-rated measures of therapeutic alliance with their clinicians. In one version, participants rated their relationship with their mobile interventionist; in the second version, they rated their relationship with their community-based treatment team. Results Participants received an average of 139 text messages (SD = 37.5) each from the mobile interventionist over the twelve-week trial. On average, participants responded to 87% of the mobile interventionist’s messages that required a reply. Over 90% of participants thought the intervention was useful and rewarding, and that it helped them be more effective and productive in their lives. Participants’ assessments of their relationship with the mobile interventionist were positive. Paired sample t-test found the therapeutic alliance ratings participants provided for their mobile interventionist were significantly higher than those provided for their community-based treatment team clinicians who they met with regularly. Conclusions Our findings suggest that text-message “hovering” can be conducted successfully with individuals with psychotic disorders and substance abuse. Developing a cadre of mobile interventionists who are specifically trained on how to engage patients via mobile devices while adhering to ethical guidelines and regulatory standards may be an effective way to strengthen service delivery models, improve patient outcomes, and reduce costs. PMID:25391277

Using the Medical Research Council framework for development and evaluation of complex interventions in a low resource setting to develop a theory-based treatment support intervention delivered via SMS text message to improve blood pressure control.

PubMed

Bobrow, Kirsten; Farmer, Andrew; Cishe, Nomazizi; Nwagi, Ntobeko; Namane, Mosedi; Brennan, Thomas P; Springer, David; Tarassenko, Lionel; Levitt, Naomi

2018-01-23

Several frameworks now exist to guide intervention development but there remains only limited evidence of their application to health interventions based around use of mobile phones or devices, particularly in a low-resource setting. We aimed to describe our experience of using the Medical Research Council (MRC) Framework on complex interventions to develop and evaluate an adherence support intervention for high blood pressure delivered by SMS text message. We further aimed to describe the developed intervention in line with reporting guidelines for a structured and systematic description. We used a non-sequential and flexible approach guided by the 2008 MRC Framework for the development and evaluation of complex interventions. We reviewed published literature and established a multi-disciplinary expert group to guide the development process. We selected health psychology theory and behaviour change techniques that have been shown to be important in adherence and persistence with chronic medications. Semi-structured interviews and focus groups with various stakeholders identified ways in which treatment adherence could be supported and also identified key features of well-regarded messages: polite tone, credible information, contextualised, and endorsed by identifiable member of primary care facility staff. Direct and indirect user testing enabled us to refine the intervention including refining use of language and testing of interactive components. Our experience shows that using a formal intervention development process is feasible in a low-resource multi-lingual setting. The process enabled us to pre-test assumptions about the intervention and the evaluation process, allowing the improvement of both. Describing how a multi-component intervention was developed including standardised descriptions of content aimed to support behaviour change will enable comparison with other similar interventions and support development of new interventions. Even in low-resource settings, funders and policy-makers should provide researchers with time and resources for intervention development work and encourage evaluation of the entire design and testing process. The trial of the intervention is registered with South African National Clinical Trials Register number (SANCTR DOH-27-1212-386; 28/12/2012); Pan Africa Trial Register (PACTR201411000724141; 14/12/2013); ClinicalTrials.gov ( NCT02019823 ; 24/12/2013).

Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial.

PubMed

Sundström, Christopher; Gajecki, Mikael; Johansson, Magnus; Blankers, Matthijs; Sinadinovic, Kristina; Stenlund-Gens, Erik; Berman, Anne H

2016-01-01

The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes. An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselor guidance via asynchronous text messages only. In the choice group, 65% (13 of 20 participants) chose guidance via asynchronous text messages. At the 10-week post-treatment follow-up, an intention-to-treat (ITT) analysis showed that participants in the two guidance groups (choice and messages) reported significantly lower past week alcohol consumption compared to the group without guidance; 10.8 (SD = 12.1) versus 22.6 (SD = 18.4); p = 0.001; Cohen's d = 0.77. Participants in both guidance groups reported significantly lower scores on the AUDIT at follow-up compared to the group without guidance, with a mean score of 14.4 (SD = 5.2) versus 18.2 (SD = 5.9); p = 0.003; Cohen's d = 0.68. A higher proportion of participants in the guidance groups said that they would recommend the program compared to the group without guidance (81% for choice; 93% for messages versus 47% for self-help). Self-help programs for problematic alcohol use can be more effective in reducing alcohol consumption over a 10-week period when counselor guidance is added. Clinicaltrials.gov NCT02384304.

A 3-Arm randomised controlled trial of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants to prevent childhood obesity.

PubMed

Wen, Li Ming; Rissel, Chris; Baur, Louise A; Hayes, Alison J; Xu, Huilan; Whelan, Anna; Hua, Myna; Shaw, Miranda; Phongsavan, Philayrath

2017-01-14

With an increasing prevalence of obesity in young children globally, there is an urgent need for the development of effective early interventions. A previous Healthy Beginnings Trial using a nurse-led home visiting program has demonstrated that providing mothers with evidence-based advice can improve maternal practice regarding obesity prevention, and can reduce Body Mass Index (BMI) in the first few years of life. However, the costs for scale-up of home visiting limit its population reach. This trial aims to determine the efficacy of Communicating Healthy Beginnings Advice by Telephone (CHAT) to mothers with infants in improving infant feeding practices and preventing the early onset of childhood overweight and obesity. We propose a 3-arm randomised controlled trial (RCT) with a consecutive sample of 1056 mothers with their newborn children in New South Wales (NSW) Australia. Pregnant women who are between weeks 28 and 34 of their pregnancy will be invited to participate in the CHAT trial. Informed consent will be obtained, and after baseline data collection, participants will be randomly allocated to the telephone intervention, text messaging intervention, or the control group. The intervention comprises telephone consultations or text messages, together with 6 intervention packages being mailed at specific times from the third trimester of pregnancy until 12 months post birth. The main trial outcome measures include a) duration of breastfeeding, b) timing of introduction of solids, c) nutrition behaviours, physical activity and television viewing, and d) weight and BMI z-score at 12 and 24 months, e) cost-effectiveness, as well as f) feasibility and acceptability of the interventions. The results will ascertain whether early intervention using telephone consultation or text messaging together with staged mailed intervention resources can be feasible and effective in improving infant feeding practices, physical activity and reducing children's BMI in the early years of life. If proven to be feasible, effective as well as cost-effective, the trial results will inform a series of recommendations for policy and practice related to promoting healthy infant feeding and physical activity in young children in the first years of life. The CHAT Trial is registered with the Australian Clinical Trial Registry ( ACTRN12616001470482p ). It was registered on October 21, 2016.

Using Facebook and text messaging to deliver a weight loss program to college students.

PubMed

Napolitano, Melissa A; Hayes, Sharon; Bennett, Gary G; Ives, Allison K; Foster, Gary D

2013-01-01

Between 31 and 35% of the college-aged population is overweight or obese, yet few weight loss trials for this population have been conducted. This study examined the feasibility, acceptability, and initial efficacy of a technology-based 8-week weight loss intervention among college students. Students (N = 52) were randomly assigned to one of the three arms: Facebook (n = 17); Facebook Plus text messaging and personalized feedback (n = 18); Waiting List control (n = 17), with assessments at 4 weeks and 8 weeks (post-treatment). Participants were 20.47 ± 2.19 years old, 86.45 ± 17.11 kg, with a body mass index of 31.36 ± 5.3 kg/m(2) . Participants were primarily female (86.5%), and the sample was racially diverse (57.7% Caucasian, 30.8% African American, 5.8% Hispanic, and 5.7% other races). The primary outcome was weight loss after 8 weeks (post-treatment); 96.0% of the participants completed this assessment. At 8 weeks, the Facebook Plus group had significantly greater weight loss (-2.4 ± 2.5 kg) than the Facebook (-0.63 ± 2.4 kg) and Waiting List (-0.24 ± 2.6 kg) (both Ps < 0.05). Weight change at 8 weeks was not significantly different between the Facebook and Waiting List groups. Results show preliminary efficacy and acceptability of the two active intervention arms (97.0% found the program helpful, 81.3% found the videos/handouts helpful, and 100% would recommend the program to others). Results indicate the potential for an innovative weight loss intervention that uses technology platforms (Facebook and text messaging) that are frequently used and already integrated into the cultural life of college students. Copyright © 2012 The Obesity Society.

Keep on brushing: a longitudinal study of motivational text messaging in young adults aged 18-24 years receiving Work and Income Support.

PubMed

Schluter, Philip; Lee, Martin; Hamilton, Greg; Coe, Gill; Messer-Perkins, Heather; Smith, Belinda

2015-01-01

Using text messaging, underpinned by the Health Belief Model, this study aimed to improve tooth brushing frequencies among unemployed young adults aged 18-24 years. Set within Work and Income's Linwood Community Link office (one Christchurch branch of the New Zealand Government's employment and beneficiary services), unemployed young adults aged 18-24 years with access to a mobile phone were recruited using either a purpose-built computer kiosk or Work and Income's Facebook site. Participants completed a baseline survey and then received and responded to a series of motivational text messages over 10 weeks. Self-reported tooth brushing frequency was the primary outcome variable. Important socio-demographic (age, gender, ethnicity, employment status) and method-specific (level of attrition, distribution of successful text messages deliveries, active withdrawal) variables were also collected. Longitudinal analyses of these responses employed generalized estimating equation (GEE) models. Four hundred and three registered for the trial, of whom 171 (42%) were eligible. Self-reported tooth brushing twice or more per day increased from 51% at baseline to 70% at week 3, 74% at week 6, and 73% at week 9 - an increase significant in crude (P<0.001) and adjusted (P<0.001) GEE analyses. No important differences were noted between age, gender, or ethnic groups, although attrition was relatively high with only 26% participating by week 9. However, no evidence of differential attrition was observed. Invention through motivational text messaging improved the measured oral health self-care behavior in a hard-to-reach group carrying a disproportionately heavy oral health burden. This intervention warrants further investigation. © 2014 American Association of Public Health Dentistry.

Text messaging to support a perinatal collaborative care model for depression: A multi-methods inquiry.

PubMed

Bhat, Amritha; Mao, Johnny; Unützer, Jürgen; Reed, Susan; Unger, Jennifer

Mental health care integrated into obstetric settings improves access to perinatal depression treatments. Digital interactions such as text messaging between patient and provider can further improve access. We describe the use of text messaging within a perinatal Collaborative Care (CC) program, and explore the association of text messaging content with perinatal depression outcomes. We analyzed data from an open treatment trial of perinatal CC in a rural obstetric clinic. Twenty five women with Patient Health Questionnaire-9 score of ≥10 enrolled in CC, and used text messaging to communicate with their Care Manager(CM). We used surveys and focus groups to assessacceptability of text messaging with surveys and focus groups. We calculated the number of text messages exchanged, and analyzed content to understand usage patterns. We explored association between text messaging content and depression outcomes. CMs initiated 85.4% messages, and patients responded to 86.9% messages. CMs used text messaging for appointment reminders, and patients used it to obtain obstetric and parenting information. CMs had concerns about the likelihood of boundary violations. Patients appreciated the asynchronous nature of text messaging. Text messaging is feasible and acceptable within a perinatal CC program. We need further research into the effectiveness of text messaging content, and response protocols. Copyright © 2018 Elsevier Inc. All rights reserved.

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Borland, Ron; Rodgers, Anthony; Gu, Yulong

2012-11-14

Innovative and effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well-integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes such as smoking cessation. To determine whether mobile phone-based interventions are effective at helping people who smoke, to quit. For the most recent update, we searched the Cochrane Tobacco Addiction Group Specialised Register in May 2012. We also searched UK Clinical Research Network Portfolio for current projects in the UK and the ClinicalTrials register for on-going or recently completed studies. We searched through the reference lists of identified studies and attempted to contact the authors of ongoing studies, with no restrictions placed on language or publication date. We included randomized or quasi-randomized trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Information on risk of bias and methodological details was extracted using a standardised form. Participants who dropped out of the trials or were lost to follow-up were considered to be smoking. We calculated risk ratios (RR) for each included study. Meta-analysis of the included studies was undertaken using the Mantel-Haenszel fixed-effect method. Where meta-analysis was not possible, summary and descriptive statistics are presented. Five studies with at least six month cessation outcomes were included in this review. Three studies involve a purely text messaging intervention that has been adapted over the course of these three studies for different populations and contexts. One study is a multi-arm study of a text messaging intervention and an internet QuitCoach separately and in combination. The final study involves a video messaging intervention delivered via the mobile phone. When all five studies were pooled, mobile phone interventions were shown to increase the long term quit rates compared with control programmes (RR 1.71, 95% CI 1.47 to 1.99, over 9000 participants), using a definition of abstinence of no smoking at six months since quit day but allowing up to three lapses or up to five cigarettes. Statistical heterogeneity was substantial as indicated by the I² statistic (I² = 79%), but as all included studies were similar in design, intervention and primary outcome measure, we have presented the meta-analysis in this review. The current evidence shows a benefit of mobile phone-based smoking cessation interventions on long-term outcomes, though results were heterogenous with findings from three of five included studies crossing the line of no effect. The studies included were predominantly of text messaging interventions. More research is required into other forms of mobile phone-based interventions for smoking cessation, other contexts such as low income countries, and cost-effectiveness.

Does nutritional counseling in telemedicine improve treatment outcomes for diabetes? A systematic review and meta-analysis of results from 92 studies.

PubMed

Su, Dejun; McBride, Chelsea; Zhou, Junmin; Kelley, Megan S

2016-09-01

A growing number of studies and reviews have documented the impact of telemedicine on diabetes management. However, no meta-analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective. Original research articles examining the effect of telemedicine interventions on HbA1c levels in patients with Type 1 or Type 2 diabetes were included in this study. A literature search was performed and 92 studies were retained for analysis. We examined stratified results by differentiating interventions using no nutritional counseling from those that used nutritional counseling. We further compared between nutritional counseling administered via short message systems (SMS) such as email and text messages, and nutritional counseling administered via telephone or videoconference. Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not. Furthermore, subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone. The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes. Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference. © The Author(s) 2015.

The effectiveness of mobile-health behaviour change interventions for cardiovascular disease self-management: A systematic review.

PubMed

Pfaeffli Dale, Leila; Dobson, Rosie; Whittaker, Robyn; Maddison, Ralph

2016-05-01

Mobile wireless devices (mHealth) have been used to deliver cardiovascular disease self-management interventions to educate and support patients in making healthy lifestyle changes. This systematic review aimed to determine the effectiveness of mHealth interventions on behavioural lifestyle changes and medication adherence for cardiovascular disease self-management. A comprehensive literature search was conducted from inception through to 3 March 2015 using MEDLINE, PubMed, PsycINFO, EMBASE and The Cochrane Library. Eligible studies used an experimental trial design to determine the effectiveness of an mHealth intervention to change lifestyle behaviours in any cardiovascular disease population. Data extracted included intervention and comparison group characteristics with a specific focus on the use of behaviour change techniques. Seven studies met our inclusion criteria and were included in the qualitative synthesis. All interventions were delivered in part by mobile phone text messaging. Three studies were effective at improving adherence to medication and two studies increased physical activity behaviour. No effects were observed on dietary behaviour or smoking cessation, measured in one study each. Simple text messaging interventions appeared to be most effective; however, no clear relationships were found between study findings and intervention dose, duration or behaviour change techniques targeted. Our review found mHealth has the potential to change lifestyle behaviour. Results are still limited to a small number of trials, inconsistent outcome measures and ineffective reporting of intervention characteristics. Large scale, longitudinal studies are now warranted to gain a clear understanding of the effects of mHealth on behaviour change in the cardiovascular disease population. © The European Society of Cardiology 2015.

The impact of tailored text messages on health beliefs and medication adherence in adults with diabetes: A randomized pilot study.

PubMed

Gatwood, Justin; Balkrishnan, Rajesh; Erickson, Steven R; An, Lawrence C; Piette, John D; Farris, Karen B

2016-01-01

Inadequate medication adherence reduces optimal health outcomes and can lead to increased costs, particularly in patients with diabetes. Efforts to improve adherence have resulted in limited effects; approaches leveraging mobile technology have emerged, but their focus has mainly been limited to simple reminder messages. The purpose of this pilot study was to test the effectiveness of tailored text messages focusing on improving medication adherence and health beliefs in adults with diabetes. Adults aged 21-64, with uncontrolled diabetes, and taking at least one anti-diabetic medication were recruited and randomized into 2 study arms: daily tailored text messaging for 90 days or standard care. Comparing baseline and endpoint survey responses, changes in theory-driven health beliefs and attitudes were assessed. The impact on medication adherence was evaluated using pharmacy claims by calculating the percent of days covered (PDC). A total of 75 subjects were consented, and 48 were randomized. Mean PDC at baseline were comparable between cohorts (84.4% and 87.1%, respectively). Declines in adherence were observed in both groups over time but no significant differences were observed between groups or from baseline to the end of the active study period. Unadjusted tests suggested that perceived benefits and competence might have improved in the intervention arm. Tailoring mobile phone text messages is a novel way to address medication nonadherence and health beliefs; further investigation to this combined technique is needed to better understand its impact on behavior change in adults with diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

TextWithSurgeryPatients - A Research Hypothesis in Enhancing Education and Physical Assessment for Abdominal Surgical Patients.

PubMed

Hansen, Margaret

2016-01-01

Medical surgical nurses may not have the time or resources to provide effective pre- and post-operative instructions for patients in today's healthcare system. And, making timely physical assessments following discharge from the hospital is not always straightforward. Therefore, the risk for readmission associated with post-surgical complications is a concern. At present, mobile healthcare technologies and patient care are precipitously evolving and may serve as a resource to enhance communication between the healthcare provider and patient. A mobile telephone text message (short message service [SMS]) intervention for abdominal surgical patients may foster effective education (communication) and timely self-reported physical assessment in the home environment hence preventing deleterious outcomes. The aim of this research proposal is to identify the feasibility of using a SMS intervention via smart phones to improve health outcomes via timely communication, reach large numbers of at-risk surgical patients and, establish and sustain uniform protocols in a cost-efficient manner.

Interactive weekly mobile phone text messaging plus motivational interviewing in promotion of breastfeeding among women living with HIV in South Africa: study protocol for a randomized controlled trial.

PubMed

Zunza, Moleen; Cotton, Mark F; Mbuagbaw, Lawrence; Lester, Richard; Thabane, Lehana

2017-07-17

South Africa recently phased out access to free formula milk in the public sector in support of breastfeeding for women living with HIV. Few women living with HIV in South Africa choose breastfeeding and among those who do, many stop breastfeeding early. We sought to explore the feasibility of using mobile phone text messaging coupled with motivational interviewing to enhance adherence to breastfeeding practices. A randomized, parallel group, single-center pilot trial. Electronic sequence generation and random allocation will be done centrally. Women of low socioeconomic status, from Cape Town, South Africa will be randomly assigned within 24 h of giving birth at a primary healthcare clinic to a structured weekly text message plus motivational interviewing and usual standard of care, using a permutation of different block sizes. Criteria for feasibility success will include: five participants recruited per week (over 12 weeks), about 75% of all eligible participants consent for study participation, complete evaluation of outcomes in at least 70% of all recruited participants, breastfeeding adherence rates of at least 70% in the intervention group, six months after delivery. Participants will be evaluated soon after giving birth and post-delivery at weeks 2, 6, 10, and 24. Primary analysis will follow the "intention-to-treat" principle. Sub-group analysis will be used to assess sub-group effects. This pilot trial will evaluate the feasibility of conducting a larger trial on communication and support approaches to improve adherence to breastfeeding by HIV-infected women. Text messaging and motivational interviewing are simple interventions which may allow participants to access personalized adherence advice and support. ClinicalTrials.gov: NCT02949713 . Registered on 26 October 2016; Pan African Clinical Trial Registry PACTR201611001855404 . Registered on 8 November 2016.

Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.

PubMed

Park, Linda G; Collins, Eileen G; Shim, Janet K; Whooley, Mary A

2017-07-18

Adherence to antiplatelet medications is critical to prevent life threatening complications (ie, stent thrombosis) after percutaneous coronary interventions (PCIs), yet rates of nonadherence range from 21-57% by 12 months. Mobile interventions delivered via text messaging or mobile apps represent a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The Mobile4Meds study seeks to determine whether text messaging or a mobile app, compared with an educational website control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome (ACS) or PCI. The three aims of the study are to: (1) determine preferences for content and frequency of text messaging to promote medication adherence through focus groups; (2) identify the most patient-centered app that promotes adherence, through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and (3) compare adherence to antiplatelet medications in Veterans after ACS/PCI via a randomized clinical trial (RCT). We will utilize a mixed-methods design that uses focus groups to achieve the first and second aims (N=32). Patients will be followed for 12 months after being randomly assigned to one of three arms: (1) customized text messaging, (2) mobile app, or (3) website-control groups (N=225). Medication adherence will be measured with electronic monitoring devices, pharmacy records, and self-reports. Enrollment for the focus groups is currently in progress. We expect to enroll patients for the RCT in the beginning of 2018. Determining the efficacy of mobile technology using a Veteran-designed protocol to promote medication adherence will have a significant impact on Veteran health and public health, particularly for individuals with chronic diseases that require strict medication adherence. ClinicalTrials.gov NCT03022669. ©Linda G Park, Eileen G Collins, Janet K Shim, Mary A Whooley. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.07.2017.

Understanding text-based persuasion and support tactics of concerned significant others.

PubMed

van Stolk-Cooke, Katherine; Hayes, Marie; Baumel, Amit; Muench, Frederick

2015-01-01

The behavior of concerned significant others (CSOs) can have a measurable impact on the health and wellness of individuals attempting to meet behavioral and health goals, and research is needed to better understand the attributes of text-based CSO language when encouraging target significant others (TSOs) to achieve those goals. In an effort to inform the development of interventions for CSOs, this study examined the language content of brief text-based messages generated by CSOs to motivate TSOs to achieve a behavioral goal. CSOs generated brief text-based messages for TSOs for three scenarios: (1) to help TSOs achieve the goal, (2) in the event that the TSO is struggling to meet the goal, and (3) in the event that the TSO has given up on meeting the goal. Results indicate that there was a significant relationship between the tone and compassion of messages generated by CSOs, the CSOs' perceptions of TSO motivation, and their expectation of a grateful or annoyed reaction by the TSO to their feedback or support. Results underscore the importance of attending to patterns in language when CSOs communicate with TSOs about goal achievement or failure, and how certain variables in the CSOs' perceptions of their TSOs affect these characteristics.

Effectiveness of Electronic Reminders to Improve Medication Adherence in Tuberculosis Patients: A Cluster-Randomised Trial.

PubMed

Liu, Xiaoqiu; Lewis, James J; Zhang, Hui; Lu, Wei; Zhang, Shun; Zheng, Guilan; Bai, Liqiong; Li, Jun; Li, Xue; Chen, Hongguang; Liu, Mingming; Chen, Rong; Chi, Junying; Lu, Jian; Huan, Shitong; Cheng, Shiming; Wang, Lixia; Jiang, Shiwen; Chin, Daniel P; Fielding, Katherine L

2015-09-01

Mobile text messaging and medication monitors (medication monitor boxes) have the potential to improve adherence to tuberculosis (TB) treatment and reduce the need for directly observed treatment (DOT), but to our knowledge they have not been properly evaluated in TB patients. We assessed the effectiveness of text messaging and medication monitors to improve medication adherence in TB patients. In a pragmatic cluster-randomised trial, 36 districts/counties (each with at least 300 active pulmonary TB patients registered in 2009) within the provinces of Heilongjiang, Jiangsu, Hunan, and Chongqing, China, were randomised using stratification and restriction to one of four case-management approaches in which patients received reminders via text messages, a medication monitor, combined, or neither (control). Patients in the intervention arms received reminders to take their drugs and reminders for monthly follow-up visits, and the managing doctor was recommended to switch patients with adherence problems to more intensive management or DOT. In all arms, patients took medications out of a medication monitor box, which recorded when the box was opened, but the box gave reminders only in the medication monitor and combined arms. Patients were followed up for 6 mo. The primary endpoint was the percentage of patient-months on TB treatment where at least 20% of doses were missed as measured by pill count and failure to open the medication monitor box. Secondary endpoints included additional adherence and standard treatment outcome measures. Interventions were not masked to study staff and patients. From 1 June 2011 to 7 March 2012, 4,292 new pulmonary TB patients were enrolled across the 36 clusters. A total of 119 patients (by arm: 33 control, 33 text messaging, 23 medication monitor, 30 combined) withdrew from the study in the first month because they were reassessed as not having TB by their managing doctor (61 patients) or were switched to a different treatment model because of hospitalisation or travel (58 patients), leaving 4,173 TB patients (by arm: 1,104 control, 1,008 text messaging, 997 medication monitor, 1,064 combined). The cluster geometric mean of the percentage of patient-months on TB treatment where at least 20% of doses were missed was 29.9% in the control arm; in comparison, this percentage was 27.3% in the text messaging arm (adjusted mean ratio [aMR] 0.94, 95% CI 0.71, 1.24), 17.0% in the medication monitor arm (aMR 0.58, 95% CI 0.42, 0.79), and 13.9% in the combined arm (aMR 0.49, 95% CI 0.27, 0.88). Patient loss to follow-up was lower in the text messaging arm than the control arm (aMR 0.42, 95% CI 0.18-0.98). Equipment malfunction or operation error was reported in all study arms. Analyses separating patients with and without medication monitor problems did not change the results. Initiation of intensive management was underutilised. This study is the first to our knowledge to utilise a randomised trial design to demonstrate the effectiveness of a medication monitor to improve medication adherence in TB patients. Reminders from medication monitors improved medication adherence in TB patients, but text messaging reminders did not. In a setting such as China where universal use of DOT is not feasible, innovative approaches to support patients in adhering to TB treatment, such as this, are needed. Current Controlled Trials, ISRCTN46846388.

The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review.

PubMed

Househ, Mowafa

2016-06-01

Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. © The Author(s) 2014.

Can you hear me now? Limited use of technology among an urban HIV-infected cohort.

PubMed

Shacham, E; Stamm, K; Overton, E T

2009-08-01

Recent studies support technology-based behavioral interventions for individuals with HIV. This study focused on the use of cell phone and internet technologies among a cohort of 515 HIV-infected individuals. Socio-demographic and clinic data were collected among individuals presenting at an urban Midwestern university HIV clinic in 2007. Regular internet usage occurred more often with males, Caucasians, those who were employed, had higher income, and were more educated. Higher levels of education and income >$10,000 predicted regular usage when controlling for race, employment, and gender. Cell phone ownership was associated with being Caucasian, employed, more educated, and salary >$10,000. Employment was the only predictor of owning a cell phone when controlling for income, race, and education. Individuals who were <40 years of age, employed, and more educated were more likely to know how to text message. Employment and post-high school education predicted knowledge of text messaging, when controlling for age. Disparities among internet, cell phone, and text messaging usage exist among HIV-infected individuals.

Diabetes Self-Management Care via Cell Phone: A Systematic Review

PubMed Central

Krishna, Santosh; Boren, Suzanne Austin

2008-01-01

Background The objective of this study was to evaluate the evidence on the impact of cell phone interventions for persons with diabetes and/or obesity in improving health outcomes and/or processes of care for persons with diabetes and/or obesity. Methods We searched Medline (1966–2007) and reviewed reference lists from included studies and relevant reviews to identify additional studies. We extracted descriptions of the study design, sample size, patient age, duration of study, technology, educational content and delivery environment, intervention and control groups, process and outcome measures, and statistical significance. Results In this review, we included 20 articles, representing 18 studies, evaluating the use of a cell phone for health information for persons with diabetes or obesity. Thirteen of 18 studies measured health outcomes and the remaining 5 studies evaluated processes of care. Outcomes were grouped into learning, behavior change, clinical improvement, and improved health status. Nine out of 10 studies that measured hemoglobin A1c reported significant improvement among those receiving education and care support. Cell phone and text message interventions increased patient–provider and parent–child communication and satisfaction with care. Conclusions Providing care and support with cell phones and text message interventions can improve clinically relevant diabetes-related health outcomes by increasing knowledge and self-efficacy to carry out self-management behaviors. PMID:19885219

Diabetes self-management care via cell phone: a systematic review.

PubMed

Krishna, Santosh; Boren, Suzanne Austin

2008-05-01

The objective of this study was to evaluate the evidence on the impact of cell phone interventions for persons with diabetes and/or obesity in improving health outcomes and/or processes of care for persons with diabetes and/or obesity. We searched Medline (1966-2007) and reviewed reference lists from included studies and relevant reviews to identify additional studies. We extracted descriptions of the study design, sample size, patient age, duration of study, technology, educational content and delivery environment, intervention and control groups, process and outcome measures, and statistical significance. In this review, we included 20 articles, representing 18 studies, evaluating the use of a cell phone for health information for persons with diabetes or obesity. Thirteen of 18 studies measured health outcomes and the remaining 5 studies evaluated processes of care. Outcomes were grouped into learning, behavior change, clinical improvement, and improved health status. Nine out of 10 studies that measured hemoglobin A1c reported significant improvement among those receiving education and care support. Cell phone and text message interventions increased patient-provider and parent-child communication and satisfaction with care. Providing care and support with cell phones and text message interventions can improve clinically relevant diabetes-related health outcomes by increasing knowledge and self-efficacy to carry out self-management behaviors.

Integrating technology into cognitive behavior therapy for adolescent depression: a pilot study.

PubMed

Kobak, Kenneth A; Mundt, James C; Kennard, Betsy

2015-01-01

Rapid advances in information technology and telecommunications have resulted in a dramatic increase in the use of mobile devices and the internet to enhance and facilitate access to treatment. Cognitive behavior therapy (CBT) is an empirically based treatment that is well suited for enhancement by new technologies, particularly with youth. To facilitate the dissemination of this evidence-based treatment, we developed a technology-enhanced CBT intervention for the treatment of adolescent depression consisting of (1) online therapist training (2) in-session use of tablets for teaching clients CBT concepts and skills, and (3) text messaging for between session homework reminders and self-monitoring. Eighteen licensed clinicians (social workers n = 7, psychologists n = 9) were randomized to have their patients receive either the intervention (CBT) or treatment as usual (TAU). Each clinician treated four adolescents for 12 weeks. Clinicians in the CBT arm completed an online tutorial on CBT treatment of adolescent depression, then received an iPad with access to patient education materials for teaching CBT concepts to patients during sessions. Individualized text messages were integrated into treatment for homework reminders, support, and outcomes measurement. Outcome measures included a 49-item multiple choice test for tutorial effectiveness; the system usability scale (SUS) for user satisfaction; quick inventory of depressive symptomatology-adolescent version (QIDS-A-Pat); and clinician and patient ratings on the therapeutic alliance scale for adolescents (TASA). A significant increase in knowledge of CBT concepts was found after completing the tutorial, t(8) = 7.02, p < 0.001. Clinician and patient ratings of user satisfaction were high for both the iPad teaching tools, and the text messaging. Ninety-five percent of teens said reviewing their text messages with their therapist was helpful, and all said they would use text messaging in treatment again. Ratings of the therapeutic alliance were higher in the CBT arm t(131) = 4.03, p = 0.001. A significant reduction in depression was found in both groups [t(34) = 8.453, p < 0.001 and t(29) = 6.67, p < 0.001 for CBT and TAU, respectively). Clinical ratings of improvement were greater on all outcome measures for the CBT arm; however, none reached statistical significance. Effect sizes (Cohen's d) ranged from small (QIDS-A) to large (TASA). Results support the feasibility of this technology-enhanced CBT intervention as a means of improving CBT treatment of adolescent depression and may help address the critical shortage of therapists trained on empirically based treatments.

The SmokefreeTXT (SFTXT) Study: Web and Mobile Data Collection to Evaluate Smoking Cessation for Young Adults.

PubMed

Squiers, Linda; Brown, Derick; Parvanta, Sarah; Dolina, Suzanne; Kelly, Bridget; Dever, Jill; Southwell, Brian G; Sanders, Amy; Augustson, Erik

2016-06-27

Text messaging (short message service, SMS) has been shown to be effective in delivering interventions for various diseases and health conditions, including smoking cessation. While there are many published studies regarding smoking cessation text messaging interventions, most do not provide details about the study's operational methods. As a result, there is a gap in our understanding of how best to design studies of smoking cessation text messaging programs. The purpose of this paper is to detail the operational methods used to conduct a randomized trial comparing three different versions of the National Cancer Institute's SmokefreeText (SFTXT) program, designed for smokers 18 to 29 years of age. We detail our methods for recruiting participants from the Internet, reducing fraud, conducting online data collection, and retaining panel study participants. Participants were recruited through website advertisements and market research online panels. Screening questions established eligibility for the study (eg, 18 to 29 years of age, current smoker). Antifraud measures screened out participants who could not meet the study requirements. After completing a baseline survey, participants were randomized to one of three study arms, which varied by type and timing of text message delivery. The study offered US $20 gift cards as incentives to complete each of four follow-up surveys. Automated email reminders were sent at designated intervals to increase response rates. Researchers also provided telephone reminders to those who had not completed the survey after multiple email reminders. We calculated participation rates across study arms and compared the final sample characteristics to the Current Population Survey to examine generalizability. Recruitment methods drove 153,936 unique visitors to the SFTXT Study landing page and 27,360 began the screener. Based on the screening questions, 15,462 out of 27,360 responders (56.51%) were eligible to participate. Of the 15,462 who were eligible, 9486 passed the antifraud measures that were implemented; however, 3882 failed to verify their email addresses or cell phone numbers, leaving 5604 who were invited to complete the baseline survey. Of the 5604 who were invited, 4432 completed the baseline survey, but only 4027 were retained for analysis because 405 did not receive the intervention. Although antifraud measures helped to catch participants who failed study requirements and could have biased the data collected, it is possible that the email and cell phone verification check excluded some potentially eligible participants from the study. Future research should explore ways to implement verification methods without risking the loss of so many potential participants. Clinical Trials.gov NCT01885052; https://clinicaltrials.gov/ct2/show/NCT01885052; (Archived by WebCite at http://www.webcitation.org/6iWzcmFdw).

The SmokefreeTXT (SFTXT) Study: Web and Mobile Data Collection to Evaluate Smoking Cessation for Young Adults

PubMed Central

Brown, Derick; Parvanta, Sarah; Dolina, Suzanne; Kelly, Bridget; Dever, Jill; Southwell, Brian G; Sanders, Amy; Augustson, Erik

2016-01-01

Background Text messaging (short message service, SMS) has been shown to be effective in delivering interventions for various diseases and health conditions, including smoking cessation. While there are many published studies regarding smoking cessation text messaging interventions, most do not provide details about the study’s operational methods. As a result, there is a gap in our understanding of how best to design studies of smoking cessation text messaging programs. Objective The purpose of this paper is to detail the operational methods used to conduct a randomized trial comparing three different versions of the National Cancer Institute’s SmokefreeText (SFTXT) program, designed for smokers 18 to 29 years of age. We detail our methods for recruiting participants from the Internet, reducing fraud, conducting online data collection, and retaining panel study participants. Methods Participants were recruited through website advertisements and market research online panels. Screening questions established eligibility for the study (eg, 18 to 29 years of age, current smoker). Antifraud measures screened out participants who could not meet the study requirements. After completing a baseline survey, participants were randomized to one of three study arms, which varied by type and timing of text message delivery. The study offered US $20 gift cards as incentives to complete each of four follow-up surveys. Automated email reminders were sent at designated intervals to increase response rates. Researchers also provided telephone reminders to those who had not completed the survey after multiple email reminders. We calculated participation rates across study arms and compared the final sample characteristics to the Current Population Survey to examine generalizability. Results Recruitment methods drove 153,936 unique visitors to the SFTXT Study landing page and 27,360 began the screener. Based on the screening questions, 15,462 out of 27,360 responders (56.51%) were eligible to participate. Of the 15,462 who were eligible, 9486 passed the antifraud measures that were implemented; however, 3882 failed to verify their email addresses or cell phone numbers, leaving 5604 who were invited to complete the baseline survey. Of the 5604 who were invited, 4432 completed the baseline survey, but only 4027 were retained for analysis because 405 did not receive the intervention. Conclusions Although antifraud measures helped to catch participants who failed study requirements and could have biased the data collected, it is possible that the email and cell phone verification check excluded some potentially eligible participants from the study. Future research should explore ways to implement verification methods without risking the loss of so many potential participants. ClinicalTrial Clinical Trials.gov NCT01885052; https://clinicaltrials.gov/ct2/show/NCT01885052; (Archived by WebCite at http://www.webcitation.org/6iWzcmFdw) PMID:27349898

Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps.

PubMed

Abroms, Lorien C; Whittaker, Robyn; Free, Caroline; Mendel Van Alstyne, Judith; Schindler-Ruwisch, Jennifer M

2015-12-21

A growing body of evidence demonstrates that text messaging-based programs (short message service [SMS]) on mobile phones can help people modify health behaviors. Most of these programs have consisted of automated and sometimes interactive text messages that guide a person through the process of behavior change. This paper provides guidance on how to develop text messaging programs aimed at changing health behaviors. Based on their collective experience in designing, developing, and evaluating text messaging programs and a review of the literature, the authors drafted the guide. One author initially drafted the guide and the others provided input and review. Steps for developing a text messaging program include conducting formative research for insights into the target audience and health behavior, designing the text messaging program, pretesting the text messaging program concept and messages, and revising the text messaging program. The steps outlined in this guide may help in the development of SMS-based behavior change programs.

The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review

PubMed Central

Free, Caroline; Phillips, Gemma; Galli, Leandro; Watson, Louise; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy

2013-01-01

Background Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. Methods and Findings We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990–Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72–0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47–1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77–2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. Conclusions Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes. Please see later in the article for the Editors' Summary PMID:23349621

Reading Text While Driving

PubMed Central

Horrey, William J.; Hoffman, Joshua D.

2015-01-01

Objective In this study, we investigated how drivers adapt secondary-task initiation and time-sharing behavior when faced with fluctuating driving demands. Background Reading text while driving is particularly detrimental; however, in real-world driving, drivers actively decide when to perform the task. Method In a test track experiment, participants were free to decide when to read messages while driving along a straight road consisting of an area with increased driving demands (demand zone) followed by an area with low demands. A message was made available shortly before the vehicle entered the demand zone. We manipulated the type of driving demands (baseline, narrow lane, pace clock, combined), message format (no message, paragraph, parsed), and the distance from the demand zone when the message was available (near, far). Results In all conditions, drivers started reading messages (drivers’ first glance to the display) before entering or before leaving the demand zone but tended to wait longer when faced with increased driving demands. While reading messages, drivers looked more or less off road, depending on types of driving demands. Conclusions For task initiation, drivers avoid transitions from low to high demands; however, they are not discouraged when driving demands are already elevated. Drivers adjust time-sharing behavior according to driving demands while performing secondary tasks. Nonetheless, such adjustment may be less effective when total demands are high. Application This study helps us to understand a driver’s role as an active controller in the context of distracted driving and provides insights for developing distraction interventions. PMID:25850162

A Social Marketing Intervention to Prevent Drowning Among Inner-City Youth.

PubMed

Glassman, Tavis J; Castor, Tom; Karmakar, Monita; Blavos, Alexis; Dagenhard, Paige; Domigan, Julianne; Sweeney, Erin; Diehr, Aaron; Kucharewski, Ruthie

2018-03-01

Water-related injuries and fatalities pose serious public health issues, especially to African American youth, a demographic group that drowns at disproportionately high rates. The purpose of this study was to determine if a social marketing intervention targeting the parents and guardians of inner-city youth (U.S. Midwest) could positively influence their perceptions concerning water safety. Researchers employed a quasi-experimental design using matched pairs to evaluate the intervention. Participants consisted of parents who enrolled their children in a six-session survival-swimming course. Guided by the Health Belief Model, the researchers disseminated six prevention messages using six different channels (brochure, e-mail, SMS text message, postcard, Facebook, and window cling). The findings from a two-way analysis of covariance revealed that treatment group participants' knowledge and perceptions of water-related threat all changed favorably. Additionally, all participants planned to reenroll their children in swim lessons. A social marketing campaign using the Health Belief Model improved inner-city parents' knowledge regarding water safety and enhanced their self-efficacy. This study provides practitioners with feasible strategies (prevention messages) to supplement swim lessons, with the ultimate goal of preventing drowning among at-risk youth.

Text Messages Promoting Mental Imagery Increase Self-Reported Physical Activity in Older Adults: A Randomized Controlled Study.

PubMed

Robin, Nicolas; Toussaint, Lucette; Coudevylle, Guillaume R; Ruart, Shelly; Hue, Olivier; Sinnapah, Stephane

2018-06-22

This study tested whether text messages prompting adults 50 years of age and older to perform mental imagery would increase aerobic physical activity (APA) duration using a randomized parallel trial design. Participants were assigned to an Imagery 1, Imagery 2, or placebo group. For 4 weeks, each group was exposed to two conditions (morning text message vs. no morning text message). In the morning message condition, the imagery groups received a text message with the instruction to mentally imagine performing an APA, and the placebo group received a placebo message. All participants received an evening text message of "Did you do your cardio today? If yes, what did you do?" for 3 days per week. Participants of the imagery groups reported significantly more weekly minutes of APA in the morning text message condition compared with the no morning message condition. Electronic messages were effective at increasing minutes of APA.

A randomised controlled trial of an SMS-based mobile epilepsy education system.

PubMed

Lua, Pei Lin; Neni, Widiasmoro Selamat

2013-01-01

We evaluated an epilepsy education programme based on text messaging (SMS). Epilepsy outpatients from three hospitals in Malaysia were randomised into two groups: intervention and control. Patients in the control group were supplied with printed epilepsy educational material while those in the intervention group also received text messages from the Mobile Epilepsy Educational System (MEES). A total of 136 patients completed the study (mean age 31 years; 91% Malay; 51% with an illness duration of more than 5 years). A between-group analysis showed that the awareness, knowledge and attitudes (AKA) about epilepsy did not significantly differ between the groups at baseline (P > 0.05). The intervention patients reported better AKA levels during follow-up compared to the control patients (P < 0.05). A within-group analysis showed that in intervention patients, there were significant improvements in all AKA domains with larger effect sizes (P < 0.01) while control patients also exhibited significant improvement in most domains except for Awareness but with smaller effect sizes. After controlling for possible confounding variables (age, gender, educational qualification, monthly income and baseline mean for each domain), the intervention group still reported significantly higher AKA than the control group particularly in Awareness (P < 0.001) and Total AKA (P = 0.003). There was also significantly better medication adherence and clinic attendance in the intervention group (P < 0.05). The results suggest that the addition of the MEES to conventional epilepsy education is effective in improving AKA.

Harm Reduction Text Messages Delivered During Alcohol Drinking: Feasibility Study Protocol

PubMed Central

2012-01-01

Background: Recent research using mobile phone interventions to address public health issues such as smoking, obesity, depression, and diabetes provides a basis for trialing a similar approach toward reducing the negative consequences of risky drinking. Objective: This feasibility study aims to recruit drinkers between 18–34 years to a website where they will design and enter their own personal messages (repeating or one-off) to be sent to their mobile phones when they are drinking to remind them of their pre-drinking safety intentions. Methods/Design: Participants in the treatment group will have access to the messaging function for 3 months and will be compared to a control group who will have 3 months access to a web chat site only. Data collection will occur at baseline, 3 months, and 6 months. The primary outcome is a change in unintended negative consequences from drinking at 3 months. Secondary outcomes include the acceptability of the intervention to this population, recruitment rate, participant retention, reduction in alcohol consumption, and the self-motivation discourse in participant messages. Discussion: Existing alcohol interventions in New Zealand attempt to reduce alcohol consumption in the population, but with little effect. This study aims to target unintended negative consequences resulting from drinking by empowering the drinkers themselves to deliver safety messages during the drinking session. If proven effective, this strategy could provide a cost-effective means of reducing the public health burden associated with risky drinking. Trial Registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000242921 PMID:23611773

High-Yield HIV Testing, Facilitated Linkage to Care, and Prevention for Female Youth in Kenya (GIRLS Study): Implementation Science Protocol for a Priority Population.

PubMed

Inwani, Irene; Chhun, Nok; Agot, Kawango; Cleland, Charles M; Buttolph, Jasmine; Thirumurthy, Harsha; Kurth, Ann E

2017-12-13

Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections. We will compare two seek recruitment strategies, three test strategies, and pilot adaptive linkage to care interventions (sequential multiple assignment randomized trial [SMART] design) among AGYW in the age range of 15 to 24 years in Homa Bay County, western Kenya. AGYW will be recruited in the home or community-based setting and offered three testing options: oral fluid HIV self-testing, staff-aided rapid HIV testing, or referral to a health care facility for standard HIV testing services. Newly diagnosed AGYW with HIV will be enrolled in the SMART trial pilot to determine the most effective way to support initial linkage to care after a positive diagnosis. They will be randomized to standard referral (counseling and a referral note) or standard referral plus SMS text message (short message service, SMS); those not linked to care within 2 weeks will be rerandomized to receive an additional SMS text message or a one-time financial incentive (approximately US $4). We will also evaluate a primary prevention messaging intervention to support identified high-risk HIV-negative AGYW to reduce their HIV risk and adhere to HIV retesting recommendations. We will also conduct analyses to determine the incremental cost-effectiveness of the seek, testing and linkage interventions. We expect to enroll 1200 participants overall, with a random selection of 100 high-risk HIV-negative AGYW for the SMS prevention intervention (HIV-negative cohort) and approximately 108 AGYW who are living with HIV for the SMART design pilot of adaptive linkage to care interventions (HIV-positive cohort). We anticipate that the linkage to care interventions will be feasible and acceptable to implement. Lastly, the use of SMS text messages to engage participants will provide pilot data to the Kenyan government currently exploring a national platform to track and support linkage, adherence to treatment, retention, and prevention interventions for improved outcomes. Lessons learned will inform best approaches to identify new HIV diagnoses to increase AGYW's uptake of HIV prevention, testing, and linkage to care services in a high HIV-burden African setting. ClinicalTrials.gov NCT02735642; https://clinicaltrials.gov/ct2/show/NCT02735642 (Archived by WebCite at http://www.webcitation.org/6vgLLHLC9). ©Irene Inwani, Nok Chhun, Kawango Agot, Charles M Cleland, Jasmine Buttolph, Harsha Thirumurthy, Ann E Kurth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 13.12.2017.

Mobile Health (mHealth) Technology for the Management of Hypertension and Hyperlipidemia: Slow Start but Loads of Potential.

PubMed

Rehman, Hasan; Kamal, Ayeesha K; Morris, Pamela B; Sayani, Saleem; Merchant, Anwar T; Virani, Salim S

2017-03-01

Hypertension and hyperlipidemia represent two major risk factors for atherosclerotic cardiovascular disease. Mobile health or mHealth is defined as the use of mobile phone and wireless technologies to support the achievement of health objectives. Management of hypertension, and to some extent hyperlipidemia, has often employed mHealth interventions given lower cost and greater patient engagement compared to traditional methods. These interventions include the use of text messaging, wireless devices, and mobile phone applications. This review considers recent studies evaluating the effectiveness of mHealth interventions in the management of hypertension and hyperlipidemia. Numerous studies have evaluated the role of mHealth interventions in the management of hypertension, while very few have evaluated their role in hyperlipidemia. Text messaging has been used most frequently. However, the trend is shifting towards the use of mobile phone applications and wireless devices. Interventions in developing countries have been modified for greater applicability to local settings. mHealth interventions were found to be frequently effective. However, studies comparing the relative efficacy of various mHealth strategies are scarce. Long-term cardiovascular outcomes data and analyses relating to cost effectiveness are also lacking. mHealth interventions may be effective in improving hypertension management. More studies are needed to evaluate the role of mHealth strategies in hyperlipidemia management, particularly in identifying high-risk individuals and improving medication adherence. Studies assessing the long-term impact of these interventions, comparing different interventions and analyzing their relative cost effectiveness, are also needed. Following recently published guidelines on reporting results of mHealth interventions will provide a more meaningful context for interpreting these promising early studies.

E-mail to Promote Colorectal Cancer Screening Within Social Networks: Acceptability and Content

PubMed Central

CUTRONA, SARAH L.; WAGNER, JOANN; ROBLIN, DOUGLAS W.; GAGLIO, BRIDGET; WILLIAMS, ANDREW; TORRES-STONE, ROSALIE; MAZOR, KATHLEEN M.

2016-01-01

Effective techniques to encourage colorectal cancer (CRC) screening in underscreened populations have included social support interventions and email reminders from physicians. Personalized email messages to promote CRC screening within social networks could be even more effective, but have not been studied. We interviewed 387 email users, aged 42-73 years in Massachusetts, Hawaii, and Georgia. Participants were asked to edit a sample message in which the sender shares a recent colonoscopy experience and urges the recipient to discuss CRC screening with a doctor. For those reporting willingness to send this message, changes to the message and suggested subject lines were recorded. Edited text was analyzed for content and concordance with original message. The majority of participants (74.4%) were willing to email a modifiable message. Of those willing, 63.5% edited the message. Common edits included deletion (17.7%) or modification (17.4%) of a negatively framed sentence on colon cancer risks and addition or modification of personalizing words (15.6%). Few edits changed the meaning of the message (5.6%) and even fewer introduced factual inaccuracies (1.7%). Modifiable email messages offer a way for screened individuals to promote CRC screening to social network members. Accuracy and impact of such messages should be further studied. PMID:25839968

Text4Heart II - improving medication adherence in people with heart disease: a study protocol for a randomized controlled trial.

PubMed

Maddison, Ralph; Stewart, Ralph; Doughty, Rob; Scott, Tony; Kerr, Andrew; Benatar, Jocelyne; Whittaker, Robyn; Rawstorn, Jonathan C; Rolleston, Anna; Jiang, Yannan; Estabrooks, Paul; Sullivan, Rachel Karen; Bartley, Hannah; Pfaeffli Dale, Leila

2018-01-25

Cardiac rehabilitation (CR) is an essential component of contemporary management for patients with coronary heart disease, including following an acute coronary syndrome (ACS). CR typically involves education and support to assist people following an ACS to make lifestyle changes and prevent subsequent events. Despite its benefits, uptake and participation in tradition CR programs is low. The use of mobile technologies (mHealth) offers the potential to improve reach, access, and delivery of CR support. We aim to determine the effectiveness and cost-effectiveness of a text-messaging intervention (Text4Heart II) to improve adherence to medication and lifestyle change in addition to usual care in people following an ACS. A second aim is to use the RE-AIM framework to inform the potential implementation of Text4Heart II within health services in New Zealand. Text4Heart II is a two-arm, parallel, superiority randomized controlled trial conducted in two large metropolitan hospitals in Auckland, New Zealand. Three hundred and thirty participants will be randomized to either a 24-week theory- and evidence-based personalized text message program to support self-management in addition to usual CR, or usual CR alone (control). Outcomes are assessed at 6 and 12 months. The primary outcome is the proportion of participants adhering to medication at 6 months as measured by dispensed records. Secondary outcomes include medication adherence at 12 months, the proportion of participants adhering to self-reported healthy behaviors (physical activity, fruit and vegetable consumption, moderating alcohol intake and smoking status) measured using a composite health behavior score, self-reported medication adherence, cardiovascular risk factors (lipids, blood pressure), readmissions and related hospital events at 6 and 12 months. A cost-effectiveness analysis will also be conducted. Using the RE-AIM framework, we will determine uptake and sustainability of the intervention. The Text4Heart II trial will determine the effectiveness of a text-messaging intervention to improve adherence to medication and lifestyle behaviors at both 6 and 12 months. Using the RE-AIM framework this trial will provide much needed data and insight into the potential implementation of Text4Heart II. This trial addresses many limitations/criticisms of previous mHealth trials; it builds on our Text4Heart pilot trial, it is adequately powered, has sufficient duration to elicit behavior change, and the follow-up assessments (6 and 12 months) are long enough to determine the sustained effect of the intervention. Australian New Zealand Clinical Trials Registry, ID: ACTRN12616000422426 . Registered retrospectively on 1 April 2016.

The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma.

PubMed

MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, Aaron

2018-05-07

Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in racial minority populations, particularly minority adolescents and young adults, although illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood. The objective of the pilot study was to test the feasibility, acceptability, and signals of efficacy of an intervention targeting adherence to controller medication in African American youth (ages 18-29) with asthma. All elements of the protocol were piloted in a National Heart, Lung, and Blood Institute (NHLBI)-funded pilot study (1R34HL107664 MacDonell). Results suggested feasibility and acceptability of the protocol as well as proof of concept. We are now ready to test the intervention in a larger randomized clinical trial. The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low controller medication adherence recruited from clinic, emergency department, and community settings. Half of the sample will be randomized to receive a multicomponent technology-based intervention targeting adherence to daily controller medication. The multicomponent technology-based intervention consists of 2 components: (1) 2 sessions of computer-delivered motivational interviewing targeting medication adherence and (2) individualized text messaging focused on medication adherence between the sessions. Text messages will be individualized based on ecological momentary assessment. The remaining participants will complete a series of computer-delivered asthma education modules matched for length, location, and method of delivery of the intervention session. Control participants will also receive text messages between intervention sessions. Message content will be the same for all control participants and contain general facts about asthma (not tailored). It is hypothesized that youth randomized to multicomponent technology-based intervention will show improvements in medication adherence (primary outcome) and asthma control (secondary outcome) compared with comparison condition at all postintervention follow-ups (3, 6, 9, and 12 months). The proposed study was funded by NHLBI from September 1, 2016 through August 31, 2021. This project will test a brief, technology-based intervention specifically targeting adherence to asthma controller medications in an under-researched population, African American emerging adults. If successful, our multicomponent technology-based intervention aimed at improving adherence to asthma medications has the potential to improve quality of life of minority emerging adults with asthma at relatively low cost. It could eventually be integrated into clinical settings and practice to reach a large number of emerging adults with asthma. ClinicalTrials.gov NCT03121157; https://clinicaltrials.gov/ct2/show/NCT03121157 (Archived by WebCite at http://www.webcitation.org/6wq4yWHPv). ©Karen MacDonell, Sylvie Naar, Wanda Gibson-Scipio, Jean-Marie Bruzzese, Bo Wang, Aaron Brody. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.05.2018.

Teenagers and Texting: Use of a Youth Ecological Momentary Assessment System in Trajectory Health Research With Latina Adolescents

PubMed Central

Hardeman, Rachel R; Kwon, Gyu; Lando-King, Elizabeth; Zhang, Lei; Genis, Therese; Brady, Sonya S; Kinder, Elizabeth

2014-01-01

Background Adolescent females send and receive more text messages than any others, with an average of 4050 texts a month. Despite this technological inroad among adolescents, few researchers are utilizing text messaging technology to collect real time, contextualized data. Temporal variables (ie, mood) collected regularly over a period of time could yield useful insights, particularly for evaluating health intervention outcomes. Use of text messaging technology has multiple benefits, including capacity of researchers to immediately act in response to texted information. Objective The objective of our study was to custom build a short messaging service (SMS) or text messaging assessment delivery system for use with adolescents. The Youth Ecological Momentary Assessment System (YEMAS) was developed to collect automated texted reports of daily activities, behaviors, and attitudes among adolescents, and to examine the feasibility of YEMAS. This system was created to collect and transfer real time data about individual- and social-level factors that influence physical, mental, emotional, and social well-being. Methods YEMAS is a custom designed system that interfaces with a cloud-based communication system to automate scheduled delivery of survey questions via text messaging; we designed this university-based system to meet data security and management standards. This was a two-phase study that included development of YEMAS and a feasibility pilot with Latino adolescent females. Relative homogeneity of participants was desired for the feasibility pilot study; adolescent Latina youth were sought because they represent the largest and fastest growing ethnic minority group in the United States. Females were targeted because they demonstrate the highest rate of text messaging and were expected to be interested in participating. Phase I involved development of YEMAS and Phase II involved piloting of the system with Latina adolescents. Girls were eligible to participate if they were attending one of the participating high schools and self-identified as Latina. We contacted 96 adolescents; of these, 24 returned written parental consent forms, completed assent processes, and enrolled in the study. Results YEMAS was collaboratively developed and implemented. Feasibility was established with Latina adolescents (N=24), who responded to four surveys daily for two two-week periods (four weeks total). Each survey had between 12 and 17 questions, with responses including yes/no, Likert scale, and open-ended options. Retention and compliance rates were high, with nearly 18,000 texts provided by the girls over the course of the pilot period. Conclusions Pilot results support the feasibility and value of YEMAS, an automated SMS-based text messaging data collection system positioned within a secure university environment. This approach capitalizes on immediate data transfer protocols and enables the documentation of participants’ thoughts, feelings, and behaviors in real time. Data are collected using mobile devices that are familiar to participants and nearly ubiquitous in developed countries. PMID:25098355

College Smoking-Cessation Using Cell Phone Text Messaging.

ERIC Educational Resources Information Center

Obermayer, Jami L.; Riley, William T.; Jean-Mary, Jersino

2004-01-01

Although rates of smoking among college-aged students continue to rise, few interventions that focus on college smokers' unique motivations and episodic smoking patterns exist. The authors developed and evaluated a prototype program targeting college students that integrates Web and cell phone technologies to deliver a smoking-cessation…

Individualized texting for adherence building (iTAB): improving antiretroviral dose timing among HIV-infected persons with co-occurring bipolar disorder.

PubMed

Moore, David J; Poquette, Amelia; Casaletto, Kaitlin B; Gouaux, Ben; Montoya, Jessica L; Posada, Carolina; Rooney, Alexandra S; Badiee, Jayraan; Deutsch, Reena; Letendre, Scott L; Depp, Colin A; Grant, Igor; Atkinson, J Hampton

2015-03-01

HIV+ persons with co-occurring bipolar disorder (HIV+/BD+) have elevated rates of medication nonadherence. We conducted a 30-day randomized controlled trial of a two-way, text messaging system, iTAB (n = 25), compared to an active comparison (CTRL) (n = 25) to improve antiretroviral (ARV) and psychotropic (PSY) adherence and dose timing. Both groups received medication adherence psychoeducation and daily texts assessing mood. The iTAB group additionally received personalized medication reminder texts. Participants responded to over 90 % of the mood and adherence text messages. Mean adherence, as assessed via electronic monitoring caps, was high and comparable between groups for both ARV (iTAB 86.2 % vs. CTRL 84.8 %; p = 0.95, Cliff's d = 0.01) and PSY (iTAB 78.9 % vs. CTRL 77.3 %; p = 0.43, Cliff's d = -0.13) medications. However, iTAB participants took ARVs significantly closer to their intended dosing time than CTRL participants (iTAB: 27.8 vs. CTRL: 77.0 min from target time; p = 0.02, Cliff's d = 0.37). There was no group difference on PSY dose timing. Text messaging interventions may represent a low-burden approach to improving timeliness of medication-taking behaviors among difficult-to-treat populations. The benefits of improved dose timing for long-term medication adherence require additional investigation.

Individualized Texting for Adherence Building (iTAB): Improving Antiretroviral Dose Timing Among HIV-Infected Persons with Co-occurring Bipolar Disorder

PubMed Central

Poquette, Amelia; Casaletto, Kaitlin B.; Gouaux, Ben; Montoya, Jessica L.; Posada, Carolina; Rooney, Alexandra S.; Badiee, Jayraan; Deutsch, Reena; Letendre, Scott L.; Depp, Colin A.; Grant, Igor; Atkinson, J. Hampton

2015-01-01

HIV+ persons with co-occurring bipolar disorder (HIV+/BD+) have elevated rates of medication nonadherence. We conducted a 30-day randomized controlled trial of a two-way, text messaging system, iTAB (n = 25), compared to an active comparison (CTRL) (n = 25) to improve antiretroviral (ARV) and psychotropic (PSY) adherence and dose timing. Both groups received medication adherence psychoeducation and daily texts assessing mood. The iTAB group additionally received personalized medication reminder texts. Participants responded to over 90 % of the mood and adherence text messages. Mean adherence, as assessed via electronic monitoring caps, was high and comparable between groups for both ARV (iTAB 86.2 % vs. CTRL 84.8 %; p = 0.95, Cliff’s d = 0.01) and PSY (iTAB 78.9 % vs. CTRL 77.3 %; p = 0.43, Cliff’s d = −0.13) medications. However, iTAB participants took ARVs significantly closer to their intended dosing time than CTRL participants (iTAB: 27.8 vs. CTRL: 77.0 min from target time; p = 0.02, Cliff’s d = 0.37). There was no group difference on PSY dose timing. Text messaging interventions may represent a low-burden approach to improving timeliness of medication-taking behaviors among difficult-to-treat populations. The benefits of improved dose timing for long-term medication adherence require additional investigation. PMID:25504449

Babies Living Safe & Smokefree: randomized controlled trial of a multilevel multimodal behavioral intervention to reduce low-income children's tobacco smoke exposure.

PubMed

Collins, Bradley N; Lepore, Stephen J

2017-03-14

Addressing children's tobacco smoke exposure (TSE) remains a public health priority. However, there is low uptake and ineffectiveness of treatment, particularly in low-income populations that face numerous challenges to smoking behavior change. A multilevel intervention combining system-level health messaging and advice about TSE delivered at community clinics that disseminate the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), combined with nicotine replacement and intensive multimodal, individual-level behavioral intervention may improve TSE control efforts in such high-risk populations. This trial uses a randomized two-group design with three measurement points: baseline, 3-month and 12-month follow-up. The primary outcome is bioverified child TSE; the secondary outcome is bioverified maternal quit status. Smoking mothers of children less than 6 years old are recruited from WIC clinics. All participants receive WIC system-level intervention based on the "Ask, Advise, Refer (AAR)" best practices guidelines for pediatrics clinics. It includes training all WIC staff about the importance of maternal tobacco control; and detailing clinics with AAR intervention prompts in routine work flow to remind WIC nutrition counselors to ask all mothers about child TSE, advise about TSE harms and benefits of protection, and refer smokers to cessation services. After receiving the system intervention, mothers are randomized to receive 3 months of additional treatment or an attention control intervention: (1) The multimodal behavioral intervention (MBI) treatment includes telephone counseling sessions about child TSE reduction and smoking cessation, provision of nicotine replacement therapy, a mobile app to support cessation efforts, and multimedia text messages about TSE and smoking cessation; (2) The attention control intervention offers equivalent contact as the MBI and includes nutrition-focused telephone counseling, mobile app, and multimedia text messages about improving nutrition. The control condition also receives a referral to the state smoking cessation quitline. This study tests an innovative community-based, multilevel and integrated multimodal approach to reducing child TSE in a vulnerable, low-income population. The approach is sustainable and has potential for wide reach because WIC can integrate the tobacco intervention prompts into routine workflow and refer smokers to free evidence-based behavioral counseling interventions, such as state quitlines. Clinicaltrials.gov NCT02602288 . Registered 9 November 2015.

Factors associated with patterns of mobile technology use among persons who inject drugs.

PubMed

Collins, Kelly M; Armenta, Richard F; Cuevas-Mota, Jazmine; Liu, Lin; Strathdee, Steffanie A; Garfein, Richard S

2016-01-01

New and innovative methods of delivering interventions are needed to further reduce risky behaviors and increase overall health among persons who inject drugs (PWID). Mobile health (mHealth) interventions have potential for reaching PWID; however, little is known about mobile technology use (MTU) in this population. In this study, the authors identify patterns of MTU and identified factors associated with MTU among a cohort of PWID. Data were collected through a longitudinal cohort study examining drug use, risk behaviors, and health status among PWID in San Diego, California. Latent class analysis (LCA) was used to define patterns of MTU (i.e., making voice calls, text messaging, and mobile Internet access). Multinomial logistic regression was then used to identify demographic characteristics, risk behaviors, and health indicators associated with mobile technology use class. In LCA, a 4-class solution fit the data best. Class 1 was defined by low MTU (22%, n = 100); class 2, by PWID who accessed the Internet using a mobile device but did not use voice or text messaging (20%, n = 95); class 3, by primarily voice, text, and connected Internet use (17%, n = 91); and class 4, by high MTU (41%, n = 175). Compared with low MTU, high MTU class members were more likely to be younger, have higher socioeconomic status, sell drugs, and inject methamphetamine daily. The majority of PWID in San Diego use mobile technology for voice, text, and/or Internet access, indicating that rapid uptake of mHealth interventions may be possible in this population. However, low ownership and use of mobile technology among older and/or homeless individuals will need to be considered when implementing mHealth interventions among PWID.

Systematic review of mobile health behavioural interventions to improve uptake of HIV testing for vulnerable and key populations.

PubMed

Conserve, Donaldson F; Jennings, Larissa; Aguiar, Carolina; Shin, Grace; Handler, Lara; Maman, Suzanne

2017-02-01

Introduction This systematic narrative review examined the empirical evidence on the effectiveness of mobile health (mHealth) behavioural interventions designed to increase the uptake of HIV testing among vulnerable and key populations. Methods MEDLINE/PubMed, Embase, Web of Science, and Global Health electronic databases were searched. Studies were eligible for inclusion if they were published between 2005 and 2015, evaluated an mHealth intervention, and reported an outcome relating to HIV testing. We also reviewed the bibliographies of retrieved studies for other relevant citations. The methodological rigor of selected articles was assessed, and narrative analyses were used to synthesize findings from mixed methodologies. Results A total of seven articles met the inclusion criteria. Most mHealth interventions employed a text-messaging feature and were conducted in middle- and high-income countries. The methodological rigor was moderate among studies. The current literature suggests that mHealth interventions can have significant positive effects on HIV testing initiation among vulnerable and key populations, as well as the general public. In some cases, null results were observed. Qualitative themes relating to the use of mobile technologies to increase HIV testing included the benefits of having low-cost, confidential, and motivational communication. Reported barriers included cellular network restrictions, poor linkages with physical testing services, and limited knowledge of appropriate text-messaging dose. Discussion MHealth interventions may prove beneficial in reducing the proportion of undiagnosed persons living with HIV, particularly among vulnerable and key populations. However, more rigorous and tailored interventions are needed to assess the effectiveness of widespread use.

Systematic review of mobile-health behavioral interventions to improve uptake of HIV testing for vulnerable and key populations

PubMed Central

Conserve, Donaldson F.; Jennings, Larissa; Aguiar, Carolina; Shin, Grace; Handler, Lara; Maman, Suzanne

2016-01-01

Objective This systematic narrative review examined the empirical evidence on the effectiveness of mobile health (mHealth) behavioral interventions designed to increase uptake of HIV testing among vulnerable and key populations. Methods MEDLINE/PubMed, Embase, Web of Science, and Global Health electronic databases were searched. Studies were eligible for inclusion if they were published between 2005 and 2015, evaluated an mHealth intervention, and reported an outcome relating to HIV testing. We also reviewed the bibliographies of retrieved studies for other relevant citations. The methodological rigor of selected articles was assessed, and narrative analyses were used to synthesize findings from mixed methodologies. Results A total of seven articles met the inclusion criteria. Most mHealth interventions employed a text-messaging feature and were conducted in middle- and high-income countries. The methodological rigor was moderate among studies. The current literature suggests that mHealth interventions can have significant positive effects on HIV testing initiation among vulnerable and key populations, as well as the general public. In some cases, null results were observed. Qualitative themes relating to use of mobile technologies to increase HIV testing included the benefits of having low-cost, confidential, and motivational communication. Reported barriers included cellular network restrictions, poor linkages with physical testing services, and limited knowledge of appropriate text-messaging dose. Conclusions MHealth interventions may prove beneficial in reducing the proportion of undiagnosed persons living with HIV, particularly among vulnerable and key populations. However, more rigorous and tailored intervention trials are needed to assess the effectiveness of widespread use. PMID:27056905

The efficacy of motivational counselling and SMS reminders on daily sitting time in patients with rheumatoid arthritis: a randomised controlled trial.

PubMed

Thomsen, Tanja; Aadahl, Mette; Beyer, Nina; Hetland, Merete Lund; Løppenthin, Katrine; Midtgaard, Julie; Christensen, Robin; Østergaard, Mikkel; Jennum, Poul Jørgen; Esbensen, Bente Appel

2017-09-01

The aim of this report is to investigate the efficacy of an individually tailored, theory-based behavioural intervention for reducing daily sitting time, pain and fatigue, as well as improving health-related quality of life, general self-efficacy, physical function and cardiometabolic biomarkers in patients with rheumatoid arthritis (RA). In this randomised controlled trial 150 patients with RA were randomised to an intervention or a no-intervention control group. The intervention group received three individual motivational counselling sessions and short message service or text messages aimed at reduction of sedentary behaviour during the 16-week intervention period. Primary outcome was change in daily sitting time measured objectively by ActivPAL. Secondary outcomes included change in pain, fatigue, physical function, general self-efficacy, quality of life, blood pressure, blood lipids, haemoglobin A1c, body weight, body mass index, waist circumference and waist-hip ratio. 75 patients were allocated to each group. Mean reduction in daily sitting time was -1.61 hours/day in the intervention versus 0.59 hours/day increase in the control group between-group difference -2.20 (95% CI -2.72 to -1.69; p<0.0001) hours/day in favour of the intervention group. Most of the secondary outcomes were also in favour of the intervention. An individually tailored, behavioural intervention reduced daily sitting time in patients with RA and improved patient-reported outcomes and cholesterol levels. NCT01969604; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of social and technological distraction on pedestrian crossing behaviour: an observational study

PubMed Central

Thompson, Leah L; Rivara, Frederick P; Ayyagari, Rajiv C; Ebel, Beth E

2013-01-01

Objectives The objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians. Methods Pedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site. Results Observers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians. Conclusions Distracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury. PMID:23243104

The connecting health and technology study: a 6-month randomized controlled trial to improve nutrition behaviours using a mobile food record and text messaging support in young adults.

PubMed

Kerr, Deborah A; Harray, Amelia J; Pollard, Christina M; Dhaliwal, Satvinder S; Delp, Edward J; Howat, Peter A; Pickering, Mark R; Ahmad, Ziad; Meng, Xingqiong; Pratt, Iain S; Wright, Janine L; Kerr, Katherine R; Boushey, Carol J

2016-04-21

Early adulthood represents the transition to independent living which is a period when changes in diet and body weight are likely to occur. This presents an ideal time for health interventions to reduce the effect of health problems and risk factors for chronic disease in later life. As young adults are high users of mobile devices, interventions that use this technology may improve engagement. The Connecting Health and Technology study aimed to evaluate the effectiveness of tailored dietary feedback and weekly text messaging to improve dietary intake of fruit, vegetables and junk food over 6 months among a population-based sample of men and women (aged 18-30 years). A three-arm, parallel, randomized control trial was conducted. After baseline assessments, participants were randomized to one of three groups: A) dietary feedback and weekly text messages, B) dietary feedback only or C) control group. Dietary intake was assessed using a mobile food record App (mFR) where participants captured images of foods and beverages consumed over 4-days at baseline and post-intervention. The primary outcomes were changes in serves of fruits, vegetables, energy-dense nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSB). The intervention effects were assessed using linear mixed effect models for change in food group serves. Young adults (n = 247) were randomized to group A (n = 82), group B (n = 83), or group C (n = 82). Overall, no changes in food group serves for either intervention groups were observed. An unanticipated outcome was a mean weight reduction of 1.7 kg (P = .02) among the dietary feedback only. Men who received dietary feedback only, significantly reduced their serves of EDNP foods by a mean of 1.4 serves/day (P = .02). Women who received dietary feedback only significantly reduced their intake of SSB (P = .04) by an average of 0.2 serves/day compared with controls. Tailored dietary feedback only resulted in a decrease in EDNP foods in men and SSB in women, together with a reduction in body weight. Using a mobile food record for dietary assessment and tailored feedback has great potential for future health promotion interventions targeting diet and weight in young adults. Australian Clinical Trials Registry Registration number: ACTRN12612000250831 .

TXT@WORK: pediatric hospitalists and text messaging.

PubMed

Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Steinberger, Erik

2014-07-01

Many studies assess provider-patient communication through text messaging; however, minimal research has addressed communication among physicians. The purpose of this study was to evaluate the use of text messaging by pediatric hospitalists. A brief, anonymous, electronic survey was distributed through the American Academy of Pediatrics Section on Hospital Medicine Listserv in February 2012. Survey questions assessed work-related text messaging. Of the 106 pediatric hospitalist respondents, 97 met inclusion criteria. Most were female (73%) and had been in practice <10 years (67%). Ninety-one percent of responders used a smartphone. More than half sent (60%) and received (61%) work-related text messages, some (12%) more than 10 times per shift. More than half (53%) received work-related text messages when not at work. When asked to identify all potential work recipients, most often sent work-related text messages to other pediatric hospitalists (64%), fellows or resident physicians (37%), and subspecialists/consulting physicians (28%). When asked their preferred mode for brief communication, respondents' preferences varied. Many (46%) respondents worried privacy laws can be violated by sending/receiving text messages, and some (30%) reported having received protected health information (PHI) through text messages. However, only 11% reported their institution offered encryption software for text messaging. Physicians were using text messaging as a means of brief, work-related communication. Concerns arose regarding transfer of PHI using unsecure systems and work-life balance. Future research should examine accuracy and effectiveness of text message communication in the hospital, as well as patient privacy issues.

A Web-Based, Computer-Tailored Smoking Prevention Program to Prevent Children From Starting to Smoke After Transferring to Secondary School: Randomized Controlled Trial

PubMed Central

Mercken, Liesbeth; Candel, Math; de Vries, Hein; Oenema, Anke

2015-01-01

Background Smoking prevalence rates among Dutch children increase rapidly after they transit to secondary school, in particular among children with a low socioeconomic status (SES). Web-based, computer-tailored programs supplemented with prompt messages may be able to empower children to prevent them from starting to smoke when they transit to secondary school. Objective The main aim of this study is to evaluate whether computer-tailored feedback messages, with and without prompt messages, are effective in decreasing children’s smoking intentions and smoking behavior after 12 and 25 months of follow-up. Methods Data were gathered at baseline (T0), and after 12 months (T1) and 25 months (T2) of follow-up of a smoking prevention intervention program called Fun without Smokes. A total of 162 schools were randomly allocated to a no-intervention control group, an intervention prompt group, or an intervention no-prompt group. A total of 3213 children aged 10 to 12 years old participated in the study and completed a Web-based questionnaire assessing their smoking intention, smoking behavior, and sociocognitive factors, such as attitude, social influence, and self-efficacy, related to smoking. After completion, children in the intervention groups received computer-tailored feedback messages in their own email inbox and those messages could be accessed on the intervention website. Children in the prompt group received prompt messages, via email and short message service (SMS) text messaging, to stimulate them to reuse the intervention website with nonsmoking content. Multilevel logistic regression analyses were performed using multiple imputations to assess the program effects on smoking intention and smoking behavior at T1 and T2. Results A total of 3213 children participated in the Fun without Smokes study at T0. Between T0 and T1 a total of 1067 children out of the original 3213 (33.21%) dropped out of the study. Between T0 and T2 the number of children that did not participate in the final measurement was 1730 out of the original 3213 (53.84%). No significant program effects were observed for any of the intervention groups compared to the control group at T1 for the intention to engage in smoking—prompt, OR 0.67 (95% CI 0.30-1.50), no-prompt, OR 0.76 (95% CI 0.34-1.67)—or for smoking behavior—prompt, OR 1.13 (95% CI 0.13-9.98), no-prompt, OR 0.50 (95% CI 0.04-5.59). Similar nonsignificant program effects were found at T2 for the intention to start smoking—prompt, OR 0.78 (95% CI 0.26-2.32), no-prompt, OR 1.31 (95% CI 0.45-3.82)—and smoking behavior—prompt, OR 0.53 (95% CI 0.12-2.47), no-prompt, OR 1.01 (95% CI 0.24-4.21). Conclusions This study showed that the Web-based, computer-tailored feedback messages with and without prompt messages were not effective in modifying children’s smoking intentions and smoking behavior as compared to no information. Future smoking prevention interventions are recommended to start closer to the age of actual smoking uptake. Furthermore, future studies on Web-based, computer-tailored smoking prevention programs should focus on assessing and controlling exposure to the educational content and the response to the prompt messages. Trial Registration Netherlands Trial Register NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI). PMID:25759248

Completeness of Human Papilloma Virus Vaccination: A Systematic Review.

PubMed

Kang, Hee Sun; De Gagne, Jennie C; Son, Ye Dong; Chae, Sun-Mi

It has been reported that some adolescents and young women who started taking human papillomavirus (HPV) vaccination are not completing all three doses. The aim of this study was to systematically review intervention studies on HPV vaccination completion. Intervention studies with a comparison group that assessed HPV vaccination completion rate as the primary outcome variable in adolescents and adults younger than 26years of age, and published in English from 2006 to 2016, were eligible for review. Five studies from a literature search of CINAHL, EMBASE, PsycARTICLES, PubMed, SCOPUS, and Web of Science databases were included in this review. The overall quality of the reviewed studies was moderate, and the studies have mainly been conducted in a high-income country. Intervention strategies were DVD-based education on HPV and reminders that were delivered via either electronic or non-electronic methods. Some studies used fixed type of electronic reminders. Others chose preference-based electronic reminders, allowing participants to select one or two delivery options from e-mail, text message, automated telephone message, or Facebook message. Non-electronic reminders were letters sent by standard mail. The rates of HPV vaccination completeness increased with the interventions. However, the completeness rate of HPV vaccination remained unsatisfactory and lower than its initiation rate. Educational and reminder interventions for HPV vaccination could contribute to HPV vaccination completion. However, this review highlights the need for more high-quality studies to identify the best way to promote vaccination completion. Copyright © 2017 Elsevier Inc. All rights reserved.

Patient-clinician mobile communication: analyzing text messaging between adolescents with asthma and nurse case managers.

PubMed

Yoo, Woohyun; Kim, Soo Yun; Hong, Yangsun; Chih, Ming-Yuan; Shah, Dhavan V; Gustafson, David H

2015-01-01

With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient-clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. Mobile texting messaging has the potential to play an important role in patient-clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication.

Understanding text-based persuasion and support tactics of concerned significant others

PubMed Central

van Stolk-Cooke, Katherine; Hayes, Marie; Baumel, Amit

2015-01-01

The behavior of concerned significant others (CSOs) can have a measurable impact on the health and wellness of individuals attempting to meet behavioral and health goals, and research is needed to better understand the attributes of text-based CSO language when encouraging target significant others (TSOs) to achieve those goals. In an effort to inform the development of interventions for CSOs, this study examined the language content of brief text-based messages generated by CSOs to motivate TSOs to achieve a behavioral goal. CSOs generated brief text-based messages for TSOs for three scenarios: (1) to help TSOs achieve the goal, (2) in the event that the TSO is struggling to meet the goal, and (3) in the event that the TSO has given up on meeting the goal. Results indicate that there was a significant relationship between the tone and compassion of messages generated by CSOs, the CSOs’ perceptions of TSO motivation, and their expectation of a grateful or annoyed reaction by the TSO to their feedback or support. Results underscore the importance of attending to patterns in language when CSOs communicate with TSOs about goal achievement or failure, and how certain variables in the CSOs’ perceptions of their TSOs affect these characteristics. PMID:26312172

Baseline Motivation Type as a Predictor of Dropout in a Healthy Eating Text Messaging Program.

PubMed

Coa, Kisha; Patrick, Heather

2016-09-29

Growing evidence suggests that text messaging programs are effective in facilitating health behavior change. However, high dropout rates limit the potential effectiveness of these programs. This paper describes patterns of early dropout in the HealthyYou text (HYTxt) program, with a focus on the impact of baseline motivation quality on dropout, as characterized by Self-Determination Theory (SDT). This analysis included 193 users of HYTxt, a diet and physical activity text messaging intervention developed by the US National Cancer Institute. Descriptive statistics were computed, and logistic regression models were run to examine the association between baseline motivation type and early program dropout. Overall, 43.0% (83/193) of users dropped out of the program; of these, 65.1% (54/83; 28.0% of all users) did so within the first 2 weeks. Users with higher autonomous motivation had significantly lower odds of dropping out within the first 2 weeks. A one unit increase in autonomous motivation was associated with lower odds (odds ratio 0.44, 95% CI 0.24-0.81) of early dropout, which persisted after adjusting for level of controlled motivation. Applying SDT-based strategies to enhance autonomous motivation might reduce early dropout rates, which can improve program exposure and effectiveness.

Reading text while driving: understanding drivers' strategic and tactical adaptation to distraction.

PubMed

Liang, Yulan; Horrey, William J; Hoffman, Joshua D

2015-03-01

In this study, we investigated how drivers adapt secondary-task initiation and time-sharing behavior when faced with fluctuating driving demands. Reading text while driving is particularly detrimental; however, in real-world driving, drivers actively decide when to perform the task. In a test track experiment, participants were free to decide when to read messages while driving along a straight road consisting of an area with increased driving demands (demand zone) followed by an area with low demands. A message was made available shortly before the vehicle entered the demand zone. We manipulated the type of driving demands (baseline, narrow lane, pace clock, combined), message format (no message, paragraph, parsed), and the distance from the demand zone when the message was available (near, far). In all conditions, drivers started reading messages (drivers' first glance to the display) before entering or before leaving the demand zone but tended to wait longer when faced with increased driving demands. While reading messages, drivers looked more or less off road, depending on types of driving demands. For task initiation, drivers avoid transitions from low to high demands; however, they are not discouraged when driving demands are already elevated. Drivers adjust time-sharing behavior according to driving demands while performing secondary tasks. Nonetheless, such adjustment may be less effective when total demands are high. This study helps us to understand a driver's role as an active controller in the context of distracted driving and provides insights for developing distraction interventions. © 2014, Human Factors and Ergonomics Society.

Efficacy of a technology-based, integrated smoking cessation and alcohol intervention for smoking cessation in adolescents: Results of a cluster-randomised controlled trial.

PubMed

Haug, Severin; Paz Castro, Raquel; Kowatsch, Tobias; Filler, Andreas; Schaub, Michael P

2017-11-01

To test the efficacy of a technology-based integrated smoking cessation and alcohol intervention versus a smoking cessation only intervention in adolescents. This was a two-arm, parallel-group, cluster-randomised controlled trial with assessments at baseline and six months follow-up. Subjects in both groups received tailored mobile phone text messages to support smoking cessation for 3months, and the option of registering for a program incorporating strategies for smoking cessation centred around a self-defined quit date. Subjects in the integrated intervention group also received tailored feedback regarding their consumption of alcohol and, for binge drinkers, tailored mobile phone text messages encouraging them to maintain their drinking within low-risk limits over a 3-month period. Primary outcome measures were the 7-day point prevalence of smoking abstinence and change in cigarette consumption. In 360 Swiss vocational and upper secondary school classes, 2127 students who smoked tobacco regularly and owned a mobile phone were invited to participate in the study. Of these, 1471 (69.2%) participated and 6-month follow-up data were obtained for 1116 (75.9%). No significant group differences were observed for any of the primary or secondary outcomes. Moderator analyses revealed beneficial intervention effects concerning 7-day smoking abstinence in participants with higher versus lower alcohol consumption. Overall, the integrated smoking cessation and alcohol intervention exhibited no advantages over a smoking cessation only intervention, but it might be more effective for the subgroup of adolescent smokers with higher alcohol consumption. Providing a combined smoking cessation and alcohol intervention might be recommended for adolescent smokers with higher-level alcohol consumption. Copyright © 2017 Elsevier Inc. All rights reserved.

Partnering with middle school students to design text messages about HPV vaccination.

PubMed

Cates, Joan R; Ortiz, Rebecca R; North, Steve; Martin, Amanda; Smith, Richalle; Coyne-Beasley, Tamera

2015-03-01

Human papillomavirus (HPV) vaccination is routinely recommended for U.S. adolescents ages 11 to 12 years, yet vaccine coverage remains low. Text message HPV immunization reminders to parents have been effective with increasing uptake, but text messages directly to adolescents in order to increase HPV vaccination uptake are unknown. The purpose of this study was to examine the acceptability of text messages about HPV vaccination and message preferences among adolescents. Middle school students (n = 43) assisted in designing text messages to promote HPV vaccine among their peers. Through seven focus groups and two in-class surveys, we assessed students' knowledge of HPV vaccine, use of texting, and preferences for text messages and sources. The average age of participants was 13 years, and all were White (17 males, 26 females) in this rural setting. More than 70% used text messaging with a cell phone. The text message with the best composite score (M = 2.33, SD = 0.72) for likeability, trustworthiness, and motivation to seek more information was a gain frame emphasizing reduction in HPV infection if vaccinated against HPV. Text messages with lower scores emphasized threats of disease if not vaccinated. Participants (68%) preferred doctors as their information source. Text messaging to adolescents may be a strategy to improve HPV knowledge and vaccination. © 2014 Society for Public Health Education.

Adolescents’ Text Message Communication and Growth in Antisocial Behavior across the First Year of High School

PubMed Central

Ehrenreich, Samuel E.; Underwood, Marion K.; Ackerman, Robert A.

2013-01-01

This study examined whether adolescents communicate about antisocial topics and behaviors via text messaging and how adolescents’ antisocial text message communication relates to growth in rule-breaking and aggression as reported by youth, parents, and teachers. Participants (n = 172; 82 girls) received BlackBerry devices configured to capture all text messages sent and received. Four days of text messages during the 9th grade year were coded for discussion of antisocial activities. The majority of participants engaged in at least some antisocial text message communication. Text messaging about antisocial activities significantly predicted increases in parent, teacher, and self-reports of adolescents’ rule-breaking behavior, as well as teacher and self-reports of adolescents’ aggressive behavior. Text message communication may provide instrumental information about how to engage in antisocial behavior and reinforce these behaviors as normative within the peer group. PMID:24014161

Can mobile phone multimedia messages and text messages improve clinic attendance for Aboriginal children with chronic otitis media? A randomised controlled trial.

PubMed

Phillips, James H; Wigger, Christine; Beissbarth, Jemima; McCallum, Gabrielle B; Leach, Amanda; Morris, Peter S

2014-05-01

Does phone multimedia messages (MMS) to families of Indigenous children with tympanic membrane perforation (TMP): (i) increase clinic attendance; (ii) improve ear health; and (iii) provide a culturally appropriate method of health promotion? Fifty-three Australian Aboriginal children with a TMP living in remote community households with a mobile phone were randomised into intervention (n = 30) and control (n = 23) groups. MMS health messages in local languages were sent to the intervention group over 6 weeks. there was no significant difference in clinic attendance, with 1.3 clinic visits per child in both groups (mean difference -0.1; 95% confidence interval (CI) -1.1, 0.9; P = 0.9). (i) there was no significant change in healed perforation (risk difference 6%; 95% CI -10, 20; P = 0.6), middle ear discharge (risk difference -1%; 95% CI -30, 30; P = 1.0) or perforation size (mean difference 3%; 95% CI -11, 17; P = 0.7) between the groups; (ii) 84% (95% CI 60, 90) in the control and 70% (95% CI 50, 80) in the intervention group were happy to receive MMS health messages in the future. The difference was not significant (risk difference -14%; 95% CI -37, 8; P = 0.3). Although there was no improvement in clinic attendance or ear health, this randomised controlled trial of MMS in Indigenous languages demonstrated that MMS is a culturally appropriate form of health promotion. Mobile phones may enhance management of chronic disease in remote and disadvantaged populations. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

A Technology-Based Peer Education Intervention: Results from a Sexual Health Textline Feasibility Study

ERIC Educational Resources Information Center

O'Malley, Teagen L.; Horowitz, Katie Rose; Garth, José; Mair, Christina; Burke, Jessica G.

2017-01-01

Sexuality health education is moving beyond the classroom, with technology expanding youth access to sexual health information. While text message services are increasingly being used to provide information, a peer education approach has yet to be incorporated. Results from this feasibility study support a sexual health textline (IOTAS),…

School Counselors and the Cyberbully: Interventions and Implications

ERIC Educational Resources Information Center

Chibbaro, Julia S.

2007-01-01

Cyberbullying, the act of using technologies such as e-mails, cell phones, or text messaging with the intent of causing harm to others, is akin to traditional bullying in many aspects. This article offers a review of the current literature on the topic of cyberbullying, a comparison of traditional bullying and cyberbullying and suggestions for…

A randomized controlled trial of soap opera videos streamed to smartphones to reduce risk of sexually transmitted human immunodeficiency virus (HIV) in young urban African American women.

PubMed

Jones, Rachel; Hoover, Donald R; Lacroix, Lorraine J

2013-01-01

Love, Sex, and Choices (LSC) is a soap opera video series created to reduce HIV sex risk in women. LSC was compared to text messages in a randomized trial in 238 high-risk mostly Black young urban women. 117 received 12-weekly LSC videos, 121 received 12-weekly HIV prevention messages on smartphones. Changes in unprotected sex with high risk partners were compared by mixed models. Unprotected sex with high risk men significantly declined over 6 months post-intervention for both arms, from 21-22 acts to 5-6 (p < 0.001). This reduction was 18 % greater in the video over the text arm, though this difference was not statistically significant. However, the LSC was highly popular and viewers wanted the series to continue. This is the first study to report streaming soap opera video episodes to reduce HIV risk on smartphones. LSC holds promise as an Internet intervention that could be scaled-up and combined with HIV testing. Copyright © 2013 Elsevier Inc. All rights reserved.

Taking care of suicidal patients with new technologies and reaching-out means in the post-discharge period

PubMed Central

Falcone, Giulia; Nardella, Adele; Lamis, Dorian A; Erbuto, Denise; Girardi, Paolo; Pompili, Maurizio

2017-01-01

Suicide is a global public health problem with over one million people dying by suicide each year worldwide. Research efforts have focused on developing and testing novel suicide prevention strategies employing recent technological advances. In order to provide a review regarding the role of new technologies (e.g., postcards/letters, text messages, crisis cards, telephone contacts, online interventions) in suicide prevention, we searched PubMed, ScienceDirect, ResearchGate, and Crisis to identify all papers in English from 1977 to 2016. Our results indicated that brief contact interventions show promise in reducing the number of episodes of repeated self-harm and/or suicide attempts following discharge from the Emergency Department or psychiatric units. Innovative methods of contact (e.g., text messages) are easily implemented by clinicians and received by patients in the period of post discharge and have been shown to be beneficial. However, more research employing randomized clinical trials investigating the potential benefits of these novel suicide prevention methods is warranted. Future researchers should continue improving and testing new technologies in the prevention of suicide. PMID:29043154

Social media messaging in pregnancy: comparing content of Text4baby to content of free smart phone applications of pregnancy.

PubMed

Lewkowitz, Adam K; O'Donnell, Betsy E; Nakagawa, Sanae; Vargas, Juan E; Zlatnik, Marya G

2016-03-01

Text4baby is the only free text-message program for pregnancy available. Our objective was to determine whether content differed between Text4baby and popular pregnancy smart phone applications (apps). Researchers enrolled in Text4baby in 2012 and downloaded the four most-popular free pregnancy smart phone apps in July 2013; content was re-extracted in February 2014. Messages were assigned thematic codes. Two researchers coded messages independently before reviewing all the codes jointly to ensure consistency. Logistic regression modeling determined statistical differences between Text4baby and smart phone apps. About 1399 messages were delivered. Of these, 333 messages had content related to more than one theme and were coded as such, resulting in 1820 codes analyzed. Compared to smart phone apps, Text4baby was significantly more likely to have content regarding Postpartum Planning, Seeking Care, Recruitment and Prevention and significantly less likely to mention Normal Pregnancy Symptoms. No messaging program included content regarding postpartum contraception. To improve content without increasing text message number, Text4baby could replace messages on recruitment with messages regarding normal pregnancy symptoms, fetal development and postpartum contraception.

The BlackBerry Project: The Hidden World of Adolescents’ Text Messaging and Relations With Internalizing Symptoms

PubMed Central

Underwood, Marion K.; Ehrenreich, Samuel E.; More, David; Solis, Jerome S.; Brinkley, Dawn Y.

2013-01-01

In this naturalistic study of adolescents’ text messaging, participants (N = 172, 81 girls, age 14) were given BlackBerry devices configured to save their text messages to a secure archive for coding. Two, 2-day transcripts collected four months apart within the same academic year were microcoded for content. Results showed that most text message utterances were positive or neutral, and that adolescents sent text messages primarily to peers and to romantic partners. Only a few sex differences emerged. Frequency of text messages containing negative talk positively predicted overall internalizing symptoms and anxious depression. Text messaging about sex was positively associated with overall internalizing and somatic complaints for girls, but not for boys. PMID:25750494