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      What's in a message? Delivering sexual health promotion to young people in Australia via text messaging

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          Abstract

          Background

          Advances in communication technologies have dramatically changed how individuals access information and communicate. Recent studies have found that mobile phone text messages (SMS) can be used successfully for short-term behaviour change. However there is no published information examining the acceptability, utility and efficacy of different characteristics of health promotion SMS. This paper presents the results of evaluation focus groups among participants who received twelve sexual health related SMS as part of a study examining the impact of text messaging for sexual health promotion to on young people in Victoria, Australia.

          Methods

          Eight gender-segregated focus groups were held with 21 males and 22 females in August 2008. Transcripts of audio recordings were analysed using thematic analysis. Data were coded under one or more themes.

          Results

          Text messages were viewed as an acceptable and 'personal' means of health promotion, with participants particularly valuing the informal language. There was a preference for messages that were positive, relevant and short and for messages to cover a variety of topics. Participants were more likely to remember and share messages that were funny, rhymed and/or tied into particular annual events. The message broadcasting, generally fortnightly on Friday afternoons, was viewed as appropriate. Participants said the messages provided new information, a reminder of existing information and reduced apprehension about testing for sexually transmitted infections.

          Conclusions

          Mobile phones, in particular SMS, offer health promoters an exciting opportunity to engage personally with a huge number of individuals for low cost. The key elements emerging from this evaluation, such as message style, language and broadcast schedule are directly relevant to future studies using SMS for health promotion, as well as for future health promotion interventions in other mediums that require short formats, such as social networking sites.

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          College smoking-cessation using cell phone text messaging.

          Jami L Obermayer, William Riley, Ofer Asif … (2004)
          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 intervention. To guide the user through the creation and initialization of an individualized quitting program delivered by means of cell phone text messaging, the program uses assessment tools delivered with the program Web site. Forty-six regular smokers were recruited from local colleges and provided access to the program. At 6-week follow-up, 43% had made at least one 24-hour attempt to quit, and 22% were quit--based on a 7-day prevalence criterion. The findings provide support for using wireless text messages to deliver potentially effective smoking-cessation behavioral interventions to college students.
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            Txt2stop: a pilot randomised controlled trial of mobile phone-based smoking cessation support.

            Gary R. Whittaker, Robert Free, Daniel Knight … (2009)
            To conduct a pilot randomised controlled trial of mobile phone-based smoking cessation support intervention for the UK population. Randomised controlled trial (txt2stop). Community. 200 participants responding to radio, poster and leaflet-based promotions regarding the trial. The response rate for the outcome measures planned for the main trial. Participants' qualitative responses to open-ended questions about the intervention content. Secondary outcomes were the outcomes planned for the main trial including the point prevalence of self-reported smoking at 4 weeks and pooled effect estimate for the short-term results for the STOMP and txt2stop trials. The response rate at 4 weeks was 96% and at 6 months was 92%. The results at 4 weeks show a doubling of self-reported quitting relative risk (RR) 2.08 (95% CI 1.11 to 3.89), 26% vs 12%. The pooled effect estimate combining txt2stop and a previous New Zealand trial in the short term is RR 2.18 (95% CI 1.79 to 2.65). Mobile phone-based smoking cessation is an innovative means of delivering smoking cessation support, which doubles the self-reported quit rate in the short term. It could represent an important, but as yet largely unused, medium to deliver age-appropriate public health measures. The long-term effect of this mobile phone-based smoking cessation support will be established by a large randomised controlled trial currently in recruitment.
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              Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring.

              April W. Armstrong, Alice Watson, Maryanne Makredes … (2009)
              To evaluate the effectiveness of cellular telephone text messaging as a reminder tool for improving adherence to sunscreen application. We conducted a randomized, controlled trial of the effect of an electronic text-message reminder system on adherence to sunscreen application. Adherence to daily sunscreen use was evaluated using a novel electronic monitoring device. Participants were recruited from the general community. Seventy participants constituted a volunteer sample from the general community. The inclusion criteria required participants to be 18 years or older, to own a cellular telephone with text-message features, and to know how to retrieve text messages. Intervention Half of the participants received daily text-message reminders via cellular telephone for 6 weeks, and the other half did not receive reminders. The text-message reminders consisted of 2 components: a "hook" text detailing daily local weather information and a "prompt" text reminding users to apply sunscreen. Main Outcome Measure The primary end point of the study was adherence to sunscreen application measured by the number of days participants applied sunscreen during the 6-week study period. All 70 participants completed the 6-week study. There were no statistically significant differences in baseline characteristics between the 2 study groups. At the end of the study period, the 35 participants who did not receive reminders had a mean daily adherence rate of 30.0% (95% confidence interval, 23.1%-36.9%). In comparison, the 35 participants who received daily text-message reminders had a mean daily adherence rate of 56.1% (95% confidence interval, 48.1%-64.1%) (P < .001). Among the participants in the reminder group, 24 (69%) reported that they would keep using the text-message reminders after the study, and 31 (89%) reported that they would recommend the text-message reminder system to others. Subgroup analysis did not reveal any significant demographic factors that predicted adherence. Despite awareness of the benefits of sunscreen, adherence is low, even in this population, for whom adherence was knowingly monitored. Short-term data demonstrate that using existing cellular telephone text-message technology offers an innovative, low-cost, and effective method of improving adherence to sunscreen application. The use of ubiquitous communications technology, such as text messaging, may have implications for large-scale public health initiatives. Trial Registration clinicaltrials.gov Identifier: NCT00535769.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2458
                Publication date Collection: 2010
                Publication date (Electronic): 29 December 2010
                Volume: 10
                Page: 792
                Affiliations
                [1 ]Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia
                [2 ]Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
                [3 ]The Nossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, Australia
                [4 ]Centre for Women's Health, Gender and Society, The University of Melbourne, Melbourne, Victoria, Australia
                Article
                Publisher ID: 1471-2458-10-792
                DOI: 10.1186/1471-2458-10-792
                PMC ID: 3022861
                PubMed ID: 21190584
                SO-VID: 5ebff77a-11d4-40df-8d77-aa007ed7420b
                Copyright © Copyright ©2010 Gold et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 2 September 2010
                Date accepted : 29 December 2010
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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