218178 Txt 4 Hlth: A systematic review of SMS-based behavioral interventions for health

Monday, November 8, 2010

Eric R. Buhi, MPH, PhD, CHES , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Alison Oberne, MA, MPH , Center for Health Services Research, Vanderbilt Medical Center, Nashville, TN
Hollie J. Fuhrmann, MA , College of Public Health, University of South Florida, Tampa, FL
Mobile technologies are being widely adopted, on a global scale. Short message service (SMS; text messaging) and multimedia message service (MMS) represent important modalities for mobile communication and health promotion/behavior change interventions (i.e., mobile health/ mhealth initiatives). Our purpose here is to summarize a systematic review of the literature, analyze the efficacy of behavioral mhealth interventions, and examine strengths/weaknesses of this literature. Following the Matrix Method for systematic reviews, we searched 4 databases (MEDLINE, PsycINFO, ISI Web of Knowledge, Google Scholar). For inclusion, studies had to: be published in peer-reviewed, English-language journals; examine use of SMS/MMS alone or alongside other modalities; address health-related behavioral change; and be published before July 2009. The 31 reviewed studies were published in 20 different journals, representing a variety of fields/substantive areas. Most studies centered on diabetes (n=17) or smoking cessation (n=7). Three interventions utilized SMS alone, 15 employed SMS coupled with the Internet, and the remainder relied on SMS, the Internet, and some other technology. Intervention length ranged from 4 weeks to 1 year. Four of five reports did not note utilization of a theoretical framework to guide intervention. Half of studies were conducted under rigorous (i.e., experimental) designs; although, 17 involved very small samples (<50 respondents). Twenty studies were based in Europe or Korea; none took place in Latin America or Africa. Most interventions resulted in statistically significant health behavioral changes. After reviewing the scope and impact of mobile phones as a public health promotion modality, we recommend directions for future mhealth research/practice.

Learning Areas:
Communication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research

Learning Objectives:
1. Describe the characteristics (e.g., health content area, intervention duration) and methodological traits (e.g., use of behavioral theory, study design and sample) of SMS-based health behavior change intervention studies. 2. Identify strengths and weaknesses of the behavioral mhealth intervention literature.

Keywords: Telehealth, Health Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a research interest in the influence of technology on health behavior and the use of new technologies for health behavior change. I have active research projects studying such issues, including: • 2010 – Principal Investigator: A feasibility study and preliminary trial of mobile video messaging in a tobacco use cessation program, American Cancer Society – Institutional Research Grant (ACS-IRG CYCLE 28, FALL 2009) program ($30,000). (Submitted) • 2009-2010 – Principal Investigator: A preliminary study assessing the value of incorporating text messaging into an existing tobacco cessation program, University of South Florida Area Health Education Center (AHEC), Tobacco Training and Cessation Program ($43,000). (Funded) • 2009-2011 – Principal Investigator: Internet sex-seeking behaviors and associated STD risks among youth visiting publicly funded teen health clinics, American Sexually Transmitted Disease Association (ASTDA) Development Award ($118,703). (Funded) • 2008-2009 – Principal Investigator: Seeking out sex online: A novel 3-campus research study of HIV and other sexual health risks among young people, Florida Center for AIDS Research ($15,000). (Funded) • 2008-2009 – Principal Investigator: Formation of on- and off-line sexual relationships: A research study of sexual health risks and college students’ experiences, Foundation for the Scientific Study of Sexuality Grants-in-Aid Program ($1,000). (Funded) • 2007-2008 – Principal Investigator: Finding accurate sexual health information on the Internet: An observational study, University of South Florida Internal Awards Program ($8,789). (Completed) I also have published in this area: Buhi, E. R., Daley, E. M., Oberne, A., Smith, S. A., Schneider, T., & Fuhrmann, H. J. Quality and accuracy of sexual health information websites visited by young people. Journal of Adolescent Health. In press. Buhi, E. R., Daley, E. M., Fuhrmann, H. J., Smith, S. A. (2009). An observational study of how young people search for online sexual health information. Journal of American College Health, 58(2), 101-111.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.