R U Txtng 4 Ur Hlth? 3 Areas Where The ‘Conscience In Your Pocket’ Improves Health Outcomes

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Twenty years ago, people were just a phone call away.  Then voicemail became the most convenient way to reach people.  Subsequently, along came email.  Now, short message service (SMS) “texts” are the best way to reach a great many people with short messages that remind them about healthful behaviors.  Want to learn more?  Well, text me!  (Just kidding.  Seriously, though.  Click through, and let’s take a look at 3 ways this ‘conscience in your pocket’ can improve health outcomes.)

SMS text messages get kind of a bad rap in the popular consciousness, and for some very good reasons.

Text messaging has been implicated with killing direct human interaction.  When was the last time you were out at a restaurant and saw a situation like this:

Of course, not only is SMS text messaging steadily shaping our fundamental social behaviors as humans, there is a justifiably strong emphasis on making sure people use SMS text messaging at appropriate times:


Against this societal backdrop, how could SMS text messaging possibly be the health-related ‘conscience’ that promotes beneficial health behavior changes and social health equity?  Here are 3 examples of real-life text messaging campaigns that work.  Because, science!

1. SMS text messages reduce obesity.  Patrick and colleagues conducted a randomized clinical trial to assess the effect of SMS text messaging on weight loss in overweight adults.  Sixty-five overweight men and women were randomized to receive either printed media (received monthly) or SMS text messaging (2 to 5 times daily).  The primary outcome measure was body weight, which was assessed at enrollment into the study and again after 16 weeks of intervention.  At 16 weeks, the subjects who received SMS text messages lost approximately 5 more pounds than the printed media group.  The difference was statistically significant, controlling for age, gender, and baseline weight.  The clinical relevance of this difference can be debated, although these results indicate a potentially favorable effect of massed daily SMS communication over less frequent printed media.  Simple messages can go a long way…

2. SMS text messages improve sexual health literacy.  Lim and colleagues compared the effect of SMS text messages and email regarding sexual health topics and no intervention  in 994 people aged 16-29 years.  Subjects randomized to receive SMS and email messages received about 1 SMS text message per month and less frequent emails.  Outcome measures included the frequency of various self-reported sexual behaviors at 3, 6. and 12 months following enrollment into the study.  STI knowledge was significantly higher in women and men in the SMS group compared to the control group by the end of the study.  Women in the SMS group were more likely than women in the control group to report receiving a test for sexually transmitted infection or discussing sexual health with a clinician, but men in the SMS group were no more likely than men in the control group.  These results indicate a potential benefit on sexual health literacy of a combined approach to mobile communication.  The apparent difference in genders to the intervention suggests the need for further study to optimize gender-specific mobile communication.  And it avoids the need for you to seek advice from people whom you potentially would rather not find out…

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3. SMS text messages improve self-management of diabetes mellitus.  A number of studies have been conducted that assess the effect of SMS text message programs on the frequency of self-management behaviors in chronic diseases.  Diabetes mellitus is one health condition that has been among the most widely studied.  After six months of SMS text messaging, a study conducted by a group at the University of Chicago demonstrated that patients with diabetes showed improved glycemic control and an 8.8% reduction in health care costs.  An automated SMS text message program for low-income, urban Latinos with diabetes was more effective when it cued specific behaviors, such as medication reminders or challenged the patient to take a specific action than general texts.  Text messages aimed at health behavior changes were also effective in preventing Type 2 diabetes in a cohort of at-risk men in southwest India.  In this population, concise communication from that ‘conscience in your pocket’ appears to contribute to better health behaviors and outcomes…


tl;dr: txtng 4 ur hlth is gud 4 u!

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4 thoughts on “R U Txtng 4 Ur Hlth? 3 Areas Where The ‘Conscience In Your Pocket’ Improves Health Outcomes

  1. This was an incredibly well written post that I thoroughly enjoyed reading. You do a great job of including your own voice and personality, which draws the reader in. In addition to that you then use excellent examples showing your reader exactly what your talking about. You also do a great job of providing your reader with great resources through the hyperlinks that you provide. Not to mention that your title really draws the reader in, well it sure did with me. One way to strengthen your great post would be to pull it all together with a final statement bringing it back to the public health professional. I am not sure if you have control of this or not ( I have not been able to figure it out), but maybe formatting the pictures a little differently. Overall, I have really enjoyed reading all your posts!

  2. Thanks for summarizing 3 effective mobile health campaigns that you came across! It does seem to make intuitive sense that simple reminders throughout the day with specific actionable items or reminders can make a difference. With all of the focus on how sitting is the new smoking, I wonder if there is room for a mobile campaign to remind people to get up at regular intervals and do specific stretches, etc. I agree with Brianna, that your post would benefit from a concluding statement that wraps everything all up. I also think reflecting more on your personal experiences might help the reader connect to you a little more. Great job!

    • Thanks, Jersey. Great example to consider sitting. Yes, I think you’re right there may be a good link between a text campaign and sitting for the reasons you mentioned. I’ll continue to work on a strong concluding statement and bringing more personal experience into my posts. I have to say, though, that most of these things I’ve explored this semester are very new to me (dinosaur alert!), so personal experience is lacking. That said, I will try to reflect a little more on the experience I gather throughout the week. Thanks for the great feedback throughout the course. I’m grateful for the chance to be pushed to get better on all this new stuff.

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