SMS and Health :   A Systematic Review of the Uses of Mobile Phone Text Messaging  in Chronic Disease Prevention & Managem...
Acknowledgements <ul><li>This work was carried out under an FY10 Independent Research & Development award from RTI Interna...
SMS Statistics <ul><li>Text messaging is the most widely used data application in the world, with 2.4B active users, or 74...
Disease Statistics <ul><li>More than 100M Americans are currently living with at least one chronic health condition.  </li...
WWHI Focus Areas http://www.westwirelesshealth.org/wireless-health/focus-areas-disease-management.html (Accessed 15AUG2010)
Underlying Theories  <ul><li>The process of text messaging itself may complement important constructs (e.g., cues to actio...
Welcome to mHealth <ul><li>Mobile health (mHealth) is the use of mobile phone technology to deliver health care. </li></ul...
Literature Review Methods <ul><li>A list of search terms were informed by an environmental scan of grey literature, includ...
Literature Review Methods <ul><li>The keyword phrases were entered into ISI Web of Science, MEDLINE, Cochrane Library, Psy...
Literature Review Methods <ul><li>The abstract, title, authors, journal name, and publication date were exported into Word...
Summary Findings <ul><li>Existing literature on health applications of SMS for health is mostly exploratory in nature. </l...
Disease prevention & management areas <ul><li>Appointment reminders / adherence  </li></ul><ul><li>Asthma / COPD  </li></u...
Summary Findings <ul><li>Current applications of SMS for health focus on: </li></ul><ul><ul><li>Health information-seeking...
Summary Findings <ul><li>The majority of quantitative studies found evidence of a short-term effect regarding a behavioral...
Summary Findings <ul><li>There are no RCTs assessing the effect of text messaging on medication adherence in diseased popu...
Conclusions <ul><li>Initial results suggest that SMS-delivered interventions have positive short-term behavioral outcomes....
Contact <ul><li>Robert D Furberg, MBA </li></ul><ul><li>Research Programmer / Analyst </li></ul><ul><li>Health Communicati...
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A Systematic Review of the Uses of Mobile Phone Text Messaging in Chronic Disease Prevention & Management

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Delivered at the 2010 CDC National Conference on Health Communication, Marketing, and Media;
Panel session entitled, Examining the Power of Text Messages for Health Promotion and Disease Prevention

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  • A recent PricewaterhouseCoopers analysis determined that productivity losses in workers with chronic disease (such as disability &amp; unplanned absences and inefficiencies) are four times the cost of early treatment.
  • A Systematic Review of the Uses of Mobile Phone Text Messaging in Chronic Disease Prevention & Management

    1. 1. SMS and Health : A Systematic Review of the Uses of Mobile Phone Text Messaging in Chronic Disease Prevention & Management National Conference on Health Communication, Marketing, and Media Examining the Power of Text Messages for Health Promotion and Disease Prevention Session 19 August 2010 Robert D Furberg, MBA Research Programmer / Analyst Health Communication Program RTI International
    2. 2. Acknowledgements <ul><li>This work was carried out under an FY10 Independent Research & Development award from RTI International. </li></ul><ul><li>Design & development of SMS gateway. </li></ul><ul><li>Literature review was carried out to inform design specifications. </li></ul><ul><li>The project team also includes: </li></ul><ul><ul><li>Annice Kim, PhD </li></ul></ul><ul><ul><li>Jennifer Gard, MPH </li></ul></ul><ul><ul><li>Ron Thigpen, MSLS </li></ul></ul><ul><ul><li>Mark Howell, MSLS </li></ul></ul><ul><ul><li>Stacey Weger, MSW </li></ul></ul><ul><ul><li>Nancy Braxton, BA </li></ul></ul>
    3. 3. SMS Statistics <ul><li>Text messaging is the most widely used data application in the world, with 2.4B active users, or 74% of all mobile phone subscribers. </li></ul><ul><li>There are 285.6M wireless subscribers in the United States (91% penetration). Nearly 25% of Americans report being wireless only households. </li></ul><ul><li>1.56T text messages were sent in the United States in 2010. </li></ul><ul><li>152.7B text messages were sent each month. </li></ul>
    4. 4. Disease Statistics <ul><li>More than 100M Americans are currently living with at least one chronic health condition. </li></ul><ul><li>Unlike acute illnesses that may be amenable to short-term intervention, chronic diseases require long-term monitoring and management, lifestyle changes, and adherence to medication regimens that may be inconvenient or produce side effects. </li></ul><ul><li>Chronic diseases account for more than 75% of the $2.3T cost of our healthcare system. </li></ul>
    5. 5. WWHI Focus Areas http://www.westwirelesshealth.org/wireless-health/focus-areas-disease-management.html (Accessed 15AUG2010)
    6. 6. Underlying Theories <ul><li>The process of text messaging itself may complement important constructs (e.g., cues to action, reinforcement, and social support) central to many behavioral theories. </li></ul><ul><li>Text messaging can be used as a means to deliver prevention components based on theoretical models such as the Theory of Planned Behavior and the Health Belief Model. </li></ul>
    7. 7. Welcome to mHealth <ul><li>Mobile health (mHealth) is the use of mobile phone technology to deliver health care. </li></ul><ul><li>Recently, the investigation and application of this technology to public health has emerged as the “the only viable interactive means of reaching people on a massive scale around the world.&quot; (TextMessaging4Health) </li></ul><ul><li>There is a growing body of evidence that demonstrates the potential of mobile communications to radically improve healthcare services, even in some of the most remote and resource-constrained environments. </li></ul>
    8. 8. Literature Review Methods <ul><li>A list of search terms were informed by an environmental scan of grey literature, including key reports, and previous literature reviews on mHealth conducted by RTI staff. </li></ul><ul><li>Final search terms used for the review included: </li></ul><ul><ul><li>“ cell phone” </li></ul></ul><ul><ul><li>“ mobile phone” </li></ul></ul><ul><ul><li>“ text message” </li></ul></ul><ul><ul><li>“ Short Message Service” </li></ul></ul><ul><ul><li>“ SMS” </li></ul></ul><ul><li>All of the search terms were paired with the keyword “health” to narrow the scope of results. </li></ul>
    9. 9. Literature Review Methods <ul><li>The keyword phrases were entered into ISI Web of Science, MEDLINE, Cochrane Library, PsychINFO, and PubMed databases for years 1995 to 2010. </li></ul><ul><li>RTI’s Library & Information Services initially conducted this literature search of the PubMed database on 11/17/09; the search was expanded to include additional sources listed above and repeated on 04/19/2010. </li></ul><ul><li>A total of 203 unique results were retrieved. </li></ul>
    10. 10. Literature Review Methods <ul><li>The abstract, title, authors, journal name, and publication date were exported into Word and EndNote. </li></ul><ul><li>Full-text articles were retrieved for all entries by Library & Information Services. </li></ul><ul><li>Two research associates were oriented to the abstraction form and carried out a controlled review on a standard set of citations to verify results prior to initiating the review. </li></ul>
    11. 11. Summary Findings <ul><li>Existing literature on health applications of SMS for health is mostly exploratory in nature. </li></ul><ul><li>Most researchers use descriptive and qualitative methods to characterize SMS campaigns. </li></ul><ul><li>Several articles describe surveys of subjects with chronic disease and their level of interest in the use SMS. </li></ul><ul><li>Randomized or quasi-experimental controlled trials of interventions for disease prevention or management are rare. </li></ul>
    12. 12. Disease prevention & management areas <ul><li>Appointment reminders / adherence </li></ul><ul><li>Asthma / COPD </li></ul><ul><li>Cardiovascular disease </li></ul><ul><li>Diabetes </li></ul><ul><li>Diet / Nutrition </li></ul><ul><li>HIV / AIDS </li></ul><ul><li>Mental Health </li></ul><ul><li>Review articles </li></ul><ul><li>Sexual / Reproductive health </li></ul><ul><li>Smoking cessation </li></ul><ul><li>“Other” </li></ul>
    13. 13. Summary Findings <ul><li>Current applications of SMS for health focus on: </li></ul><ul><ul><li>Health information-seeking </li></ul></ul><ul><ul><li>Health education / intervention </li></ul></ul><ul><ul><li>Patient support </li></ul></ul><ul><ul><li>Mental health treatment </li></ul></ul><ul><ul><li>Biomedical and public health research </li></ul></ul><ul><ul><li>Patient-provider communication </li></ul></ul><ul><ul><li>Fundraising </li></ul></ul>
    14. 14. Summary Findings <ul><li>The majority of quantitative studies found evidence of a short-term effect regarding a behavioral or clinical outcome related to disease management. </li></ul><ul><li>Evidence for text messaging in disease prevention interventions was observed for weight loss, smoking cessation, and diabetes management. </li></ul>
    15. 15. Summary Findings <ul><li>There are no RCTs assessing the effect of text messaging on medication adherence in diseased populations. </li></ul><ul><li>Nevertheless, several studies of medication adherence interventions show the benefits of medication reminders. </li></ul><ul><li>There is also evidence of the benefits of periodic prompts and reminders as stand-alone interventions for health behavior. </li></ul>
    16. 16. Conclusions <ul><li>Initial results suggest that SMS-delivered interventions have positive short-term behavioral outcomes. </li></ul><ul><li>The increasing uptake of mobile technologies suggests that text messaging may be used to improve existing prevention and management practices. </li></ul><ul><li>The quality of studies in this emerging field of research needs to improve to allow the full potential of this medium to be explored. </li></ul>
    17. 17. Contact <ul><li>Robert D Furberg, MBA </li></ul><ul><li>Research Programmer / Analyst </li></ul><ul><li>Health Communication Program </li></ul><ul><li>RTI International </li></ul><ul><li>tel: 919.316.3726 </li></ul><ul><li>sms: 919.452.8021 </li></ul><ul><li>twitter: @medicfurby </li></ul><ul><li>[email_address] </li></ul>

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