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mHealth – the 4 building blocks for text messaging in Public Health

How do you meet the growing demand for innovative text message integration in public health interventions?

February 25th 2016

The Public Health Strategy and the NHS 5 Year Forward Plan both call for better use of mobile 1st, ‘on-demand’ and digital health interventions to target prevention and incentivise healthy behaviours. But how do you do it?

mHealth – the use of text messaging in health interventions is growing. As discussed in a our previous article, ‘Is mHealth the answer for cash-strapped Public Health?’, it has numerous advantages. But what are the secrets to making it work?

In a recent meta-analysis of text-messaging interventions, De Leon and colleagues (2015) et al identified the most important characteristics to be:

  1. Strategies not education

Most interventions reported delivering educational content, reminders or both. However this type of content was not closely associated with effectiveness in the absence of strategies for behaviour change. Of the 13 studies that reported non-significant results 4 provided health education only, whereas of the 42 that reported significant results only 5 provided education only.

  1. Tailoring of messages

In the meta-analysis conducted by De Leon et al, tailoring featured in 34 of the 55 studies. This ranged from using the participant’s name to tailoring by stage of change or by a patient’s baseline activity. Participants reported a preference for tailored messages, seeing them as more meaningful and/or helpful. A text messaging support system for young people with diabetes, ‘Sweet Talk’, included messages based on patient profiles and diabetes self-management goals. The authors conclude that, “Such personalisation appears fundamental to behavioural support interventions” (Franklin et al, 2008)  

  1. Feedback and support

Feedback was also identified as a factor contributing to the success of interventions. Studies with significant results tended to provide participants with feedback regarding progress in making a given health behavior change. Interventions with prompts delivered less frequently, e.g. on a monthly basis, did better if they included feedback. Bock et al’s participants also indicated that social networking functions and the ability to connect with others on the programme were important for them.

  1. High frequency

Orr and King’s (2015) meta-analysis of random controlled trials of message interventions found that text frequency mediated intervention effectiveness, with multiple messages per day showing a significantly greater effect (g = 0.395) than that of lower doses (g = 0.244)

The evidence for mHealth interventions

In an award-winning programme for Hertfordshire Public Health recognised with an RSPH Health Award in 2015, Do Something Different delivered a range of mHealth programmes that meet all of the criteria above.

Four health programmes with 900 residents showed a high-level of self-reported behaviour change, including:

  • Subjective wellbeing up by 21%
  • Anxiety and depression down significantly, more than 50% moving out of the ‘clinical’ category
  • Physical activity up by 37%
  • Alcohol consumption down by 20%
  • Fruit and veg consumption up by 29%
  • Weight down by an average of 5.8 lbs
  • 50% of people went and visited Herts amenities

View the Full Report

In a smoking cessation pilot with Brighton & Hove CCG, the Do Something Different  mHealth Smoke Free Me programme is achieving 55% quit rates – higher than the NHS average.

Read More

Join our FREE webinar to learn more about mHealth

To learn more, join our 30-minute lunchtime webinar, ‘Changing Health Behaviours in a Digital Age‘, presented by Professor Karen Pine, expert in health and wellbeing behaviour change through mobile technologies.

Wednesday March 9th, 2016
1:00 PM

Register Now