Txt2Change: A Case Study of Using Text Messaging to Improve Health Behaviors

Theoretical Background and research questions/hypothesis: With more than 270 million Americans (or 87% of U.S. population) owning mobile devices, text messaging provides a way to communicate immediately with users in times of emergencies (hurricanes, earthquakes, etc.), reaching users who may not have access to traditional communication channels. Text messages are also a critical outlet to reach underserved audiences.  In fact, research shows that persons in cell-phone-only households have higher rates of binge drinking or excess alcohol consumption, are more likely to smoke, less likely to have had a flu shot in the last year, less likely to be tested for HIV, and less likely to have a usual place to go for medical care, etc.    

Methods: In September 2009, CDC launched a text messaging pilot to reach users with important health messages.  With more than 15,000 subscribers, CDC felt it was critical to evaluate the effectiveness of the messages in communicating vital health information and the potential of this technology to change subscribers’ health behaviors. 

 In March 2010, CDC conducted an evaluation of the text messaging pilot.  More than 230 subscribers completed the evaluation.

Results:  Key findings include:

• 71% of respondents stated that they were satisfied or very satisfied with the text messages
• 91% said the messages were easy to understand, 90% said they were credible, 89% said they were friendly, and 70% said they provided helpful information to improve my health
• 62% of respondents said that they had used the information in the text messages to improve their health. 

Conclusions: This widespread reach of mobile technologies provides a tremendous opportunity for the Centers for Disease Control and Prevention (CDC) to develop innovative text messaging programs to address important health issues such as smoking cessation, nutrition & physical activity awareness, STD information, H1N1 Flu, food outbreaks, etc.

Implications for research and/or practice:  Not only are text messages an excellent way to reach users in times of emergencies, but the technology also affords an opportunity to communicate with underserved audiences who may not have access to a the Internet.  Since mobile phones are with arm’s reach approximately 19 hours a day, text messages provide a unique opportunity to provide health information to users when and when they need it.