Collaborative Design, Development and Implementation of the Txt4health Service

Background:

The txt4health campaign is part of the Beacon Community Cooperative Agreement Program, an ONC grant program for communities to build and strengthen health information technology infrastructure to support clinical quality improvement and population health goals. Crescent City, Southeast Michigan, and Greater Cincinnati are each leveraging local resources and partnerships to tailor the campaign to meet the needs of their specific population.

Program background: In January 2012, as part of the Federally-funded Beacon Community Program, Txt4Health launched in three communities -- New Orleans, Detroit, and Cincinnati. This new public health campaign and texting service joined in the fight against type 2 diabetes, using texting technology to allow individuals to assess their diabetes risk levels; connect with the care delivery system and the wealth of existing diabetes / wellness resources; and engage with and manage their health. The three Beacon Communities engaged with partners throughout their cities -- and worked closely with the CDC, the DHHS Office of the National Coordinator for Information Technology, the American Diabetes Association, and their technology partner Voxiva -- to roll out major public health campaigns aimed at getting people to “text in” and enroll to the program.

Evaluation Methods and Results: We applied a pre and post campaign population-based evaluation design to assess the effectiveness of the social marketing campaign in raising awareness of the txt4health program in the community. We will present the results of the pre and post surveys conducted in the Greater New Orleans, as well as the enrollment information from the program data that was collected via text messaging, which includes information on the primary objectives of the campaign: raise awareness about type 2 diabetes, encourage participants to set weight loss and physical activity goals, and link participants to local care and resources.

Conclusions: The txt4health campaign is one of the largest population based mobile health program in the U.S. with over 1,700 participants enrolled. Over seventy-five percent (75%) of participants were either obese or overweight; sixty-seven percent (67%) set a weight loss or physical activity goal; and over 50% sought local care and resources at some point during the 14-week intervention. Over thirty percent (30%) of Greater New Orleans residents were aware of the txt4health campaign and core messaging.

Implications for research and/or practice: New strategies and innovations in care are required to stem the increasing burden of chronic diseases such as type 2 diabetes and cardiovascular disease. Effective information technology tools can be used to generate awareness of risk factors for these conditions, and to promote early screening and prevention in the general public. Testing mHealth programs at the population and public health level for conditions like type 2 diabetes is therefore imperative.