Study Shows Text Message-Based Health Interventions Are Working

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With the coming of the Apple Watch and all its myriad health-tracking features, along with the dozens of models of other fitness trackers on the market, our collective eyes are focused on the intersection of health and technology. Luckily, a new review of existing studies indicates that tech can have a real impact on people’s health: although in a format that may not get as much attention as it should. The study found that interactions with the old standby SMS text message can be remarkably effective in getting people on the right track.

Published in the Annual Review of Public Health, the new work is a “review of reviews,” which means that it’s an overall analysis of many other studies to get a broad look at the findings on the subject. This particular analysis looks at the newish field of “text messaging interventions,” any of a variety of services that provide text-based health assistance.

There are several different types of text messaging interventions; typically, they’re designed to help address ongoing problems like disease management, weight loss, quitting smoking, and disease prevention. Sometimes they’re automated, non-personalized messages — ”Keep up the good work!” or similar. Sometimes they’re a direct line to a specialist, who can offer real-time coaching or help to a patient. The review found that the latter, more personalized type, is more effective, but that even the automated variety is notably more effective than not using these services at all.

But why text messaging? Surely, with our incredible phones (and wearables), there are more advanced options, with audio and video and interactive functionality. Dan Kamins, CEO of TextMarks, an SMS platform that can be used for health-related topics, sees several strengths in texting that can’t be found in more “advanced” options. For one thing, price. “Text messaging can be received on any mobile phone — you don't need a smartphone or an app to download,” he says. “This helps reach out to a wider audience, including lower income families who may not have access to the Internet or a smartphone.” For another, even those of us with smartphones treat text messaging differently: as we triage the many notifications and alerts our phones get, text messaging tends to be among the most urgent. “98% of texts are opened and read within minutes of receipt,” says Kamins.

Apps, too, can be confusing. “With an app, you have to download it, and then you have to learn how to use all its bells and whistles,” says Christopher G. Fox of Syncresis, a health and tech consultancy firm. “It's a crowded market where many apps do similar things, so it's hard to know as a patient which one is best for you. And the interface is different in every one.”

Fox thinks that, while text messaging is still an excellent tool for the majority of people, the future will bring all kinds of new possibilities. “The next wave of patient reminders will likely be wearables, especially if Apple succeeds in making them a truly mass technology,” he says. “But if you're a care provider, you probably want to invest in something that works for the broadest base of patients who might benefit.” Still, text messaging has been more resistant to change than many other kinds of communication; as chat apps like Gchat, then WhatsApp and Kik, video communications apps like Skype, FaceTime, and broadcasting apps like Meerkat and Periscope all vie for our attention, the humble SMS text is still an integral part of all our phones — just as our health is an important part of our lives.

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