Review: Most text message health interventions were effective

By Aditi Pai
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text message IBM ebolaA majority of published text message interventions between 2009 and 2014 that addressed diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence were effective, according to a systematic review of reviews published in The Annual Review of Public Health.

The review looked at 15 studies that reviewed 228 text message intervention studies addressing health promotion, disease prevention, and chronic disease self management. Study sizes ranged from 10 to 5,800 participants.

When the researchers assessed the reviews by effectiveness, they reported five of the 15 reviews -- focused on a wide range of disease prevention and health promotion topics -- found text messaging interventions had "statistically significant positive effects on health outcomes and/or behaviors". These reviews looked at studies that focused on smoking cessation, physical activity, weight loss, and chronic disease self-management.

Three of the 15 reviews focused on physical activity, diet, and weight loss. One of these reviews reported that six out of 13 studies found a statistically significant clinical outcome. A meta-analysis of these studies found that participants in the study had seven times greater weight loss on average than non-SMS control participants. 

Another review focused on physical activity, diet, and weight loss found that 11 of the 14 reviewed studies reported a decrease in weight. While five of 10 studies reported a reduction in body mass index, three of six studies reported a statistically significant increase in physical activity, and two of three studies found a reduction in blood pressure.

Five reviews focused on medication adherence. One such review included several chronic conditions, for example diabetes, asthma, and HIV/AIDS in its analysis and the text message interventions were tested for medication adherence. This review found that 18 out of 29 studies reported improvements in medication adherence rates, but 11 studies reported no differences. According to the researchers, the authors of this review added that many of the 11 studies that reported no differences used "basic and repetitive SMS content", while other studies that had positive outcomes used "varied and motivational content".

And one of the 15 reviews analyzed effects of texting on smoking cessation. The review's meta-analysis of five studies -- that included 9,100 participants -- found that mobile phone interventions increased long-term quit rates, when compared with control programs.