insights into the success of text messaging for health

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INSIGHTS INTO THE SUCCESS OF TEXT MESSAGING FOR HEALTH

Alyson Rixner Director of Healthcare SoluAons [email protected]

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1.  IntroducAon to Mobile Commons 2.  Benefits of Text Messaging 3.  Key Text Messaging StaAsAcs 4.  SMS ApplicaAons in Health 5.  Highlights from Key Efficacy Studies 6.  Examples of Successful Campaigns 7.  Q&A

What You Will Learn Today


Mobile Commons Select Customers


The Solution §  Web applicaAon for managing mobile communicaAon: §  Text Messaging §  Phone Calls § Mobile Web § Mobile TransacAons § MMS

About Mobile Commons


Mobile Plaaorm Features

Text Messaging Send text messages to one person or a million people.

Scheduling & Targe.ng Reach the right person at exactly the right moment.

Alerts & Reminders Send a text to remind people about appointments and important dates.

Live SMS Chat Respond quickly to users in real-‐Ame and answer quesAons via SMS.

Mobile CRM View detailed profiles of every user and track every acAon.

Informa.on Lookup Help people find the informaAon they need with a simple text.

Surveys, Polls & Quizzes Run surveys and quizzes to paAent gather informaAon and save results right to users' profiles.

Reports & Analy.cs Analyze your campaign performance at all levels and track every acAon.


# of SMS Health Studies Published

0

5

10

15

20

25

30

35

40

45

Q3 14 Q2 14 Q1 14 Q4 13 Q3 13 Q2 13 Q1 13


Analysis of ’13-‐’14 SMS Health Studies

Category # of Studies Percent

MedicaAon Adherence, Reminders 44 24%

Disease Management 38 21%

Mental Health, AddicAon 16 9%

Women’s Health 15 8%

Weight Loss 10 5%

Physical AcAvity 8 4%

Source: mobihealthnews; mHealthEvidence.org



Disease/Condi.on # of Studies Percent

HIV/AIDS 27 15%

Diabetes 21 12%

Heart Disease 5 3%

Cancer 3 2%

Blood Pressure 2 1%

Asthma 2 1%

Source: mobihealthnews; mHealthEvidence.org


The number of texAng for health studies specifically working with an adolescent or child populaAon: 32, which is about 18% of studies.



2. Benefits of Text Messaging


§  Ease of use §  Ubiquity amongst all demographics

§  InteracAve 2-‐way form of communicaAon

§  PersonalizaAon §  Immediacy

Benefits of Text Messaging


Building Healthier CommuniAes 3. Key Text Messaging StaAsAcs


99% of text messages are read.

The average text is read in 90 seconds.

Text messaging is the #1 applicaAon on phones.

*Sources: ConversaAonal AdverAsing 2010, SinglePoint; Cell Phone AcAviAes 2012, Pew Research ; How Americans Use Text Messaging 2011, Pew Research; CTIA

Key Statistics

Why Text Messaging

Mobile Use Text messaging is the most effecAve method for reaching everyone – especially underserved populaAons, young people, and minoriAes.


§  Medicaid paAents are more likely to use text message vs. those privately insured

§  Hispanics text 156% more than Caucasians

§  African Americans text 224% more than Caucasians

TexAng by Demographics


§  91% of U.S. adults own mobile phones §  However, only 56% own a smart phone

§  97% of ages 18-‐29 use text messaging §  6% of that 18-‐25 group email daily

§  75% of ages 50-‐64 use text messaging §  Largest growing group of text message users

Text Message UAlizaAon

Source: Smith A. Americans and text messaging. Pew Internet & American Life Project. 2013

91%

56%

0%

20%

40%

60%

80%

100%

Mobile Phone Users

Smart Phone Users


4. SMS ApplicaAons in Health


§ MedicaAon adherence §  Appointment reminders §  Behavior change §  Chronic disease management §  General health educaAon §  PreventaAve care •  Exercise and healthy living •  Wellness programs

SMS ApplicaAons in Health

73% of paAents want to refill prescripAons through mobile.


5. Highlights from Key Efficacy Studies and Examples of Successful Campaigns


U.S. Department of Health and Human Services Using Health Text Messages to Improve Consumer Health Knowledge, Behaviors, and Outcomes (May 2014) Study Objec.ve: §  To examine the effecAveness and acceptance of SMS intervenAons and implicaAons on the use of SMS for future programs

HHS Environmental Scan


Method: §  Examined and assessed 7 systemaAc reviews of over 60 text messaging programs

§  SystemaAc reviews are the gold standard of assessing evidence of a technology or intervenAon

§  Studies between January 2009 – October 2012




IniAaAve Focus DescripAon

Text4baby Maternal & baby health

Providing pregnant women and new mothers free health text messages in English or Spanish,

TXT4Tots Child health Providing a library of brief, evidence-‐based messages focused on nutriAon and physical acAvity targeted to parents and caregivers of children ages 1 to 5.

SmokeFreeTXT Tobacco control Delivering 24/7 Aps, moAvaAon, encouragement, and advice about smoking cessaAon through text messages .

QuitNowTXT Message Tobacco control Offering a library of free & publicly available interacAve

text messages for adults who are ready to quit smoking.

SmokeFree Moms Tobacco control Developing a library of free and publicly available text messages for pregnant women who wish to quit smoking.

Health Alerts On-‐the-‐Go Health & safety Providing CDC’s health and safety informaAon on mobile

devices.

Text Alert Toolkit Emergency response

Providing a text message library for emergency preparedness and response for voluntary use.


Results: 1.  There is a substanAal body of research with SMS 2.  SMS does bring about behavior change 3.  SMS can improve smoking cessaAon outcomes,

diabetes management, and clinical outcomes 4.  Text messaging improves treatment compliance,

including medicaAon adherence and appointment avendance

5.  Improves immunizaAon rates, increases sexual health knowledge, and reduces risky behaviors



Smoking Cessation §  26-‐35 Year Olds: 47% likely to quit when

receiving texts (control group: 35%) §  Males: 43% likely to quit when receiving

texts (control group: 29%) §  Heavy Smokers: 53% likely to quit when

receiving texts (control group: 25%)

SmokefreeTXT Doubled Quit Rates Among Teens

Case Study: NCI SmokeFreeTXT


American Journal of Public Health Influenza Vaccine Text Message Reminders for Urban, Low-‐Income Pregnant Women: A Randomized Controlled Trial (August 2013) Objec.ve: §  To evaluate the impact of influenza text message reminders in low-‐income obstetric populaAon. Pregnant women are at increased risk for influenza morbidity & mortality.

Influenza Vaccine Text Reminders



Method: §  RCT that enrolled 1,187 obstetric paAents from 5 community-‐based clinics in NYC

§  IntervenAon group received 5 weekly text messages about the importance of gexng vaccinated and 2 text message appointment reminders

§  Both groups received standard, automated telephone reminders


Results: 1.  Women who received the text messages were

30% more likely to be vaccinated 2.  Women early in the third trimester at

randomizaAon showed the greatest intervenAon effect



Flu Shot Finder §  The CDPH sent out a survey one week ayer people used the flu shot locator: §  50% respond to the survey §  33% of respondents got

vaccinated that week §  40% got vaccinated

later §  17% vaccinated

elsewhere

Text NOFLU + ZIP to 30644 to get closest locaAon of the

H1N1 vaccine

Case Study: CDPH Flu Shot Finder


Na.onal Center for Biotechnology Informa.on MedicaAon Adherence IntervenAons: ComparaAve EffecAveness (September 2012)

Objec.ve: §  To evaluate medicaAon adherence among paAents opAng in to receive text messages

MedicaAon Adherence Study


Method: §  ObservaAonal, cohort analysis of Commercial/Medicare members via a naAonal PBM

§  5,746 PBM members observed for text message arm, 290 met the inclusion criteria

§ MedicaAons observed were for chronic condiAons (diabetes, high blood pressure, etc)



Results: §  Members opAng into a text message reminder program have significantly higher chronic oral medicaAon adherence rates compared with member snot opAng in to receive text message medicaAon reminders

§  Increased adherence rates translated into an esAmated total healthcare savings of $724 per year for members parAcipaAng in the text messaging program compared with non parAcipaAng members



“We’ve had some paAents whose viral loads have dropped to

undetectable levels since they started gexng daily reminders to take their medicine.” -‐ Dr. Christel Hyden of

Columbia University

Daily Reminders

§  Adolescents and young adults are 4 #mes more likely than adults to forget to take their medicaAon or take it at the wrong Ame.

§  Project Stay -‐ a program created by the New York Presbyterian, Columbia University, and Harlem Health texts out medicaAon reminders to HIV+ paAents.

§  Every day, paAents receive a discreet text reminder to take their medicaAon, at a Ame of their choosing.

Case Study: NYP Project Stay

Mobile Commons, Inc. | www.mobilecommons.com | [email protected]

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