Can a Text Message Improve Health Outcomes?
Since 2010, US adult smartphone ownership has boomed from 20% to 85% in 2023. With this boom comes a wave of mobile health (mHealth) intervention studies to determine if this emerging technology is capable of revolutionizing healthcare delivery and patient outcomes. Thousands of studies emerged to determine which attributes of a mobile health intervention are necessary to promote healthy behavioral changes. Researchers could now use mobile technology to deliver treatments to people during their everyday lives and in their natural settings. This method of mobile treatment delivery is called ‘Ecological Momentary Interventions’ (EMIs) which was coined in 2005 by Patrick et al, however, this practice has been used for decades by clinicians to extend psychotherapy lessons into their patient’s everyday lives.
The implementation of EMI’s initially showed moderate success in the field of psychotherapy before the advent of mobile distribution methods. With the introduction of mobile technology, the scope of EMIs expanded significantly, leading to their adoption in various health domains such as smoking cessation, weight loss, anxiety management, diabetes care, eating disorders, alcohol use, and the promotion of healthy eating and physical activity (Heron et al., 2010). An influential literature review by Heron and Smyth in 2010 found that EMIs delivered by mobile phones are successful, accepted by patients, and effective in improving various health behaviors (Heron et al., 2010).
In a more recent review, Dao et al. (2021) found that in the 19 studies, users perceived EMIs to be helpful and suggested increased personalization, multimedia, and interactive capabilities to increase user compliance. The generalizability of the studies is difficult because EMI components are rarely reported, particularly due to no standardized methods (Dao et al., 2021). As this delivery of the EMIs in mHealth is emerging, studies are often small sample sizes, difficult to generalize due to no standardized components of the intervention, and a lack of studies evaluating efficacy. That being said, it is important to consider the breakdown of congruent terminology utilized in papers that assess EMI interventions. For example, an EMI could be a text message or a reminder notification. By bridging this gap in literature terminology, the studies surrounding the efficacy of EMI interventions provide further evidence that this practice is a critical component of future healthcare innovation.
The use of EMI’s through text messaging as a means to encourage patients to engage in specific behaviors in their daily lives has demonstrated moderate effectiveness across a wide range of applications. This acceptance from users is pivotal, as it opens up opportunities for further innovation in the mode of delivery. The use of text messaging is now common in doctor offices, with a 2018 MGMA Stat poll finding that 68% (of the 1615 respondents) receive texts about their upcoming doctor's appointment. This tool is employed to reduce patient no-shows, offering significant value to practitioners by decreasing missed appointments.I encourage healthcare professionals to utilize these tools for reminding patients about their specific health conditions, treatment protocols, and personalized action plans. With Preventi, we deliver text messages which prompt patients to review these materials with the hope that this will reinforce their understanding and adherence to their treatment plans, ultimately leading to better health outcomes and patient engagement. In a medical environment where patients often forget the information given by doctors, and where forgetfulness and confusion are major factors in medication noncompliance, we aspire for Preventi to be more widely embraced in medical practices as a solution to mitigate these issues.