Text messaging technology has important implications for public health initiatives, finds study

A recent study conducted by the Center for Connected Health, a division of Partners HealthCare, found that text messaging is an innovative, low-cost and effective way to improve the daily use of sunscreen, and this technology may have important implications for larger-scale public health initiatives. Study participants who received text-message reminders on their cell phones were nearly twice as adherent to applying sunscreen compared with participants who did not receive reminders. This study was the lead paper in the November issue of Archives of Dermatology (Volume 145, No. 11, November 2009), and was also featured in the Journal's Editorial, "Adherence, the Fourth Dimension in the Geometry of Dermatological Treatment."

Seventy participants completed the 6-week randomized, controlled trial, with half receiving daily text message reminders; the other half did not receive reminders. The 35 participants receiving text message reminders had a daily adherence rate of 56.1%, while the 35 study subjects who did not receive reminders had an adherence rate of 30.0% (p<.001). Adherence between the two groups were similar at week 1 of the study, but differed significantly for the remainder of the trial>

"These data clearly demonstrate that a simple daily reminder could maintain adherence to sunscreen application and encourage sun-protective behavior that could reduce the risk of skin cancer," said April W. Armstrong, M.D., the study's lead author. "It is estimated that only 20% of U.S. adults use sunscreen regularly. Because of the enormous number of people at risk for skin cancer, improving adherence to sunscreen application is essential. Text messaging has demonstrated to be a low-cost and effective way of encouraging positive sun protective behavior."

Among participants receiving text-message reminders, 69% reported that they would like to continue using the service as a way of improving adherence, and 89% reported that they would recommend the text-messaging reminder system to others.

"A number of studies have now concluded that the use of text messaging reminders in health care can improve outpatient clinic attendance, encourage weight loss, provide support to diabetic patients and can promote important behavior changes," added Joseph C. Kvedar, M.D., Director, Center for Connected Health. "Text messaging may be an effective reminder tool to promote preventative health behaviors or help individuals adhere to medication regimens."