Research ArticleCommunity-Level Text Messaging for 2009 H1N1 Prevention in China
Section snippets
Background
In 2011, an estimated 5.9 billion mobile phones were in use worldwide.1 Short message service (SMS), which allows users to send short text messages between mobile phones, has become equally widespread; an estimated 7 trillion SMS messages were sent in 2011.2 Sending and receiving SMS messages is cheap, even when used frequently.3
Messaging of this type has been used to manage specific health conditions, such as diabetes or tobacco use, in high- and low-income settings.4, 5, 6 Studies of SMS
Methods
Shanghai, China's 12320 health-based SMS program (hereafter called SMS program) was evaluated in 2010, and results were analyzed in 2010–2011. The 12320 National Hotline and SMHB staff (hereafter called stakeholders) helped set the level of rigor for data collection (single-blinded, randomized controlled method) and a priori metrics for an effective (≥5% difference in knowledge, attitudes, and behaviors between intervention and control groups) and acceptable (>70% positive response to
Results
Participants in the H1N1 versus tobacco groups did not differ by demographic characteristics (Table 1). Between the pre-SMS and post-SMS survey, the average individual knowledge score increased significantly within the H1N1 group (by 24.3%, p<0.001; Table 2) and within the tobacco group (by 20.1%, p<0.001). The 4.2% greater change in average individual knowledge score in the H1N1 group versus the tobacco group also was significant (95% CI=2.9%, 5.6%).
The average individual attitudes score
Discussion
Short message service messaging increased respondents’ self-reported uptake of 2009 H1N1 vaccination, reduced reports of influenza-like illness, and improved knowledge and attitudes about 2009 H1N1 prevention and control. To our knowledge, this is the first community-based study using a randomized controlled method to demonstrate that SMS disease prevention and control messages can influence both respondents’ self-reported health behaviors and outcomes.
The SMS messaging regarding 2009 H1N1
Acknowledgments
The authors acknowledge Robert W. Pinner for his scientific and moral support for this project.
All funding for the study was provided by the China–U.S. Collaborative Program on Emerging and Re-Emerging Infectious Diseases in Beijing, China (a cooperative agreement between the Ministry of Health of the People’s Republic of China and the DHHS).
No financial disclosures were reported by the authors of this paper.
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