Executive Summary
Sending teen girls periodic text messages reminding them to follow through on their clinic appointments for periodic birth control injections aids in improving timing and adherence to contraception, research indicates.
- According to a 2012 report from the Pew Research Center, 63% of all teens said they exchange text messages every day with people in their lives, which surpasses the frequency with which they pick other forms of daily communication.
- The Strength Of Text Messaging Is That It Is A Low Cost And Highly Acceptable Form Of Communication That Allows For Person-based Communication And Support With Young People, Say Researchers.
Sending teen girls periodic text messages reminding them to follow through on their clinic appointments for periodic birth control injections aids in improving timing and adherence to contraception, research indicates.1
According to a 2012 report from the Pew Research Center in Washington, DC, 63% of all teens said they exchange text messages every day with people in their lives.2 Texting surpasses the frequency with which they pick other forms of daily communication, including:
- phone calling by cell phone (39%);
- face-to-face socializing outside of school (35%);
- social network site messaging (29%);
- instant messaging (22%);
- talking on landlines (19%);
- e-mailing (6%).
What do researchers see as some of the greatest strengths of text messaging when it comes to reaching adolescents with important health messages?
Adolescents face significant health disparities, but they often have difficulty accessing the care and support that they need for management of health-related issues, says Maria Trent, MD, MPH, associate professor of pediatrics in the Division of General Pediatrics and Adolescent Medicine at Johns Hopkins School of Medicine in Baltimore. There are also practical barriers such as transportation, conflicts with school/extracurricular activities, and/or concerns about confidentiality that might undermine delivering location-based communication and services in clinics/medical offices, notes Trent, who serves as lead author of the current paper.
“Cell phone penetration across communities and populations (including adolescents) is high in the United States,” wrote Trent in comments emailed to Contraceptive Technology Update. “The availability of low-cost cell phone plans with both texting and internet access have substantially narrowed the digital divide, making access to information and novel communication strategies feasible across clinical settings.”
Positive aspects of texting
The strength of text messaging is that it is a low-cost and highly acceptable form of communication that allows for person-based communication and support with young people, notes Trent. It allows providers to meet adolescents where they are and to effectively communicate with them between visits, she states.
“Our research shows that in-person medical visits are critical for relationship building, but that youth are flexible in terms of using technology to obtain assistance with health maintenance and for sustaining relationships with health providers,” says Trent.
Adolescents often send and receive text messages, spending hours each day with their phones, so by providing important health messaging via text messaging, providers are taking the messages to the adolescents, agrees Jessica Fitts Willoughby, PhD, assistant professor in the Edward R. Murrow College of Communication at Washington State University in Pullman. By using text messaging, it makes the process of receiving health information convenient and accessible for them, Willoughby states.
She conducted a study assessing whether teens at a greater risk for negative sexual health outcomes would use a sexual health text message service.3 She looked at a text message service that connects teens with sexual health educators that was promoted in six public schools in North Carolina. Results indicated that teens most likely to benefit were also those most likely to use such a text message service.
“In some other research I have done with teens on text messaging services, they have said that cell phones are mostly private, with just them seeing the messages that they send and receive, and this can be highly relevant when it comes to health as well,” states Willoughby. “Also, cell phones seem to allow for this greater feeling of anonymity, and that may help to mitigate some of the possible embarrassment adolescents experience when discussing certain health topics.”
The site http://bedsider.org offers text message reminders for contraceptive users. Women can click on “your reminders” to set up reminders, or text “MyBC” to 42411 from a U.S.-based mobile phone.
Check the research
To perform the current study, Trent and researchers affiliated with Johns Hopkins Children’s Center enrolled 100 Baltimore females, ages 13-21, who use the contraceptive injection depot medroxyprogesterone acetate (DMPA). Subjects enrolled in the study were followed for nine months.
One-half of the group received standard automated calls on their home phones as reminders of their upcoming appointment. The other half received personalized daily text messages starting three days prior to their monthly appointment, and they were asked to text back their responses. Young women enrolled in the mobile phone group also received periodic texts with tips on condom use to prevent sexually transmitted infections, suggestions for maintaining healthy weight, and messages urging them to call providers with questions or concerns.
What did researchers find? Overall, 87% showed up for the first of three injections, 77% completed the second cycle of shots, and 69% came to the clinic for the third and final injection.
Data indicate teens who received text-message reminders were more likely to show up for their contraceptive shots on time than those who received traditional reminders. Almost 70% of those in the text message group came in on time for their first appointment, compared to 56% in the traditional reminder group, with 68% of text message patients coming in on time for the second shot, compared with 62% of those in the traditional reminder group. The differences between the two groups dissipated by the third appointment, though, researchers note.1
- Trent M, Thompson C, Tomaszewski K. Text messaging support for urban adolescents and young adults using injectable contraception: Outcomes of the DepoText Pilot Trial. J Adolesc Health 2015; doi: 10.1016/j.jadohealth.2015.03.008.
- Pew Internet and American Life Project. Teens, Smartphones and Texting. Accessed at http://pewrsr.ch/1fUaZVG.
- Willoughby JF. BrdsNBz: Sexually experienced teens more likely to use sexual health text message service. Health Educ Behav 2015; doi: 10.1177/1090198115577377.
