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Background: Eveningness chronotype—the tendency for later sleep and wake times—arises from a confluence of psychosocial, behavioral, and biological factors. With the onset and progression of puberty, many young people develop an eveningness chronotype, which remains prevalent through the transition into adulthood. Eveningness has been associated with increased risk for poorer health. While eveningness is modifiable, maintaining the necessary behavior changes can be challenging. The science on habits demonstrates that habit formation is a key mechanism for maintaining behavior change over time. Learning theory offers schedules of reinforcement that also hold promise for enhancing the maintenance of behavior change. The present study will evaluate the Habit-based Sleep Health Intervention (HABITs)—which combines the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) with the science of habits—and a text message intervention informed by learning theory to attempt to sustainably modify the contributors to eveningness among young adults (18–30 years of age). Methods: Participants (N = 160) will be randomly allocated to HABITs and HABITs + Texts. Both interventions include HABITs which involves three 50-min sessions followed by six 30-min sessions. Alongside the latter six sessions, HABITs + Texts will concurrently receive the text message intervention. Aims 1–3 will compare HABITs + Texts to HABITs on improvements in the outcomes of (1) utilization of sleep health behaviors and habit formation, (2) sleep and circadian functioning, and (3) functioning in five health-relevant domains, in the short (post-treatment) and longer (6-month and 12-month follow-up) term. Exploratory analysis will (1) compare HABITs and HABITs + Texts on (a) if sleep health behavior habit formation mediates the effects of intervention on improvement in outcomes and (b) if intervention effects are moderated by select variables, and (2) to evaluate if HABITs (regardless of the text message intervention) is associated with an improvement in outcomes in the short and longer term. Discussion: This study has the potential to advance knowledge on (1) the value of leveraging the science of habits and learning theory in behavior change interventions, (2) the use of a low-cost and efficient intervention for habit formation and maintenance, (3) interventions that address eveningness chronotype, and (4) processes related to behavior change during emerging adulthood. Trial registration: Clinicaltrials.gov NCT05167695. Registered on December 22, 2021. [ABSTRACT FROM AUTHOR]

Objective: Early detection through screening could improve breast cancer (BC) outcomes in sub‐Saharan Africa (SSA). We explored women's preferences for BC‐related mobile health text messaging, described the development of a mobile‐health text messaging platform, and examined the enablers and barriers to BC screening. Methods: A concurrent mixed‐method study of women aged 40–59 years was conducted. Four essential actions were carried out: (i) a baseline survey of 130 women, (ii) five focus group discussions (FGDs), (iii) a stakeholder meeting with BC research and clinical treatment specialists, and (iv) text message pretesting. The survey and FGD findings were used to create a culturally appropriate SMS platform for BC screening. Results: Thirty‐five text messages were developed and evaluated with the following communication goals in mind: 15 addressed BC awareness, six emphasized the importance of early detection, five alleviated anxieties as a barrier to BC screening, seven encouraged women to prioritize their health, and three indicated screening locations and costs. The majority (92.6%) of survey respondents who had heard of mammography (54/130) said screening was necessary. Fear of the screening procedure, receiving a positive diagnosis, and other testing‐related worries (40.7%) were identified as potential barriers to BC screening, along with low income (18.5%), a lack of BC‐related indicators (9.3%), insufficient breast awareness education (9.3%), and time restrictions (7.4%). The presence of BC‐related symptoms (27.8%), breast awareness education (24.1%), and doctor's advice (16.7%) were all potential facilitators of BC screening uptake. The majority of FGD participants favored brief texts, with 42.3% preferring one text message per day. Conclusion: Several factors limit women from accessing BC screening services; nevertheless, specific barriers such as a lack of BC education, time constraints, and disease fears can be successfully targeted through SMS messaging interventions to encourage women to use BC screening programs. [ABSTRACT FROM AUTHOR]

Background: Inadequate pain relief with moderate to severe pain remains a challenge after cesarean section and may significantly impair postoperative recovery. However, detailed assessment on the timing of severe pain, opioid consumption, influence on activities such as mobilization, breastfeeding, and caring for the infant are difficult to conduct, especially after discharge. Short message services (SMS)‐based questionnaires may offer a low‐cost way of providing such data but with the risk of insufficient response rates. We assessed the feasibility of collecting detailed, prospective data on postoperative pain and recovery during the initial hours and days following cesarean section using SMS‐based questionnaires. Methods: Prospective Danish single‐center cohort study involving elective cesarean sections under spinal anesthesia with fentanyl and bupivacaine. The postoperative pain regimen consisted of paracetamol, NSAID and oral morphine by request. Patients received an SMS‐based questionnaire at 6, 12, 18, 24, and 48 h postoperatively, as well as on days 7 and 30. Primary outcome: Response rate and time from receiving the SMS to completion of the questionnaires. Secondary outcomes: Opioid consumption and Patient Reported Outcomes Measures on pain and recovery. Results: From December 2022 to June 2023; 100 patients were included. The response rate was 78% at 6 h postoperatively, decreasing to 63% at 24 h. The median response time from receiving to answering the SMS‐based questionnaire at 6 h after cesarean section was 23 min (IQR 2–72), decreasing to 20 min (IQR 2–78) after 24 h. Severe pain, corresponding to a Numeric Rating Scale (NRS) score >6, was reported by 57% (95% CI 65–84) at 6 h, decreasing to 28% (95% CI 34–58) at 24 h. Median opioid consumption within the first 24 h was 30 mg (IQR 20–50). Conclusion: SMS‐based questionnaires on Patient Reported Outcome Measures are a feasible and cost‐effective way of prospectively collecting frequent data with acceptable response rates, even shortly after cesarean section. Secondarily 66% of patients reported severe pain during the first 24 h following cesarean section, with the highest pain scores within the initial 12 h. Future studies should focus on optimizing pain‐management within this timeframe. [ABSTRACT FROM AUTHOR]

This study aimed to test whether text messages prompting women with breast cancer to perform motor imagery would increase self-report Physical Activity (PA) duration using a randomized parallel trial design. 52 participants were assigned to a Placebo, Imagery first or Imagery second group. The groups were exposed to two counterbalanced conditions: no morning text message or morning text message for 4 weeks. In the morning text message condition, the Imagery first and Imagery second groups received a message with the instruction to imagine realizing an aerobic exercise of their choice whereas the Placebo group received a placebo message, 3 days per week. In addition, all participants received an evening text message: "Did you do your cardio today? If yes, what did you do?". Before, during and after the experimental session the participants fulfilled questionnaires assessing weekly PA, motivation to perform PA, self-efficacy and fatigue. Participants in the Imagery groups reported significantly more weekly minutes of aerobic exercise and self-efficacy scores in the imagery morning message condition compared with the no morning message condition. The imagery groups reported significantly higher PA than participants in the Placebo group when the latter received the neutral morning message. Text message can be effective in increasing minutes of aerobic exercise and self-efficacy in women with breast cancer. [ABSTRACT FROM AUTHOR]

Abstract Background Eveningness chronotype—the tendency for later sleep and wake times—arises from a confluence of psychosocial, behavioral, and biological factors. With the onset and progression of puberty, many young people develop an eveningness chronotype, which remains prevalent through the transition into adulthood. Eveningness has been associated with increased risk for poorer health. While eveningness is modifiable, maintaining the necessary behavior changes can be challenging. The science on habits demonstrates that habit formation is a key mechanism for maintaining behavior change over time. Learning theory offers schedules of reinforcement that also hold promise for enhancing the maintenance of behavior change. The present study will evaluate the Habit-based Sleep Health Intervention (HABITs)—which combines the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) with the science of habits—and a text message intervention informed by learning theory to attempt to sustainably modify the contributors to eveningness among young adults (18–30 years of age). Methods Participants (N = 160) will be randomly allocated to HABITs and HABITs + Texts. Both interventions include HABITs which involves three 50-min sessions followed by six 30-min sessions. Alongside the latter six sessions, HABITs + Texts will concurrently receive the text message intervention. Aims 1–3 will compare HABITs + Texts to HABITs on improvements in the outcomes of (1) utilization of sleep health behaviors and habit formation, (2) sleep and circadian functioning, and (3) functioning in five health-relevant domains, in the short (post-treatment) and longer (6-month and 12-month follow-up) term. Exploratory analysis will (1) compare HABITs and HABITs + Texts on (a) if sleep health behavior habit formation mediates the effects of intervention on improvement in outcomes and (b) if intervention effects are moderated by select variables, and (2) to evaluate if HABITs (regardless of the text message intervention) is associated with an improvement in outcomes in the short and longer term. Discussion This study has the potential to advance knowledge on (1) the value of leveraging the science of habits and learning theory in behavior change interventions, (2) the use of a low-cost and efficient intervention for habit formation and maintenance, (3) interventions that address eveningness chronotype, and (4) processes related to behavior change during emerging adulthood. Trial registration Clinicaltrials.gov NCT05167695. Registered on December 22, 2021.

When deciding which modes to offer, researchers consider cost, known respondent contact information, and potential mode effects. For a short survey on employment, we evaluate the effect of adding one of two new electronic data collection modes to a mailed questionnaire. We sent a survey to principals who previously responded to the National Center for Education Statistics' (NCES) National Teacher and Principal Survey (NTPS) asking about their current job status. This questionnaire, known as the Principal Follow-up Survey (PFS), has typically been administered as a short paper form that is mailed to NTPS respondents. In 2022, the PFS introduced two new modes of completion, and principals were randomly assigned to receive: (i) a paper form only; (ii) a paper form, as well as emails with a direct link to complete a web survey; or (iii) a paper form, as well as invitations by text message to complete an automated two-way short message service text survey by responding to texted "yes/no" questions. This article compares overall response rates and time-to-response by mode to determine respondent preferences for completing short surveys. Adding either electronic mode significantly increased response rates and decreased the number of days in which completed surveys were received, compared to offering only a paper questionnaire. Although email and text messages are both forms of electronic communication that may be accessible on a smartphone, the added text message survey resulted in higher response rates than the added web survey. This suggests that respondents interact differently with emails and text messages they receive and that offering an option to complete a survey by text message can increase the speed and efficiency of data collection for short surveys. [ABSTRACT FROM AUTHOR]

Abstract Introduction Adolescents and young adults (AYA) living with chronic medical conditions often struggle to develop medication adherence skills. This pilot trial evaluated the impact of a mobile health coaching intervention, Cell Phone Support (CPS), on medication adherence. Methods Interventions in this randomized trial were CPS delivered by phone calls (CPS-C), CPS delivered by text messages (CPS-T), or automated text message reminders (ATR). Participants were AYA with different chronic medical conditions (i.e., sickle cell disease, solid organ transplant, type 2 diabetes), aged 15–20 years (N = 34). We examined the feasibility, acceptability, and preliminary efficacy of each intervention. Results We examined the feasibility, acceptability, and preliminary efficacy of both CPS interventions. CPS was feasible and acceptable. There was evidence that participants found CPS to be more useful than ATR. In this pilot trial, participants receiving CPS reported relatively stronger increases in adherence, compared to those assigned to ATR. CPS-C slightly outperformed CPS-T. Conclusions Providing coaching to AYA struggling with illness self-management via their cell phones may promote their acquisition of medication adherence skills. Although larger studies are needed to confirm the results of this pilot study, phone calls and text messages are both promising modalities for delivering human cell phone support. Trial registration This trial was registered prospectively at ClinicalTrials.gov (NCT04241627) on 1/27/2020.

BackgroundPhysician burnout is a multibillion-dollar issue in the United States. Despite its prevalence, burnout is difficult to accurately measure. Institutions generally rely on periodic surveys that are subject to recall bias. SMS text message-based surveys or assessments have been used in health care and have the advantage of easy accessibility and high response rates.ObjectiveIn this pilot project, we evaluated the utility of and participant engagement with a simple, longitudinal, and SMS text message-based mental health assessment system for physician-trainees at the study institution. The goal of the SMS text message-based assessment system was to track stress, burnout, empathy, engagement, and work satisfaction levels faced by users in their normal working conditions.MethodsThree SMS text message-based questions per week for 5 weeks were sent to each participant. All data received were deidentified. Additionally, each participant had a deidentified personal web page to follow their scores as well as the aggregated scores of all participants over time. A 13-question optional survey was sent at the conclusion of the study to evaluate the usability of the platform. Descriptive statistics were performed.ResultsIn all, 81 participants were recruited and answered at least six (mean 14; median 14; range 6-16) questions for a total of 1113 responses. Overall, 10 (17%) out of 59 participants responded "Yes" to having experienced a traumatic experience during the study period. Only 3 participants ever answered being "Not at all satisfied" with their job. The highest number of responses indicating that participants were stressed or burnt out came on day 25 in the 34-day study period. There were mixed levels of concern for the privacy of responses. No substantial correlations were noted between responses and having experienced a traumatic experience during the study period. Furthermore, 12 participants responded to the optional feedback survey, and all either agreed or strongly agreed that the SMS text message-based assessment system was easy to use and the number of texts received was reasonable. None of the 12 respondents indicated that using the SMS text message-based assessment system caused stress.ConclusionsResponses demonstrated that SMS text message-based mental health assessments are potentially useful for recording physician-trainee mental health levels in real time with minimal burden, but further study of SMS text message-based mental health assessments should address limitations such as improving response rates and clarifying participants' sense of privacy when using the SMS text message-based assessment system. The findings of this pilot study can inform the development of institution-wide tools for assessing physician burnout and protecting physicians from occupational stress.

• Two messaging strategies invoking a sense of ownership were tested to evaluate their impact on COVID-19 vaccination uptake. • The behavioural science informed text messages in our study did not improve the rates of vaccination. • This may highlight the effectiveness of public health campaigns during a pandemic. • Our analysis highlighted that different population subgroups respond variably to vaccination offers. • This study highlights the importance of creating accurate data records to facilitate delivery of vaccination offers. Behavioural science constructs can be incorporated into messaging strategies to enhance the effectiveness of public health campaigns by increasing the occurrence of desired behaviours. This study investigated the impact of behavioural science-informed text message strategies on COVID-19 vaccination rates in 18–39-year-olds in an area of low uptake in London during the first vaccination offer round in the United Kingdom. This three-armed randomised trial recruited unvaccinated residents of an urban Central London suburb being offered their first vaccination between May and June 2021. Participants were randomised to receive the control (current practice) text message or one of two different behavioural science-informed COVID-19 vaccine invitation strategies. Both intervention strategies contained the phrase "your vaccine is ready and waiting for you", aiming to evoke a sense of ownership, with one strategy also including a pre-alert message. The main outcome measures were vaccination rates at 3 and 8 weeks after message delivery. A total of 88,820 residents were randomly assigned to one of the three trial arms. Each arm had a vaccine uptake rate of 27.2 %, 27.4 % and 27.3 % respectively. The mean age of participants was 28.2 years (SD ± 5.7), the mean index of multiple deprivation was 4.3 (SD ± 2.0) and 50.4 % were women. Vaccine uptake varied by demographics, however there was no significant difference between trial arms (p = 0.872). Delivery was successful for 53.6 % of text messages. Our choice of behavioural science informed messaging strategies did not improve vaccination rates above the rate seen for the current practice message. This likely reflects the wide exposure to public health campaigns during the pandemic, as such text messages nudges were unlikely to alter existing informed decision-making processes. Text message delivery was relatively low, indicating a need for accurate mobile phone number records and multi-modal approaches to reach eligible patients for vaccination. The protocol was registered at clinicaltrials.gov (NCT04895683) on 20/05/2021. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents and young adults (AYA) living with chronic medical conditions often struggle to develop medication adherence skills. This pilot trial evaluated the impact of a mobile health coaching intervention, Cell Phone Support (CPS), on medication adherence. Methods: Interventions in this randomized trial were CPS delivered by phone calls (CPS-C), CPS delivered by text messages (CPS-T), or automated text message reminders (ATR). Participants were AYA with different chronic medical conditions (i.e., sickle cell disease, solid organ transplant, type 2 diabetes), aged 15–20 years (N = 34). We examined the feasibility, acceptability, and preliminary efficacy of each intervention. Results: We examined the feasibility, acceptability, and preliminary efficacy of both CPS interventions. CPS was feasible and acceptable. There was evidence that participants found CPS to be more useful than ATR. In this pilot trial, participants receiving CPS reported relatively stronger increases in adherence, compared to those assigned to ATR. CPS-C slightly outperformed CPS-T. Conclusions: Providing coaching to AYA struggling with illness self-management via their cell phones may promote their acquisition of medication adherence skills. Although larger studies are needed to confirm the results of this pilot study, phone calls and text messages are both promising modalities for delivering human cell phone support. Trial registration: This trial was registered prospectively at ClinicalTrials.gov (NCT04241627) on 1/27/2020. [ABSTRACT FROM AUTHOR]

Abstract Background Poor adherence to long-term medication increases the risk of morbidity and mortality and decreases the quality of life of patients with hypertension. One strategy to improve treatment adherence is to use a short text message reminder. Although evidence indicates that such programs increase medication adherence, the extent of their effectiveness and translation into clinical practice needs to be better documented. Our systematic review will collect and analyze the available evidence for clinical practice implementation. This systematic review aimed to evaluate the effectiveness of short mobile phone text message reminders versus usual/standard care for medication adherence in patients with hypertension. Methods This review will include and summarize evidence from randomized controlled trials. Adults (age > 18 years) with hypertension. The comparator group received either the usual care or standard care. It encompasses standard medical care for patients not participating in a structured and supervised intervention program such as a telemedicine program. We will include studies that assess the effectiveness of short mobile phone text message reminders in improving medication adherence in patients with hypertension compared to usual care. We will search the following databases: PubMed, EMBASE, CINAHL, SCOPUS, Web of Science, Cochrane Library Central Register of Controlled Trials, and Cochrane Library. We will include studies published in English. Furthermore, we will consider studies published from the inception of the database until April 20, 2024. At least two reviewers will independently conduct study selection, data extraction, and quality assessment. A third reviewer will determine and resolve discrepancies. We will conduct a quality assessment using the ROBIS 2 critical appraisal checklist. At least two independent reviewers will crosscheck the data synthesis. Discussion We expect this review to provide current evidence for future studies and clinical practice concerning the impact of mobile phone text message reminders on medication adherence issues. We will publish our results in a peer-reviewed journal for publication. Systematic review registration PROSPERO CRD42023391236.

Abstract Background Nicotine replacement therapy (NRT) and short messaging service (SMS)-based tobacco cessation interventions have demonstrated effectiveness in reducing tobacco use in many populations, but evidence is needed on which tailored treatments are most efficacious in meeting the complex medical and psychosocial factors confronting people living with HIV (PLWH) in sub-Saharan Africa (SSA). This paper describes the protocol of a study to test the efficacy of both NRT and a tailored SMS-based tobacco use cessation intervention among PLWH in Uganda and Zambia. Methods In a randomized controlled trial, 800 adult PLWH who use tobacco will be recruited by health care professionals at HIV treatment centers where they are receiving care. Participants will be randomized to one of the four study arms: (1) standard of care [SOC; brief clinician advice to quit combined with HIV education and information aimed at encouraging HIV treatment adherence (with no mention of tobacco) delivered via text messages]; (2) SOC + 12 weeks of NRT; (3) SOC + 6 weeks of SMS text messages to support quitting tobacco use (SMS); or (4) SOC + NRT + SMS. Participants will receive a cell phone and solar panel with power bank for charging the phone. The main outcome is cessation of tobacco use by study participants verified by urinary cotinine (

Abstract Background Preliminary evidence has been presented for interventions focused on preventing alcohol consumption or reducing the occurrence of episodes of excessive drinking. The anchoring text message intervention is a newly proposed theory-based approach to reducing heavy drinking among youth. The current study tests the preliminary efficacy of this intervention for reducing heavy drinking among Mexican youth. Methods Focusing on a sample of sixteen Mexican youths—nine not-heavy drinkers and seven heavy drinkers—the participants completed a survey on alcohol consumption and anchoring heuristics. Pretest and post-test questionnaire data were collected to evaluate the effectiveness of the intervention. The anchoring text messages consisted of strategies to limit alcohol use and feedback reminder messages. Assessments were conducted at baseline, four weeks of intervention, and post-intervention. Results Logistic regression analyses indicated a significant effect on heavy drinking episodes post-intervention. The post-intervention anchoring effects among the heavy drinker participants were different from those among the non-heavy drinkers in terms of reporting heavy drinking and future drinking. The anchoring heuristic-based intervention reduced the quantity of drinking and the future estimation of drinking and improved the ability to reject alcohol in the heavy drinker group. Conclusions These findings provide preliminary support for the effectiveness of the anchoring heuristic-based intervention, conducted through text messages sent by mobile phone to reduce alcohol consumption. The intervention promoted a reduction in alcohol consumption. Future research should be directed toward investigating the anchoring effects among heavy drinkers.

Background: Poor adherence to long-term medication increases the risk of morbidity and mortality and decreases the quality of life of patients with hypertension. One strategy to improve treatment adherence is to use a short text message reminder. Although evidence indicates that such programs increase medication adherence, the extent of their effectiveness and translation into clinical practice needs to be better documented. Our systematic review will collect and analyze the available evidence for clinical practice implementation. This systematic review aimed to evaluate the effectiveness of short mobile phone text message reminders versus usual/standard care for medication adherence in patients with hypertension. Methods: This review will include and summarize evidence from randomized controlled trials. Adults (age > 18 years) with hypertension. The comparator group received either the usual care or standard care. It encompasses standard medical care for patients not participating in a structured and supervised intervention program such as a telemedicine program. We will include studies that assess the effectiveness of short mobile phone text message reminders in improving medication adherence in patients with hypertension compared to usual care. We will search the following databases: PubMed, EMBASE, CINAHL, SCOPUS, Web of Science, Cochrane Library Central Register of Controlled Trials, and Cochrane Library. We will include studies published in English. Furthermore, we will consider studies published from the inception of the database until April 20, 2024. At least two reviewers will independently conduct study selection, data extraction, and quality assessment. A third reviewer will determine and resolve discrepancies. We will conduct a quality assessment using the ROBIS 2 critical appraisal checklist. At least two independent reviewers will crosscheck the data synthesis. Discussion: We expect this review to provide current evidence for future studies and clinical practice concerning the impact of mobile phone text message reminders on medication adherence issues. We will publish our results in a peer-reviewed journal for publication. Systematic review registration: PROSPERO CRD42023391236. [ABSTRACT FROM AUTHOR]

Background: Important tools in preventing the spread of COVID-19 include contract tracing and adherence to isolation guidelines after a positive diagnosis of COVID-19. This is especially relevant among college students who are often away from support systems at home, living in high-density housing, and may not experience serious symptoms from COVID-19 while still contagious. Objective: As text message-based interventions have been found effective in addressing health behaviors among young adults, we conducted formative research to explore how text messaging could support students in adhering to isolation guidelines. Participants: A convenience sample of college students (n = 104) at one university. Methods: An online survey gathered students' perceptions of helpful components to include in a text message-based intervention. Results: Students expressed interest in receiving text messages with support, encouragement, and resources during their time in isolation following a COVID-19 diagnosis. Conclusions: Based on the results, we developed a text message-based intervention designed to provide motivation, support, distraction, and information on resources. [ABSTRACT FROM AUTHOR]

Background: Nicotine replacement therapy (NRT) and short messaging service (SMS)-based tobacco cessation interventions have demonstrated effectiveness in reducing tobacco use in many populations, but evidence is needed on which tailored treatments are most efficacious in meeting the complex medical and psychosocial factors confronting people living with HIV (PLWH) in sub-Saharan Africa (SSA). This paper describes the protocol of a study to test the efficacy of both NRT and a tailored SMS-based tobacco use cessation intervention among PLWH in Uganda and Zambia. Methods: In a randomized controlled trial, 800 adult PLWH who use tobacco will be recruited by health care professionals at HIV treatment centers where they are receiving care. Participants will be randomized to one of the four study arms: (1) standard of care [SOC; brief clinician advice to quit combined with HIV education and information aimed at encouraging HIV treatment adherence (with no mention of tobacco) delivered via text messages]; (2) SOC + 12 weeks of NRT; (3) SOC + 6 weeks of SMS text messages to support quitting tobacco use (SMS); or (4) SOC + NRT + SMS. Participants will receive a cell phone and solar panel with power bank for charging the phone. The main outcome is cessation of tobacco use by study participants verified by urinary cotinine (< 15 ng/mL) at 6 months post-enrollment. As a secondary tobacco use outcome, we will measure 7-day point-prevalence abstinence (7 consecutive days of no tobacco use) measured by self-report and biochemically-verified at 4 weeks, 8 weeks, and 3 months post enrollment. Discussion: Our study will provide insight into the efficacy, feasibility and applicability of delivering tobacco cessation interventions through health care professionals combined with tailored tobacco cessation SMS text messaging in two countries with different tobacco use patterns, policy environments, and health care resources and provide needed information to providers and policymakers looking for cost-effective tobacco cessation interventions. The previously tested SMS-platform to be used in our study is uniquely positioned to be scaled in low- and middle-income countries worldwide, in which case evidence of even modest success in reducing the prevalence of tobacco consumption among PLWH could confer enormous health and economic benefits. Trial registration: ClinicalTrials.gov Identifier NCT05487807. Registered August 4, 2022, https://clinicaltrials.gov/ct2/show/record/NCT05487807 [ABSTRACT FROM AUTHOR]

This study aimed to examine the effect of digital health interventions compared with treatment as usual on preventing and treating postpartum depression and postpartum anxiety. Searches were conducted in Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. The systematic review included full-text randomized controlled trials comparing digital health interventions with treatment as usual for preventing or treating postpartum depression and postpartum anxiety. Two authors independently screened all abstracts for eligibility and independently reviewed all potentially eligible full-text articles for inclusion. A third author screened abstracts and full-text articles as needed to determine eligibility in cases of discrepancy. The primary outcome was the score on the first ascertainment of postpartum depression or postpartum anxiety symptoms after the intervention. Secondary outcomes included screening positive for postpartum depression or postpartum anxiety --as defined in the primary study --and loss to follow-up, defined as the proportion of participants who completed the final study assessment compared with the number of initially randomized participants. For continuous outcomes, the Hedges method was used to obtain standardized mean differences when the studies used different psychometric scales, and weighted mean differences were calculated when studies used the same psychometric scales. For categorical outcomes, pooled relative risks were estimated. Of 921 studies originally identified, 31 randomized controlled trials—corresponding to 5532 participants randomized to digital health intervention and 5492 participants randomized to treatment as usual—were included. Compared with treatment as usual, digital health interventions significantly reduced mean scores ascertaining postpartum depression symptoms (29 studies: standardized mean difference, −0.64 [95% confidence interval, −0.88 to −0.40]; I 2 =94.4%) and postpartum anxiety symptoms (17 studies: standardized mean difference, −0.49 [95% confidence interval, −0.72 to −0.25]; I 2 =84.6%). In the few studies that assessed screen-positive rates for postpartum depression (n=4) or postpartum anxiety (n=1), there were no significant differences between those randomized to digital health intervention and treatment as usual. Overall, those randomized to digital health intervention had 38% increased risk of not completing the final study assessment compared with those randomized to treatment as usual (pooled relative risk, 1.38 [95% confidence interval, 1.18–1.62]), but those randomized to app-based digital health intervention had similar loss-to-follow-up rates as those randomized to treatment as usual (relative risk, 1.04 [95% confidence interval, 0.91–1.19]). Digital health interventions modestly, but significantly, reduced scores assessing postpartum depression and postpartum anxiety symptoms. More research is needed to identify digital health interventions that effectively prevent or treat postpartum depression and postpartum anxiety but encourage ongoing engagement throughout the study period. [ABSTRACT FROM AUTHOR]

Background: Preliminary evidence has been presented for interventions focused on preventing alcohol consumption or reducing the occurrence of episodes of excessive drinking. The anchoring text message intervention is a newly proposed theory-based approach to reducing heavy drinking among youth. The current study tests the preliminary efficacy of this intervention for reducing heavy drinking among Mexican youth. Methods: Focusing on a sample of sixteen Mexican youths—nine not-heavy drinkers and seven heavy drinkers—the participants completed a survey on alcohol consumption and anchoring heuristics. Pretest and post-test questionnaire data were collected to evaluate the effectiveness of the intervention. The anchoring text messages consisted of strategies to limit alcohol use and feedback reminder messages. Assessments were conducted at baseline, four weeks of intervention, and post-intervention. Results: Logistic regression analyses indicated a significant effect on heavy drinking episodes post-intervention. The post-intervention anchoring effects among the heavy drinker participants were different from those among the non-heavy drinkers in terms of reporting heavy drinking and future drinking. The anchoring heuristic-based intervention reduced the quantity of drinking and the future estimation of drinking and improved the ability to reject alcohol in the heavy drinker group. Conclusions: These findings provide preliminary support for the effectiveness of the anchoring heuristic-based intervention, conducted through text messages sent by mobile phone to reduce alcohol consumption. The intervention promoted a reduction in alcohol consumption. Future research should be directed toward investigating the anchoring effects among heavy drinkers. [ABSTRACT FROM AUTHOR]

Food insecurity is an ongoing problem in the U.S. with implications for health problems and social disadvantages. Past food insecurity intervention studies have targeted barriers to accessing healthy food. However, information barriers have not been adequately addressed by food insecurity interventions. This research included the first phase of a two-phase feasibility study that involved testing a text message as an informational nudge through interviews among a small, preliminary sample of adults in the southwest U.S. (n = 10). Interview questions focused on the message content, persuasiveness, relevancy, clarity, and details that participants liked and disliked. A qualitative content analysis of interview responses then highlighted any necessary modifications to the text message. Interview responses highlighted that the message conveyed details about how to access food assistance resources. The message was perceived as informative, clear, and friendly. Participants highlighted the need for better spacing in the message layout, more details about the Supplemental Nutrition Assistance Program (SNAP), and a better explanation for why SNAP is relevant. Text message readability, relevancy, and informativeness were common concerns raised during interviews. Participant-informed modifications to the text message were applied in preparation for using the message in a food insecurity intervention. This research is a novel contribution to the extant literature on nudges, as no known intervention study has used informational nudges to exclusively promote food security. Future food insecurity research efforts should similarly test novel interventions to ensure the intervention is acceptable and relevant for the target population. [ABSTRACT FROM AUTHOR]

Food insecurity is an economic and social condition involving limited or uncertain access to food. The problem of food insecurity in communities is influenced by economic conditions, food deserts, and barriers to accessing healthy food. Individuals experiencing food insecurity often endure concurrent problems of financial instability, hunger, and poor mental and physical health. Public and non-profit services in the U.S., such as the federally supported Supplemental Nutrition Assistance Program (SNAP) and community food banks, provide food-related assistance to individuals who are at a high risk of experiencing food insecurity. Unfortunately, many individuals who qualify for these services still experience food insecurity due to barriers preventing them from accessing food. Effective approaches for removing barriers that prevent individuals from accessing food are needed to mitigate the increased risk of chronic disease among vulnerable populations. This study tested a novel food insecurity intervention called FINDING-Food, which stands for Frequent Informational Nudges Directing Individuals to Needed Goods. Informational nudges were used to promote food security through the removal of information barriers to accessing food. The intervention used in this mixed-methods feasibility study consisted of informational nudges in the form of weekly text messages that were sent to food pantry clients experiencing food insecurity (n = 24). The study aims were to test the efficacy and acceptability of the intervention by examining whether the informational nudges could enhance food pantry utilization, increase SNAP registration, and promote food security. Quantitative study results showed a lower prevalence of food insecurity in the intervention group than the control group at the end of the study. Qualitative findings revealed how intervention group participants who completed the study (n = 9) found the text messages to be helpful and informative. These study findings can enhance future food insecurity interventions aiming to eliminate barriers that prevent individuals who are food insecure from accessing healthy food. [ABSTRACT FROM AUTHOR]

Introduction: Organ Procurement Organizations seek authorization for tissue donation from next-of-kin of deceased patients. Best practices for achieving contact and authorization are unknown, notably, authorization rates are lower for Black compared to White patients. Research Questions: Can next-of-kin (NOK) contact and authorization rates be improved if they are texted prior to telephone contact? Is a text message containing an infographic more effective, and does an infographic culturally tailored to Black families improve contact and authorization rates in the Black population? Design: This three-armed randomized trial compared (1) telephonic contact initiation (control condition); (2) generic text messaging prior to telephonic contact; and (3) text messaging one of two versions of an infographic prior to telephonic contact: (a) a generic infographic or (b) a culturally tailored infographic (sent to Black NOK only) at one Northeastern Organ Procurement Organization. Results: Tissue Donation Professionals (N = 47) and 2399 White and 745 Black NOK were included, of which 35.6% were registered donors. Authorization rates were much higher for White than Black (40.1% v 16.3%, P < 0.0001). The generic infographic resulted in significantly lower rates of contact for White NOK compared to the control condition 83.5% v 89.5%, P = 0.002), but study arm assignments were not otherwise associated with differences in contact or authorization rates. Conclusion: Although the analysis did not find a benefit for text messaging, it is possible that training for staff making requests and refining the content of the messaging could be more effective. [ABSTRACT FROM AUTHOR]

Background Physician clinical educators play important roles in teaching, providing feedback, and evaluating trainees, but they often have variable preparation and competing demands on their time that make universal participation in workshops, seminars, or short courses designed to foster these skillsets inefficient or impossible. Methods We designed and implemented a 52-week synchronous curriculum designed to address faculty opportunities to improve teaching skills, feedback for residents and medical students, and evaluation skills, which were delivered using marketing automation tools, including text messaging and email. We evaluated the programmatic impact and feasibility of using the implementation science framework. Results Over a 104-week evaluation period, there were at least 10,499 total content impressions and 4558 unique recipients, indicating the significant reach of this program to approximately 120 faculty members. Faculty engagement with continuing education materials remained stable or increased over the 2-year evaluation period, indicating that programs like ours can have sustainable impacts. Resident evaluations of faculty across the six key domains also improved after the implementation of the program. Conclusions Our experience with digital marketing tools reflects that they can be used to deliver impactful curricular content to faculty for continuing educational purposes and that faculty can use these resources in a sustainable way. However, because of the incomplete reach with any single communication, this type of content delivery is not appropriate for isolation as a material of critical importance. More research is needed to identify the best practices and additional education-related uses of this technology.

BackgroundHIV/AIDS is now a manageable chronic illness owing to effective antiretroviral therapy (ART), which involves routine follow-up care, including regular physical visits to the clinic. In the recent past, and in wake of the COVID-19 pandemic, there has been increased need for virtual care and intervention delivery, a modality known as mobile health (mHealth), which includes cell phone-delivered services for medical and public health practice.ObjectiveHere we describe cell phone use and its relationship with alcohol use in a cohort of persons living with HIV and latent tuberculosis (TB).MethodsWe performed a cross-sectional analysis of baseline data from a cohort of persons living with HIV and latent TB in HIV care in southwestern Uganda. We estimated proportions of cell phone and text message use and evaluated their associations with alcohol use-a common modifiable behavior among persons living with HIV. Cell phone use (primary outcome) was defined as owning a cell phone that is turned on at least half of the day. Any alcohol use was defined as any self-reported alcohol use in the prior 3 months or a phosphatidylethanol (an alcohol biomarker) level of ≥8 ng/mL.ResultsA total of 300 participants (median age 40 years; n=146, 48.7% male) were included in the analysis. Most (n=267, 89.0%) participants had access to a phone and of them, 26 (9.7%) shared the phone with someone else. In total, 262/300 (87.3%) of participants owned a cell phone that is turned on at least half of the time; the majority (n=269, 89.7%) rarely or never sent text messages, and over two-thirds (n=200, 66.9%) rarely or never received text messages. Most (n=214, 71.3%) had any alcohol use in the prior 3 months. In adjusted analyses, any alcohol use was not significantly associated with cell phone use (adjusted odds ratio [aOR] 0.48, 95% CI 0.18-1.25; P=.13) or sending (aOR 0.82, 95% CI 0.28-2.37; P=.71) or receiving (aOR 1.31, 95% CI 0.70-2.47; P=.40) text messages.ConclusionsThere is hope that mHealth interventions in this population can be carried out using cell phones owing to their popularity; however, the interventions may need to employ methods that do not rely on the sending and receiving of text messages only.

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Before the start of the COVID-19 pandemic, the College's Hirons Library & Learning Center (HLLC) library marketing efforts included word of mouth, information literacy instruction session, physical and electronic displays, and announcement on the library webpage to library users. In March 2020, due to the COVID-19 pandemic, the HLLC, in collaboration with the Office of Institutional Research & Training (OIRT), designed two new library marketing campaigns using the project management app, Notion. Both campaigns were designed to meet the new and changing needs of our new, predominately remote, users. In the first library marketing campaign, the HLLC's marketing goal was very focused and deliberate in purpose. The library emailed the College community messages to increase awareness and usage of the library's eBook collections. In the second library marketing campaign, the library broadened the purpose of the marketing campaigned to promote online resources, tools, and virtual programs. The library sent text messages to the students. In this edition of the column, we describe how our marketing efforts have changed due to the pandemic, including which strategies we employed, and the extent to which we recognized success with these new efforts. [ABSTRACT FROM AUTHOR]

Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents’ consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria.

Terri Call,1,&ast; Andrew D Pucker,1,&ast; Gerald McGwin Jr,2 Quentin X Franklin,1 Amy Logan1 1Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA&ast;These authors contributed equally to this workCorrespondence: Andrew D Pucker, University of Alabama at Birmingham, School of Optometry, 1716 University Blvd, Birmingham, AL, 35233, USA, Tel +1 920 579-2900, Email andrewpucker@hotmail.comPurpose: To map contact lens (CL) comfort over the full wear day and across 1 month’s wear in established, asymptomatic to minimally symptomatic, reusable, soft CL wearers.Methods: Adult, 18- to 45-year-old, participants were recruited and required to have 20/20 best-corrected visual acuity or better and must have been asymptomatic to minimally symptomatic CL wearers. Participants were required to be able to wear TOTAL30® sphere CLs and have minimal astigmatism. Participants were fit in the study CLs and asked to wear these CLs daily for the next month for 16 hours per day each day. Participants were asked to complete a visual analog scale (VAS) survey via text message at time of CL application and after 8, 10, 12, 14, and 16 hours of wear and at CL removal on days 1, 2, 3, 4, and 5 and at 2 weeks and 1 month. The utilized VAS had a ± 50 scale with positive scores being comfortable, negative scores being uncomfortable, and scores of 0 being neutral comfort.Results: Forty-eight participants were recruited who had a mean ± SD age of 26.2 ± 5.2 years (71% female). Mean initial VAS CL comfort scores at initial CL dispense were 45.56 ± 9.20 units. Mean CL wear times for any of the days evaluated were at least 14.80 ± 2.41 hours per day and did not differ across the study (p = 0.77). Mean comfort VAS scores significantly decreased over the wear day (all days p ≤ 0.02), yet there were no significant differences in VAS comfort scores across the same time of day for the duration of the study (all times p ≥ 0.06).Conclusion: This study determined that while CL wearers were slightly less comfortable at the end of the day compared to application, this comfort change was minimal given that the average participants had overwhelmingly good comfort at all time-points evaluated. Comfort scores were likewise consistent across 1 month of wear.Keywords: comfort, contact lenses, monthly, reusable, text message, visual analog scale

BackgroundCigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults. Although many young homeless smokers are motivated to quit, there are no empirically-evaluated smoking cessation programs for this population. It is important that any such program address the factors known to be associated with quitting-related outcomes among homeless young people, to provide ongoing support in a way that accommodates the mobility of this population, and does not rely on scarce service provider resources for its delivery. The objective of this project is to develop and pilot test a text messaging-based intervention (TMI), as an adjunct to brief cessation counseling and provision of nicotine patches, to help homeless young people who want to quit smoking.Methods/designThis pilot study will utilize a cluster cross-over randomized controlled design with up to 80 current smokers who desire to quit and are recruited from three drop-in centers serving young people experiencing homelessness in the Los Angeles area. All participants will be provided with a minimum standard of care: a 30-min group-based smoking cessation counseling session and free nicotine replacement. Half of these smokers will then also receive the TMI, as an adjunct to this standard care, which will provide 6 weeks of ongoing support for quitting. This support includes continued and more intensive education regarding nicotine dependence, quitting smoking, and relapse; does not require additional agency resources; can be available "on demand" to users; and includes features to personalize the quitting experience. This study will investigate whether receiving the TMI adjunct to standard smoking cessation care results in greater reductions in cigarette smoking compared to standard care alone over a 3-month period.DiscussionThis study has the potential to address an important gap in the clinical research literature on cigarette smoking cessation and provide empirical support for using a TMI to provide ongoing assistance and support for quitting among young smokers experiencing homelessness. Trial registration ClinicalTrials.gov Identifier NCT03874585. Registered March 14, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874585.

Given the role of malnutrition in childhood morbidity and mortality, the prioritisation of maternal and child nutrition programmes has grown significantly in the 21st century. Policies and programmes aim to improve infant and young child feeding, but questions persist about the most effective combination of interventions to achieve desired behaviour change. There is increasing interest in mobile‐based interventions globally, but scant evidence exists to guide donors, policymakers and programme implementers on their effectiveness. Formative research was conducted to assess the feasibility and acceptance of text message‐based interventions and to guide the final design of the text message intervention. This protocol is for a cluster‐randomised controlled trial to test the effectiveness of adding text messaging to other ongoing SBC interventions to promote egg consumption, dietary diversity and other ideal dietary practices, particularly among children 12–23 months of age in Kanchanpur, Nepal. The trial findings will contribute to the emerging body of evidence on the effectiveness of using text messages for behaviour change, specifically for young child dietary outcomes in South Asia. Recent studies have suggested that mobile‐based interventions alone may be insufficient but valuable when added to other social and behavioural interventions; this trial will help to provide evidence for or against this emerging theory. This trial was registered at ClinicalTrials.gov on 11 March 2019 (ID: NCT03926689) and has been updated twice. Key messages: Multiple rounds of formative research can facilitate higher‐quality interventions including optimal wording, timing and reach of short message service to target audiences to improve nutrition‐related behaviours.Experimental studies are needed to guide decision‐making around the use of technology‐based behaviour change interventions to improve diets.This trial to test the effectiveness of text messaging to improve young child diets, and its process evaluation, will inform future mNutrition interventions. [ABSTRACT FROM AUTHOR]

Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents' consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria. [ABSTRACT FROM AUTHOR]

ObjectiveTo evaluate the effect of different modalities of centralized reminder/recall (autodialer, text, mailed reminders) on increasing childhood influenza vaccination.Study designTwo simultaneous randomized clinical trials conducted from October 2017 to April 1, 2018, in New York State and Colorado. There were 61 931 children in New York (136 practices) and 23 845 children in Colorado (42 practices) who were randomized to different centralized reminder/recall modalities-4 arms in New York (autodialer, text, mailed, and no reminder control) and 3 arms in Colorado (autodialer, mailed, and no reminder control). The message content was similar across modalities. Up to 3 reminders were sent for intervention arms. The main outcome measure was receipt of ≥1 influenza vaccine.ResultsIn New York, compared with the control arm (26.6%), postintervention influenza vaccination rates in the autodialer arm (28.0%) were 1.4 percentage points higher (adjusted risk ratio, 1.06; 95% CI, 1.02-1.10), but the rates for text (27.6%) and mail (26.8%) arms were not different from controls. In Colorado, compared with the control arm (29.9%), postintervention influenza vaccination rates for the autodialer (32.9%) and mail (31.5%) arms were 3.0 percentage points (adjusted risk ratio, 1.08; 95% CI, 1.03-1.12) and 1.6 percentage points (adjusted risk ratio, 1.06; 95% CI, 1.02-1.10) higher, respectively. Compared with the control arm, the incremental cost per additional vaccine delivered was $20 (New York) and $16 (Colorado) for autodialer messages.ConclusionsCentralized reminder/recall for childhood influenza vaccine was most effective via autodialer, less effective via mail, and not effective via text messages. The impact of each modality was modest. Compared with no reminders, the incremental cost per additional vaccine delivered was also modest for autodialer messages.Trial registrationClinicalTrials.gov: NCT03294473 and NCT03246100.

ObjectiveTo evaluate if gabapentin 600 mg reduces pain after osmotic dilator placement the day before a dilation and evacuation (D&E) procedure.Study designWe conducted a double-blind, placebo-controlled, randomized (stratified by vaginal parity) trial among women undergoing osmotic dilator placement before D&E at 15-23 5/7 weeks gestation. Subjects received gabapentin 600 mg or placebo 30 min before dilator placement, with re-dosing 8 h later. We assessed pain after dilator placement using a numeric rating scale (NRS; scale 0-10) at 5 min, 2, 4, and 8 h, and at presentation for D&E. The primary outcome was median NRS pain score change from baseline to 8 h after dilator placement. Secondary outcomes included gabapentin-related side effects and analgesic use.ResultsOf 121 randomized women, we excluded three subjects (allergic reaction [placebo], randomization error, no NRS data), leaving 60 gabapentin and 58 placebo subjects. Of 110 (93%) women who provided 8-hour data, median pain score changes from baseline did not differ between gabapentin and placebo groups overall (2 vs. 2.5, p = 0.52), in vaginally nulliparous women (2 vs. 4, p = 0.10) or in parous women (2 vs. 1.5, p = 0.37). We found no statistically significant differences in median pain score change from baseline to any timepoint overall or when stratified by parity. Beginning at 2 h after dilator placement, more gabapentin than placebo users experienced dizziness (29/53[55%] vs. 11/53[21%], p = 0.001) and tiredness (34/54[63%] vs. 17/54[31%], p = 0.002). The proportion of women using narcotics did not differ between gabapentin (35/60[58%]) or placebo (40/58[69%]) users (p = 0.26).ConclusionsGabapentin does not reduce pain with overnight osmotic dilator placement prior to D&E and causes drug-related side effects.Implications statementWomen experience pain, mostly mild to moderate, with overnight cervical dilator placement at 15-23 5/7 weeks gestation. About 2/3 of women will use a limited quantity of narcotics if provided. Gabapentin does not decrease the pain with or following dilator placement and does not decrease narcotic use.

There is no gold standard for estimating antiretroviral therapy (ART) adherence. Feasible, acceptable, and objective measures that are cost- and time-effective are needed. US adults (N = 93) on ART for ≥ 3 months, having access to a mobile phone and internet, and willing to mail in self-collected hair samples, were recruited into a pilot study of remote adherence data collection methods. We examined the correlation of self-reported adherence and three objective remotely collected adherence measures: text-messaged photographs of pharmacy refill dates for pharmacy-refill-based adherence, text-messaged photographs of pills for pill-count-based adherence, and assays of home-collected hair samples for pharmacologic-based adherence. All measures were positively correlated. The strongest correlation was between pill-count- and pharmacy-refill-based adherence (r = 0.68; p

The popularity of short-messaging formats, like text and chat, is on the rise in the workplace with many employees preferring this style over long-form options like email. While many businesses expect employees to communicate using short messages, students may be ill-equipped to effectively use these methods due to a lack of formal training. This study sets out to understand students’ experience, confidence, and education related to professional short messaging. Results indicate a correlation between confidence and experience levels in writing text and chat messages. Further, the participants who indicated they had training on writing short messages, indicated they learned it in a business communication class. Thus, this study highlights a need for education on short messaging in the business communication classroom to increase student experience, and thus, their confidence in writing these messages.

Objectives: Considering the need of diabetic patients for accessing the care system and the role of modern media in health education and culture, we aimed to determine the effectiveness of educating via mobile SMS in controlling blood sugar. Moreover, the adherence to drug treatment of patients with type 2 diabetes was assessed. Methods: This quasi-experimental study was conducted in Isfahan City, Iran in 2018. A total of 100 diabetic patients participated in the case (intervention) and control groups. The control group underwent conventional therapies and training. SMS training was applied for the intervention group in addition to the conventional therapies. Collecting the information and data to assess adherence to patients’ treatment was done using a researcher-made 18-item questionnaire. Analyzing data was performed in SPSS software, version 20 through the employment of the independent t test, paired t test, and multivariate analysis of covariance. Results: Based on the independent t test results, no significant difference was detected between the two study groups at any time points (P>0.05) in terms of the mean fasting blood sugar. However, by analysis of covariance and adjusting the fasting blood sugar level before the intervention in the studied groups, the mean fasting blood sugar was recognized to be significantly lower in the intervention group compared to the control group in the second month (P=0.048) and the third month after the intervention (P=0.008). Discussion: There is an association between SMS education and fasting blood sugar control and adherence to treatment in the studied patients. In the field of health care education, it is possible to use patient communication techniques and short message services to control follow-up and monitor interventions.

Abstract Background Short Message Service (SMS) reminders have improved vaccine uptake in low- and middle-income countries (LMICs). However, the limited use of SMS reminders in LMICs requires evaluating the intervention’s internal and external validity to improve adoption and sustainability. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we qualitatively assessed the impact of a SMS reminder intervention implemented in Kebbi State, Northwest Nigeria between May 20, 2019 and May 31, 2020. This will guide and inform future SMS reminder interventions to improve childhood immunization uptake in LMICs. Methods In June 2020, we conducted 14 focus group discussions, 13 in-depth interviews, and 20 key informant interviews among 144 purposively selected participants from five local government areas of Kebbi State. For analysis, we used a deductive approach to develop preliminary codes based on the RE-AIM framework and the inductive approach to generate themes that emerged from the interviews. Results The perceived importance and impact of the SMS reminder in improving demand and uptake for vaccinations were the consistent contributing factors that encouraged participants’ participation. Other facilitators included the involvement of health workers in supporting SMS reminder registration and community gatekeepers using existing structures to convey messages on scheduled immunization services. Policymakers adopted the intervention because it aligns with the state’s priority to improve immunization coverage. Similarly, the SMS reminder appealed to health workers and program managers because it reduced their workload and served as a performance monitoring tool to track immunization and intervention defaulters. Despite these, low mobile phone ownership and the inability to read text messages due to the low literacy level were the main barriers during implementation. Finally, data availability on cost-effectiveness and the intervention’s impact on improving coverage was critical for scalability. Conclusions Our study demonstrated that SMS reminders in local languages could improve vaccination demand and uptake in resource-constrained settings due to their perceived importance and impact. Addressing the cited implementation barriers and promoting the facilitators is critical to its adoption and sustainability. Costing and impact data are needed to collaborate findings on the effectiveness of the SMS reminder to improve childhood vaccination uptake.

Abstract Background Adolescence presents a window of opportunity to establish good nutrition and physical activity behaviours to carry throughout the life course. Adolescents are at risk of developing cardiovascular and other chronic diseases due to poor the complex interplay of physical and mental health lifestyle risk factors. Text messaging is adolescents main form of everyday communication and text message programs offer a potential solution for support and improvement of lifestyle health behaviours. The primary aim of this study is to determine effectiveness of the Health4Me text message program to improve adolescent’s physical activity or nutrition behaviours among adolescents over 6-months, compared to usual care. Methods Health4Me is a virtual, two-arm, single-blind randomised controlled trial, delivering a 6-month healthy lifestyle text message program with optional health counselling. Recruitment will be through digital advertising and primary care services. In total, 390 adolescents will be randomised 1:1 to intervention or control (usual care) groups. The intervention group will receive 4–5 text messages per week for 6-months. All text messages have been co-designed with adolescents. Messages promote a healthy lifestyle by providing practical information, health tips, motivation and support for behaviour change for physical activity, nutrition, mental health, body image, popular digital media and climate and planetary health. Virtual assessments will occur at baseline and 6-months assessing physical health (physical activity, nutrition, body mass index, sleep), mental health (quality of life, self-efficacy, psychological distress, anxiety, depression, eating disorder risk) and lifestyle outcomes (food insecurity and eHealth literacy). Discussion This study will determine the effectiveness of a 6-month healthy lifestyle text message intervention to improve physical activity and nutrition outcomes in adolescents. Trial registration Australia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000949785 , Date registered: 05/07/2022.

This article propounds a Piecewise Symmetric Magic Cube (PSMC), the properties of which have reinvigorated its application to text encryption. A method has been introduced for the construction of magic cubes of order m × 2l, for all l , m (m even) ∈ N ∪ 0 , m ≥ 4 by using the concept of compounding. The behavior of elements in PSMC is controlled by the starting variables (Sstart and Lstart). The formula for evaluation of the magic sum of these magic cubes have been derived, which ensures magic nature of PSMC. Additionally, PSMC are applied to the field of text cryptography. The proposed text encryption model is applicable for the encryption and decryption of any language that may include numeric digits, and special characters along with their different combinations. Also, the validation of this model has been checked by focusing on the analysis of bilingual data (English-German, English-Hindi, German-Hindi, French-Arabic, and Italian-Spanish). The performance evaluation metrices (brute-force analysis, avalanche effect, CPU time analysis, Shannon entropy, and known plain text analysis) have been carried to analyze the resisting efficiency of the proposed model against different types of attacks. An analysis of encryption/ decryption time shows that decryption is more time-efficient which protects the data from getting being corrupted by the intruders. The distinct entries of PSMC remove the problem of repetition in cipher text which raises the level of security to a higher extent. [ABSTRACT FROM AUTHOR]

Background: Counteracting desires to drink are cognitive processes that exert self‐control to mitigate impulses or strengthen other, perhaps more distal, goals to limit consumption. Young adults are particularly challenged by mismatches between self‐regulation and desires to drink that make them susceptible to hazardous alcohol use. Methods: We assessed whether drinking limit goal commitment and goal confidence mediate the association between desire to get drunk and binge drinking (4+ drinks for females and 5+ drinks for males on a given occasion) among young adults exposed to text message goal‐related feedback. We randomized 297 young adults to one of two text message interventions that incorporated drinking limit goal‐related assessments and feedback over 12 weeks of intervention exposure. On the 2 days per week that they typically drank alcohol, participants were asked to report plans to drink (yes/no). If a drinking plan was endorsed, participants reported their desire to get drunk (0 [not at all] to 8 [completely]), willingness to commit to a drinking limit goal (yes/no), and (contingent on goal commitment) goal confidence (0 [not at all] to 8 [completely]). The next day, participants reported their drinking quantity, coded as a binge drinking day (yes/no). Mediation was tested using path models of simultaneous between‐ and within‐person effects using maximum likelihood. Results: At both within‐ and between‐person levels, we found significant indirect path effects of goal commitment and goal confidence between desire to get drunk and binge drinking. Greater than usual desire to get drunk was associated with lower drinking limit goal commitment and confidence, whereas greater than usual goal commitment and confidence were associated with lower likelihood of same‐day binge drinking. Discussion: Findings support a mechanistic model where contextual variations in same‐day drinking limit goal commitment and confidence mitigate the path between desire to get drunk and binge drinking among young adults. Employing just‐in‐time strategies to reinforce drinking limit goal commitment and goal confidence could reduce hazardous drinking and related harms. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. Design: Randomized, controlled trial. Setting: Two health systems in the Northeastern US between September 2020 and March 2021. Subjects: 74,811 adults. Interventions: Patients in the 19 intervention arms received 1-2 text messages in the 3 days preceding their appointment that varied in their format, interactivity, and content. Measures: Influenza vaccination. Analysis: Intention-to-treat. Results: Participants had a mean (SD) age of 50.7 (16.2) years; 55.8% (41,771) were female, 70.6% (52,826) were White, and 19.0% (14,222) were Black. Among the interventions, 5 of 19 (26.3%) had a significantly greater vaccination rate than control. On average, the 19 interventions increased vaccination relative to control by 1.8 percentage points or 6.1% (P =.005). The top performing text message described the vaccine to the patient as "reserved for you" and led to a 3.1 percentage point increase (95% CI, 1.3 to 4.9; P <.001) in vaccination relative to control. Three of the top five performing messages described the vaccine as "reserved for you." None of the interventions performed worse than control. Conclusions: Text messages encouraging vaccination and delivered prior to an upcoming appointment significantly increased influenza vaccination rates and could be a scalable approach to increase vaccination more broadly. [ABSTRACT FROM AUTHOR]

Abstract Background & aim Some cultural scenarios in pregnancy and childbirth reinforce dysfunctional sexual beliefs that reverse changes in the couple's sexual life. The present study aimed to investigate the effect of education by sending text messages on modifying dysfunctional sexual beliefs in pregnant women. Methods & materials This study is a randomized clinical trial, and 82 eligible pregnant women referred to educational-medical centers to receive prenatal care were randomly assigned to intervention or control group. The intervention group received 24 text messages during eight weeks (three text messages per week), and the control group received only routine care. Data was collected through a demographic questionnaire, reproductive profile, Spinner's Dyadic Adjustment Scale (DAS), and dysfunctional sexual beliefs questionnaire. Both groups completed the questionnaires before and one week after the intervention. Independent t-test, paired t-test, and analysis of covariance was used to analyze the data. Results The findings revealed no statistically significant difference in the baseline Dyadic Adjustment mean scores of control (132.4 ± 11.01) and intervention (130.10 ± 10.66) groups. Paired t-test analysis showed that the mean score of dysfunctional sexual beliefs was significantly decreased from (29 ± 7.61) at baseline compared to one week after intervention (10.54 ± 6.97) (p

Introduction: As a high symptom burden chronic condition, endometriosis is associated with diminished quality of life (QoL) and psychological distress. The EndoSMS text message intervention was developed to inform and support individuals living with endometriosis. The primary aim of this study is to assess the acceptability, feasibility and preliminary efficacy of EndoSMS, to improve endometriosis-specific QoL and reduce psychological distress in a randomised controlled trial, compared with care as usual. We will additionally assess the impact of EndoSMS on self-efficacy for managing endometriosis. Methodology: A two-arm parallel pilot randomised controlled trial with waitlist control was conducted. Baseline assessments included QoL, psychological distress, self-efficacy, demographic and medical variables. Following baseline survey completion, participants were randomised to either the Intervention (EndoSMS: 3-months of text messaging) or Control condition. At 3-month follow-up, all participants completed an online survey reassessing outcomes, and Intervention participants provided quantitative and qualitative user feedback on EndoSMS. Results: Data collection commenced on 18 November 2021 and was completed on 30 March 2022. Descriptive statistics will be used to analyse feasibility and acceptability of the intervention. Preliminary efficacy analyses will be conducted using linear mixed models for QoL, psychological distress and self-efficacy outcomes. Subgroup analyses will also be conducted for typically underserved populations (e.g., rural/regional). Conclusion: This pilot will provide acceptability, feasibility and preliminary efficacy evidence for the impact of a supportive text messaging program for endometriosis. It will contribute to understanding how to optimally support individuals in living with and managing their endometriosis. Trial Registration: Australian New Zealand Clinical Trials Registry.

BackgroundThe Coronavirus 2019 (COVID-19) pandemic threatened decades of progress in sexual and reproductive health (SRH) and gender-based violence as attendance at health facilities plummeted and service uptake dwindled. Similarly, misinformation regarding COVID-19 was rife. The demographics in Sierra Leone are diverse in the education, economic, and rural/urban divide. Telecommunications coverage, phone ownership, and preference for information access medium also vary greatly in Sierra Leone.AimThe aim of the intervention was to reach Sierra Leoneans at scale with information about SRH during the early stages of the COVID-19 pandemic. This paper presents the approach and insights from designing and implementing a large-scale mobile health (mHealth) messaging campaign.MethodBetween April and July 2020, a cross-sectional multichannel SRH messaging campaign was designed and launched in Sierra Leone. Through a secondary analysis of project implementation documents and process evaluation of the messaging campaign report, the project design trade-offs and contextual factors for success were identified and documented.ResultA total of 1.16 million recorded calls were initiated and 35.46 million text messages (short message service, SMS) were sent to telecommunication subscribers through a two-phased campaign. In phase one, only 31% of the 1,093,606 automated calls to 290,000 subscribers were picked up, dropping significantly at 95% confidence level (p = 1) after each of the four weeks. In addition, the listening duration dropped by one-third when a message was repeated compared to the first 3 weeks. Lessons from phase one were used to design an SMS and radio campaign in the scale-up phase. Evidence from our analysis suggests that the successful scaling of mHealth interventions during a pandemic will benefit from formative research and depend on at least six factors, including the following: (1) the delivery channels’ selection strategy; (2) content development and scheduling; (3) the persona categorization of youths; (4) stakeholder collaboration strategies; (5) technology trade-offs; and (6) cost considerations.Discussion and ConclusionThe design and implementation of a large-scale messaging campaign is a complex endeavor that requires research, collaboration with other diverse stakeholders, and careful planning. Key success ingredients are the number of messages to be delivered, the format, cost considerations, and whether engagement is necessary. Lessons for similar low-and-middle-income countries are discussed.

Background: Primary, basic, secondary, and high school teachers are constantly faced with increased work stressors that can result in psychological health challenges such as burnout, anxiety, and depression, and in some cases, physical health problems. It is presently unknown what the mental health literacy levels are or the prevalence and correlates of psychological issues among teachers in Zambia. It is also unknown if an email mental messaging program (Wellness4Teachers) would effectively reduce burnout and associated psychological problems and improve mental health literacy among teachers. Objective: The primary objectives of this study are to determine if daily supportive email messages plus weekly mental health literacy information delivered via email can help improve mental health literacy and reduce the prevalence of moderate to high stress symptoms, burnout, moderate to high anxiety symptoms, moderate to high depression symptoms, and low resilience among school teachers in Zambia. The secondary objectives of this study are to evaluate the baseline prevalence and correlates of moderate to high stress, burnout, moderate to high anxiety, moderate to high depression, and low resilience among school teachers in Zambia. Methods: This is a quantitative longitudinal and cross-sessional study. Data will be collected at the baseline (the onset of the program), 6 weeks, 3 months, 6 months (the program midpoint), and 12 months (the end point) using web-based surveys. Individual teachers will subscribe by accepting an invitation to do so from the Lusaka Apex Medical University organizational account on the ResilienceNHope web-based application. Data will be analyzed using SPSS version 25 with descriptive and inferential statistics. Outcome measures will be evaluated using standardized rating scales. Results: The Wellness4Teachers email program is expected to improve the participating teachers' mental health literacy and well-being. It is anticipated that the prevalence of stress, burnout, anxiety, depression, and low resilience among teachers in Zambia will be similar to those reported in other jurisdictions. In addition, it is expected that demographic, socioeconomic, and organizational factors, class size, and grade teaching will be associated with burnout and other psychological disorders among teachers, as indicated in the literature. Results are expected 2 years after the program's launch. Conclusions: The Wellness4Teachers email program will provide essential insight into the prevalence and correlates of psychological problems among teachers in Zambia and the program's impact on subscribers' mental health literacy and well-being. The outcome of this study will help inform policy and decision-making regarding psychological interventions for teachers in Zambia. [ABSTRACT FROM AUTHOR]

Background: Cisgender women in Kenya are at elevated risk of HIV acquisition during pregnancy and post partum. Acute HIV infection during pregnancy and breastfeeding accounts for approximately one-third of all vertical HIV transmissions. The World Health Organization recommends offering oral tenofovir-based pre-exposure prophylaxis (PrEP) to pregnant and postpartum women who are HIV negative but at substantial and ongoing risk for HIV acquisition. PrEP delivery for pregnant and postpartum women is expanding within routine maternal child health clinics in Kenya. However, approximately half of pregnant women discontinue PrEP within 30 days of initiation. Therefore, it is crucial to develop PrEP adherence strategies that enhance support for adherence when peripartum events and health issues pose challenges to sustaining PrEP adherence. Objective: We are conducting a randomized controlled trial to determine the effect of a bidirectional communication platform named Mobile Solutions for Women's and Children's Health (mWACh), which utilizes two-way SMS text messaging between patients and remote nurses to support PrEP adherence and address maternal health concerns in real time during the peripartum period. Methods: The mWACh-PrEP study is a randomized trial designed to support PrEP adherence during the peripartum period by comparing mWACh-PrEP to the standard of care (ie, in-clinic adherence counseling) among women who are HIV negative and initiating PrEP. Purposive sampling was used to select 5 facilities offering PrEP in antenatal clinics in Kisumu and Siaya Counties, and block randomization will be used to divide participants into groups. Participants in the intervention arm will receive a customized messaging curriculum via SMS text messages targeted toward their particular perinatal stage. The primary outcome, PrEP adherence at 6 months post partum, will be evaluated using a log-binomial regression model, adjusting for imbalanced baseline characteristics. Based on a previous study of directly observed dosing conditions, we will use a hair tenofovir concentration cutoff of 0.038 ng/mg (corresponding to 7 doses/week) as the primary adherence outcome measured at 6 months post partum (binary outcome). Qualitative interviews and cost-effective analyses will be conducted to understand the feasibility, acceptability, and economic impact of the intervention. Results: Enrollment began in March 2022 and is projected to continue until July 2023, with follow-up through March 2024. The study results are expected to be reported in 2025. Conclusions: This trial will provide insights into using mobile health to enhance PrEP adherence among pregnant and postpartum mothers. Additionally, the findings will have implications for the use of mobile health technology to improve adherence to other daily medications during the peripartum period. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder (OUD) has affected 2.2 million people in the United States. About 7.2 million people reported using illicit drugs in 2019, which contributed to over 70,000 overdose deaths. SMS text messaging interventions have been shown to be effective in OUD recovery. However, the interpersonal communication between individuals in OUD treatment and a support team on digital platforms has not been well examined. Objective: This study aims to understand the communication between participants undergoing OUD recovery and their e-coaches by examining the SMS text messages exchanged from the lens of social support and the issues related to OUD treatment. Methods: A content analysis of messages exchanged between individuals recovering from OUD and members of a support team was conducted. Participants were enrolled in a mobile health intervention titled "uMAT-R," a primary feature of which is the ability for patients to instantly connect with a recovery support staff or an "e-coach" via in-app messaging. Our team analyzed dyadic text-based messages of over 12 months. In total, 70 participants'messages and 1196 unique messages were analyzed using a social support framework and OUD recovery topics. Results: Out of 70 participants, 44 (63%) were between the ages of 31 and 50 years, 47 (67%) were female, 41 (59%) were Caucasian, and 42 (60%) reported living in unstable housing conditions. An average of 17 (SD 16.05) messages were exchanged between each participant and their e-coach. Out of 1196 messages, 64% (n=766) messages were sent by e-coaches and 36% (n=430) by participants. Messages of emotional support occurred the most, with 196 occurrences (n=9, 0.8%) and e-coaches (n=187, 15.6%). Messages of material support had 110 occurrences (participants: n=8, 0.7%; e-coaches: n=102, 8.5%). With OUD recovery topics, opioid use risk factors appeared in most (n=72) occurrences (patient: n=66, 5.5%; e-coach: n=6, 0.5%), followed by a message of avoidance of drug use 3.9% (n=47), which occurred mainly from participants. Depression was correlated with messages of social support (r=0.27; P=.02). Conclusions: Individuals with OUD who had mobile health needs tended to engage in instant messaging with the recovery support staff. Participants who are engaged in messaging often engage in conversations around risk factors and avoidance of drug use. Instant messaging services can be instrumental in providing the social and educational support needs of individuals recovering from OUD. [ABSTRACT FROM AUTHOR]

Background: Short Message Service (SMS) reminders have improved vaccine uptake in low- and middle-income countries (LMICs). However, the limited use of SMS reminders in LMICs requires evaluating the intervention's internal and external validity to improve adoption and sustainability. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we qualitatively assessed the impact of a SMS reminder intervention implemented in Kebbi State, Northwest Nigeria between May 20, 2019 and May 31, 2020. This will guide and inform future SMS reminder interventions to improve childhood immunization uptake in LMICs. Methods: In June 2020, we conducted 14 focus group discussions, 13 in-depth interviews, and 20 key informant interviews among 144 purposively selected participants from five local government areas of Kebbi State. For analysis, we used a deductive approach to develop preliminary codes based on the RE-AIM framework and the inductive approach to generate themes that emerged from the interviews. Results: The perceived importance and impact of the SMS reminder in improving demand and uptake for vaccinations were the consistent contributing factors that encouraged participants' participation. Other facilitators included the involvement of health workers in supporting SMS reminder registration and community gatekeepers using existing structures to convey messages on scheduled immunization services. Policymakers adopted the intervention because it aligns with the state's priority to improve immunization coverage. Similarly, the SMS reminder appealed to health workers and program managers because it reduced their workload and served as a performance monitoring tool to track immunization and intervention defaulters. Despite these, low mobile phone ownership and the inability to read text messages due to the low literacy level were the main barriers during implementation. Finally, data availability on cost-effectiveness and the intervention's impact on improving coverage was critical for scalability. Conclusions: Our study demonstrated that SMS reminders in local languages could improve vaccination demand and uptake in resource-constrained settings due to their perceived importance and impact. Addressing the cited implementation barriers and promoting the facilitators is critical to its adoption and sustainability. Costing and impact data are needed to collaborate findings on the effectiveness of the SMS reminder to improve childhood vaccination uptake. [ABSTRACT FROM AUTHOR]

Objectives: Considering the need of diabetic patients for accessing the care system and the role of modern media in health education and culture, we aimed to determine the effectiveness of educating via mobile SMS in controlling blood sugar. Moreover, the adherence to drug treatment of patients with type 2 diabetes was assessed. Methods: This quasi-experimental study was conducted in Isfahan City, Iran in 2018. A total of 100 diabetic patients participated in the case (intervention) and control groups. The control group underwent conventional therapies and training. SMS training was applied for the intervention group in addition to the conventional therapies. Collecting the information and data to assess adherence to patients' treatment was done using a researcher-made 18-item questionnaire. Analyzing data was performed in SPSS software, version 20 through the employment of the independent t test, paired t test, and multivariate analysis of covariance. Results: Based on the independent t test results, no significant difference was detected between the two study groups at any time points (P>0.05) in terms of the mean fasting blood sugar. However, by analysis of covariance and adjusting the fasting blood sugar level before the intervention in the studied groups, the mean fasting blood sugar was recognized to be significantly lower in the intervention group compared to the control group in the second month (P=0.048) and the third month after the intervention (P=0.008). Discussion: There is an association between SMS education and fasting blood sugar control and adherence to treatment in the studied patients. In the field of health care education, it is possible to use patient communication techniques and short message services to control follow-up and monitor interventions. [ABSTRACT FROM AUTHOR]