Study after study points to the power of text messaging
to connect health care providers to their patients,
improving patient compliance with medications and appointments
and giving medical professionals better data. A 2015
Johns Hopkins University study on birth control compliance
in young women is no exception, demonstrating the potential
texting holds to impact the often underserved area of
women's health.
The study, published online in the Journal of Adolescent
Health in May, recruited about 100 participants living
in Baltimore. The participants, all young women between
the ages of 13 and 21, were using the contraceptive
injection. The "birth control shot," or Depo-Provera,
is a safe and common form of hormonal birth control
that requires a dose every three months to provide protection
against pregnancy.
The study's participants were divided into two groups:
a control group that received one standard automated
phone call to their home phone before each appointment,
and a group that received a text on each of the three
days leading up to each appointment, to which they were
asked to respond. The group that received text messages
also received period text messages about STI prevention
and healthy weight maintenance while on hormonal contraceptives,
as well as general encouragement to consult a medical
professional with any concerns. All participants received
a personal phone call from a nurse.
Of all groups, 87% of the young women showed up for
their first of three injections in the nine-month period.
77% returned for their second shot, and 69% also came
back for the third and final injection for the study
period. Because each participant received personal calls
from a nurse, the study's results cannot attest to the
difference in compliance between those who receive text
messages and those who receive only standard automated
phone calls. However, a notable difference appeared
in the timeliness of the patients.
The group that received text messages was more likely
to show up on time for their injections, with 68% of
the experimental condition showing up on time for their
first shot as opposed to 56% of the control condition.
The differences diminished with each injection; 68%
of the experimental condition was on time for their
second cycle as compared with 62% of the control condition,
and there was no significant difference between the
two conditions for the third shot.
Timeliness may seem trivial, but with birth control,
it is of the utmost importance. One dose of Depo-Provera
only protects against pregnancy for three months, meaning
that if a patient is late for an additional shot, they
are likely not protected against pregnancy but may not
realize it. This means that the group that received
text messages was more likely to be fully protected
against pregnancy.
While a study comparing the efficacy of such texts
to automated phone calls would offer additional helpful
information, the Johns Hopkins study provides important
insight: text messages can indeed improve rates of perfect
compliance with birth control among young women. The
age group studied is also significant; while relatively
few women under 21 plan pregnancies, almost three in
ten young women will become pregnant at least once by
the age of 20-- and we don't need an MTV show to tell
us that unplanned teen pregnancies can be wrought with
great difficulty. In short, text messaging can be a
powerful way to improve contraceptive compliance among
a demographic in which perfect birth control compliance
is very important, and thus reduce the rate of teen
pregnancy.
Text messaging is also an effective way to reach girls
and young women from low-income families, a group that
too often falls through the cracks of the health care
system and may not have access to comprehensive, fact-based
sex education in public schools. The need for informed
access to contraceptives among this demographic is especially
high because they face these shortcomings. Because texting
enjoys great popularity among low-income communities
as well as higher-income ones, the efficacy of text
messages like the ones sent in the study may well extend
into the demographic that most needs it. Further analysis
or additional studies that assess income differences
in the results may be of particular help in this area.
Regardless of what research stands to be done, the
power of text messaging to improve health care compliance
shines as clear as ever. SMS is a truly valuable tool
for the practice of medicine and those who benefit from
it.
About the Author -
Sharon Housley is the VP of Marketing for NotePage,
Inc. a software company for communication software solutions.
http://www.notepage.net
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