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Using a Text-Messaging Intervention to Promote Behavior Change in Undeserved Adolescents in a Mobile Health Clinic

Ammerman SD, Halpern-Felsher B and Weiss C

Purpose: We developed and implemented a novel text-messaging intervention (TMI) to disseminate knowledge about adolescent-relevant health issues to underserved adolescents treated in a mobile health clinic (MHC) setting. The goal was to both increase participants’ knowledge and support positive change in participants’ health-related behaviors.

Methods: Patients from our mobile clinic sites were invited to participate in a text-messaging intervention with the aim of increasing health-related knowledge and promoting behavior change. Participants chose 1-2 topics from a list of 15 adolescent-relevant health issues. For each topic chosen, participants completed a program consisting of three text messages in a quiz format each week for 14 weeks. Participants were encouraged to reply with their answer choice; after doing so, they received a response message with the correct answer, a brief explanation, and follow-up information. Prior to and after completion of each program, participants completed a ten-item questionnaire. The results of the pre- and post-intervention assessments were compared using Wilcoxon Signed-Rank tests to identify changes in perceived knowledge, self-efficacy and health-related behaviors.

Results: 72 adolescents from our clinics completed between one and four interventions each during the 18-month-long study. Significant improvement from pre- to post-survey was found in self-reported knowledge for 7 of 14 intervention topics and self-reported behavior for 8 of 14 intervention topics.

Conclusions: Participants who engaged with the TMI showed self-reported improvements in topic-related knowledge, self-efficacy and health-related behavior choices. TMIs have considerable potential to deliver relevant health-related information and to support positive changes in participant’s health-related behaviors.