Hit Send? Programs Weigh the Pitfalls and Potential of Texting

BlogMay 19 2015

Among the 88 percent of U.S. teens with cell phones, 91 percent use text messaging. (Among adults, it’s 90 and 81 percent, respectively.) Teens send and receive an average of 30 texts per day. I’m from a pre-texting generation, and I’m not sure I fully understand its popularity. I’m also concerned about the potential for texting (and other uses of handheld electronic media) to distract children, and their parents, from paying attention to safety and the intrinsic value of face-to-face interactions.

But I’m willing to bet that this technology will come to be seen as a breakthrough for interventions designed to improve outcomes for children and families.

Text messaging seems tailor-made for keeping engaged people who are attempting to make significant changes in their behavior. Whether it’s learning better study habits, regulating one’s emotions, maintaining abstinence from drug use, or adopting new parenting techniques, reaching goals usually requires ongoing reminders (from oneself or others) to practice, monitor, and adjust behavior over time.

That engagement often does not come easily. There are too many other things competing for our attention. It’s expensive, in terms of time and other resources, for people to maintain their attendance at the clinic, the gym, the parenting class, and so on. And, it’s expensive for researchers to maintain their subjects’ engagement over a period sufficient to adequately test the effectiveness of an intervention. Attrition (dropout) plagues many evaluations, and is often a problem with those subjects who, on the basis of earlier research, could stand to benefit most from participation.

Evidence from texting interventions suggests that even brief reminders or prompts can be effective. However, text messaging can also be interactive, where recipients are prompted to make a response. Texts can be transmitted in multiple languages. They can even use icons instead of text, when communicating with participants who have low literacy. Messages can be viewed and responded to at a time of one’s own choosing.

Some of the areas where this technology has some proven success are self-management of chronic health conditions (diabetes), reminding parents to have their child vaccinated, teens’ sexual health, health promotion for new mothers and their infants, aftercare of youth recovering from substance abuse, maintaining youth abstinence from smoking, parent training for child maltreatment prevention, and parents’ promotion of children’s early literacy.

These techniques are still in the early stages of adoption, and (like any strategy) have their limitations. Obviously, participants must have cell phones, enabled for texting, and be willing to engage in this kind of dialogue. Data security concerns are well founded, but these issues are present to some degree in all data collection. However, it’s already apparent that there is a potential here for huge cost savings over conventional ways of sustaining participant involvement. Certainly, this technology holds a great deal of promise, both for facilitating research, and improving well-being.

David Murphey, senior research scientist