How 2 txt: an exploration of crafting public health messages in SMS

Health care providers are an important target audience for public health emergency preparedness, response and recovery communications. Short Message Service or text messaging to cell phones may be a promising supplemental or alternative technique for reaching health care providers with time-sensitive public health information. However, studies to date have yet to investigate the message content and formatting requirements of providers with respect to public health alerts and advisories or sought to understand how to meet these needs using Short Message Service technology.

Data collection was completed using a two-part online survey. In the first part, health care providers identified their use of different technologies for receiving information and provided input on the message components most important in a public health message. In the second part, health care providers participated in an exercise in which they shortened three public health emergency messages, ranging from 2024-2828 characters per message, to meet the 160-character limitation for text delivery. Results were analyzed to determine associations between provider types, age ranges, gender, access to various media (text, email, fax, social media, etc.), and smart phone ownership.

The following components were most frequently selected as essential for a public health message: Topic, Recommendation, Geographic Location, Signs & Symptoms, Population Affected, and Link to Additional Information. There was no statistically significant association between message component selection and provider type, age ranges, or gender. In the message conversion exercise, we found a statistically significant association between providers who reported receiving information by SMS and/or smart phone ownership and including a link to additional information in the converted message, ranging from 61% to over 72% on a per message analysis.

A substantive recommendation derived from this study is that public health agencies include a link to additional website information when sending messages in SMS format. SMS could be a useful public health tool for communicating with health care providers but further investigation of how to effectively use SMS and other mobile technologies is needed to inform public health decisions regarding adoption of messaging systems utilizing these newer technologies.