Dissemination and Implementation of a Text Messaging Campaign to Improve Health Disparities among Im/Migrant Workers

The use of short message service (SMS) text messaging technology has grown in popularity over the last twenty years, but there is limited data on the design and feasibility of campaigns to reduce work-related injury, particularly among rural workers, non-native English speakers, and illiterate or low-literacy populations. Although there is a critical need for tech equity or 'TechQuity' interventions that reduce injury and enhance the wellbeing of under-reached communities, the barriers and benefits to implementation must be empirically and systematically examined. Thus, our team used D&I science to design and implement an 18-week texting campaign for under-reached workers with a higher-than-average risk of fatal and non-fatal injury. The experimental project was conducted with English-, Spanish-, and Vietnamese-speaking commercial fishermen in the Gulf of Mexico to test the design and feasibility, and messaging focused on preventing injury from slips, trips, and falls, as well as hurricane preparedness. The ubiquity of mobile devices and the previous success of texting campaigns made this a promising approach for enhancing health and preventing injury among an under-reached population. However, the perceived benefits were not without their barriers. The lessons learned included the difficulty of navigating federal regulations regarding limits for special characters, enrolling migratory participants, and navigating areas with limited cellular service or populations with limited accessibility to technology. We conclude with short- and long-term suggestions for future technology interventions for under-reached worker populations, including ethical and policy regulations.