Text Messages Compared With Monthly Paper Diaries

Abstract

INTRODUCTION: Short-term bleeding patterns after intrauterine device (IUD) insertion are poorly characterized. Most young women text message daily. We aimed to assess success of collecting 90 days bleeding data after IUD insertion by method of data collection (text message compared with traditional paper diaries). METHODS: We enrolled women with cell phones initiating the copper T380A IUD or levonorgestrel intrauterine system and randomized participants (one-to-one) to record bleeding through daily text messages or monthly paper calendars. Women in the text group received automated daily prompts. The groups received equal compensation for completing the diaries. RESULTS: We enrolled 230 participants. The groups were similar in baseline characteristics, including age, parity, ethnicity, and education. Twenty percent of participants provided no bleeding data; of these, 76% were in the paper group; only 20% in each group provided complete 90-day data. The median diary completion was 82 days for the text group (interquartile range 40–89) and 36 days in the paper group (interquartile range 0–88). Those with 30 or fewer responses were less educated and more likely to self-identify as Hispanic than those providing more than 60 responses. CONCLUSIONS: Women providing bleeding data electronically by daily text message gave more complete data than women using traditional paper diaries; however, bleeding data were incomplete in both groups. For future studies of contraception and bleeding patterns, use of text may be superior to paper diaries.