Short Message System Research Articles

Improving routine immunization data quality using daily short message system reporting platform: An experience from Nasarawa state, Nigeria.

Routine immunization (RI) delivery was declared a public health concern in Nigeria in 2017 because of persistently low immunization coverage rates reported in independent surveys. However, administrative coverage rates remain high, suggesting serious data quality issues. We posit that a shorter timespan between service provision and data reporting can improve the monitoring of RI data, and developed a short message system (SMS) text reporting strategy to generate daily RI data points from health facilities (HFs). The goal was to assess whether daily data collection produces complete, reliable and internally consistent data points. The SMS reporting platform was piloted between December 2017 and April 2018 in two Local Government Areas (LGAs, equivalent to districts) of Nasarawa state, Nigeria. The 145 healthcare workers from 55 HFs received one mobile phone and pre-configured SIM card, and were trained to send data through predefined codes. Healthcare workers compiled the data after each vaccination session and transmitted them via SMS. We analyzed completeness, number of weekly sessions, and supportive supervision conducted. During the pilot phase, we received data from 85% (n = 47) of the 55 HFs. We expected 66 fixed-post sessions and 30 outreach sessions per week, but received data for 33 fixed-post and 8 outreach weekly session on average. More HFs reported on Tuesdays compared to other days of the week. When assessing internal consistency, we observed that the reported number of children vaccinated was sometimes higher than the number of doses available from opening a given number of vaccine vials. When found, this discrepancy was noted for all antigens during fixed-post and outreach vaccination sessions. Despite these initial discrepancies, transmitting RI data sessions via texting is feasible and can provide real-time updates to the performance of the RI services at the HF level.

A mixed-methods study to explore opportunities and challenges with using a mHealth approach to engage men who have sex with men in HIV prevention, treatment and care in Lomé, Togo.

In Togo, men who have sex with men (MSM) experience disproportionately high rates of human immuno-deficiency virus (HIV), with prevalence at 13% compared to the countrywide general HIV prevalence of 2.5%. Mobile phone adoption has grown rapidly in West Africa in recent years and mobile health (mHealth) provides an opportunity to engage high-risk populations in HIV prevention, treatment and care (PTC). This study focuses on the text messaging component of a mHealth program and resulting linkages to PTC in Lomé, Togo. We used a mixed-methods approach to collect information directly from a purposive sample of MSM to estimate the potential impact of the mHealth intervention on specific outcomes. A structured survey captured 503 MSM experiences with program activities to increase access to PTC through short message system (SMS), including data on socio-demographics, HIV knowledge and testing history, program awareness, use of services and referrals, use of mHealth, and experiences with and preferences for receiving HIV SMS messages. Twelve in-depth interviews captured qualitative data on MSM experiences and opinions related to the mHealth intervention, as well as barriers and facilitators to linkages between mHealth and clinic services. Predicted probabilities of MSM being reached by the program and linked to PTC is higher for those exposed to the program and significantly different (P<0.001). The probability of being linked to HIV prevention emerges as the highest among MSM exposed to SMS messages with 92% probability. MSM exposed to SMS had a 63% probability to be linked to treatment compared to only 40% among those not exposed to SMS. Program barriers and facilitators were identified through the thematic analysis of the qualitative data. Several facilitators to PTC were reported including: increased knowledge and awareness; convenient location of HIV testing coupled with distribution of products; ensuring individual confidentiality; and perceived care of providers. The main barriers to the program were lack of program awareness, program functionality and affordability for referral services, and peer educator training. The probability of being reached, and adhering to PTC is significantly higher among MSM exposed to HIV related SMS messages; however, the usefulness of SMS in HIV programs targeting MSM needs to be better understood.

Smart Farming for Lowland Strawberry (Fragaria x ananassa) Production

The developed system monitors the humidity levels, moisture content of the soil and surrounding temperature. Parameter values such as maximum and minimum temperature, maximum and minimum humidity values can be monitored accordingly by sending an sms to the system using arduino microcontroller, gsm module, moisture sensor and dht11 temperature/humidity sensor. This design maybe used for monitoring and controlling temperature and humidity value via sms. This system monitors and control the water content of the soil using a moisture sensor which runs under the control of a microcontroller, a dht 11 sensor to control and monitor the greenhouse humidity and proper temperature and a short messaging system (sms) to notify the caretaker/ owner on the moisture level content and temperature/humidity of the greenhouse. The system monitored and maintains the proper temperature, humidity and soil moisture content inside the greenhouse. The device has been successfully tested under simulated conditions and showed the ability of controlling temperature, humidity and soil moisture. The system notified the caretaker/farmer via short messaging system (sms) for the notification status (information) and triggering the water pump. The device showed the capability of sending sms holding the latest temperature and humidity information and also the status of the greenhouse.

Design and Implementation of a Smart System for School Children Tracking

What the world is seeing about the deterioration of public safety in various cities and the increase in the rate of crimes against children makes parents constantly worry about their children when they go to school and until they return from it. To dispel these fears, the idea emerges to create an application that allows parents to know the whereabouts of their children and notify them with a message if the children exceed the area specified for them. In this application, the process of discovering the child’s precise location in a specific area is carried out by determining the latitude and longitude using the GSM radio navigation system. After that, the mobile receives all the information about the location via the GSM modem. A GSM modem has been programmed to achieve communication between the modem and the child by two methods of communication through which the child’s location is determined. Ensuring that the child’s location is known at any time and informing the person responsible for tracking him is the primary function of this system. This device connects to the child in an appropriate manner and it turns on when the child exits the designated area for him, after which a message is sent to the tracker. The device can be triggered using a short messaging system (SMS) where the user can communicate remotely to the GSM using a mobile.

Perancangan Sistem Informasi SMS Gateway Berbasis Web dalam Meningkatkan Layanan Komunikasi pada PT. Perdana Jatiputra

One model reliable communication today is a short message short messaging system (SMS). This means that SMS should be able to conduct transactions with the database. For it is necessary to build a system called SMS Gateway. In principle, SMS Gateway is a software that uses the help computers utilizing mobile technologies are integrated in order to distribute the messages that are generated by the system information via SMS media that are handled by the cellular network. SMS Gateway is a media that can provide solutions in the delivery of information quickly and easily, applied in an effort to improve the quality of work and information and communication services in handling problems that exist in PT Perdana Jatiputra. So through the SMS media admin does not need to provide information to one by one employees through telphon or use a piece of paper to make important announcements. The result of this research is that SMS gateway can simplify the effort to improve the quality of service especially in the effort of equalization of information to all employees of PT Perdana Jatiputra. Keywords: SMS Gateway, Information System, User Interface, Gammu.

Community-Based Active Case Finding to Increase Tuberculosis Case Detection and Treatment Success Rate in High Tuberculosis Burden Areas of Arsi Zone, Oromia

<i>Background</i>: More than 9 million new cases of tuberculosis (TB) occur per year and about two million people die of TB. The probable cause of death is delay in diagnosis, low case detection rate and treatment success rate. Due to the low potential of tuberculosis (TB) microscopic examination and the need to increase rate of new TB case identification is also increased. <i>Objective</i>: To determine magnitude of active tuberculosis cases, evaluate the performance of LED-FM and X-pert MTB/RIF assay and characterize treatment outcome <i>Methods</i>: The door-to-door survey for TB in high TB burden areas of Arsi zone was performed. The participants were screened based on typical TB symptoms. The sputum samples were collected and transported to the laboratories. Culture, LED-FM and X-pert MTB/RIF assay were performed to confirm tuberculosis infection. Result was communicated through cell phone or short message system (SMS) for issuing of positive results. The health extension worker would contact diagnosed patients referred to their local health center for care. Finally, the performance of diagnostic tests, case detection rate and treatment success were determined. <i>Result</i>: In this study 344 pulmonary TB suspected study participants were involved from the three study sites. Based on the LED microscope results the general prevalence of pulmonary TB among the current study participants was 2.3%. On the other hand Gene X-pert MTB/RIF assay could show that 9 (2.6%) of the study participants became positive for pulmonary TB cases. There was 1 (0.3%) discordant result between the two assay methods. LED microscope missed one TB suspected case which was detected by Gen X-pert MTB/RIF assay and then confirmed by LJ culture media and become positive for pulmonary TB. Hence, the overall prevalence of pulmonary TB in our current study became 2.6% with 95% CI (1.2-4.5) using LJ culture media as tiebreaker. Of 344 study participants in this study, 9 (2.6%) were positive for pulmonary TB and given first line anti-TB drugs. Of the nine pulmonary TB test positive study participants who had prescribed with first line anti-TB drugs in which 2 (22.2%) were known to be cured as well as 7 (77.8%) had completed the treatment regimen prescribed for them.

Emerging Role of Short Message System (SMS) in Medical Education

Emerging Role of Short Message System (SMS) in Medical Education

Short Text Message Based Infusion Fluid Level Monitoring System

Liquids or medications administered through intravenous systems (infusion) is necessary when a patient requires immediate medication or requires slowly and continuously administered medications. This method is considered adequate in certain situations; however, the liquids/medications administration of through infusion has a risk when the nurse is late in replacing intravenous fluid. In this study, the system was designed to monitor the fluid infusion level by utilizing a short text message system. This system will provide information when the infusion fluid level is at 50 ml, 20 ml, and 0 via SMS. Moreover, a buzzer is utilized that acts as an alarm when the reaching 20 ml level, and infusion fluid have not been replaced yet, and when the intravenous fluid does not drip. Infra-red sensors and photodiodes are used to detect intravenous droplets of fluid, which are then used to calculate fluids' volume. The system is controlled using an Atmega 328 microcontroller. SIM Modem 900 is used to send SMS. Based on tests carried out, infusion fluid level monitoring systems have excellent performance. The percentage of system errors when detecting fluid level infuse is 1,21%. The function of sending fluid level information through SMS also works well

Intervention through Short Messaging System (SMS) and phone call alerts reduced HbA1C levels in ~47% type-2 diabetics-results of a pilot study.

PurposeDespite extensive research and newer methods of interventions, the incidence and prevalence of diabetes is increasing at an alarming rate. Currently, according to world health organization (WHO) statistics, 422 million individuals are suffering from diabetes worldwide. In India, recent estimates have reported a significant increase in the number of diabetics in the last decade. Poor dietary habits, minimal adherence to treatment regimens, lack of timely education are some of the contributing factors for increasing incidence and huge economic burden; which can be handled by life style behavior modifications backed up by hand holding through continuous education. Prior studies have demonstrated the efficacy of various self-management tools and educational programs in better disease management behaviors among individuals with diabetes. Among various self-management tools, educating the individuals and alerting them using mobile phone calls and short messaging system (SMS) are widely accepted due to (a) the increasing mobile phone users and (b) availability of short messaging systems in local languages in the recent years. Therefore, a pilot study was conducted to determine the benefit of educating patients through phone calls and SMS in the self-management of diabetes.ObjectivesThe objective of the study is to determine the feasibility and utility of SMS and phone call-based interventions in the management of diabetes by comparing the HbA1c values.MethodologyThe study was conducted for a period of 14 months from December 2017 till Feb 2019. Out of 380 individuals initially enrolled into the study, 120 had completed the 14-months period. Diabetes education through SMS and phone calls was provided on regular basis, and HbA1C levels at baseline, 8-months and 14-months quantified. In addition, feedback on patients’ satisfaction and utility of the SMS / Phone calls was collected using questionnaires.ResultsData from our study demonstrated that after 8-months of intervention through phone calls, a significant increase in the number of individuals with HbA1c in the range of 5.1 to 7.0 was observed (from 27 individuals at base line to 37 individuals after 8-months intervention). Much more significant improvement in the number of individuals with lower HbA1c was observed at 14-months of intervention, indicating the benefit of regular phone call-based system in managing diabetes. A Chi square (χ2) test was performed to examine if the frequencies in the cells varied at baseline and at 8 and 14 months.ConclusionChronic diseases like diabetes needs awareness and education to patients in adopting disease self-management practices. As mobile phone users are increasing in number, providing diabetes management education through mobile phone intervention could be a viable strategy for controlling diabetes.

Emergency numbers accessibility for disabled peoples’: Case of the Islamic Republic of Iran

An emergency is a serious, unexpected situation which may lead to injury, loss of life and damage to property and often needs urgent interventions. Emergency calls can bring urgent life-saving intervention in such situations. Although access to emergency lines for all persons of a society is one of the effectiveness indexes of this critical service, in most countries, these lines are not accessible for disabled people. This study examined the issue of emergency number accessibility for disabled people in the I.R. of Iran. Two persons who had been poisoned by carbon monoxide died because their deaf-mute father could not communicate with the Emergency Medical Service Center (EMSC). This led to the Emergency Medical Service Management Center (EMSMC), in collaboration with Iranian Society of Deaf People Family (ISDPF), developing a system that is a combination of short message system (SMS) and location-based information (LBI) to facilitate the communication of such disabled persons with EMSMCs. The system did not receive any emergency message until this report is provided. Because emergency call service has not been available for disabled people in Iran until now, emergency service organizations should take a proactive approach in developing a reliable and easy to use a method with the current technologies. These organizations should also provide information about the installed systems for end-users.

Utility of Short Message Service (SMS) for Remote Data Collection for HIV in Low- and Middle-Income Countries.

Purpose of ReviewShort message system (SMS) communication is widespread in low- and middle-income countries (LMICs), and may be a viable approach to address challenges with in-person data collection for HIV-related research and monitoring and evaluation. We reviewed the literature to characterize potential benefits and challenges with using SMS for remote data capture, including examples from HIV and sexual and reproductive health.Recent FindingsIn our review, we found that studies that have used SMS to capture sensitive, self-reported data found this was an acceptable and feasible strategy, and may reduce social desirability bias of self-reported data; but studies are limited. Shared phones and privacy concerns have been described as challenges, but can be addressed with enhanced security features. Response rates to SMS surveys varied significantly by topic, population, and setting.SummarySMS may improve generalizability and precision of health and behavior data for HIV in research and programs, but use in LMICs is limited. SMS systems should be carefully designed to overcome potential implementation hurdles.

Using digital devices to help people lose weight: a systematic review

PurposeWhen fighting the burden of overweight and obesity, diet remains a powerful preventive factor. The purpose of this paper is to stimulate more efficient interventions on diet change by synthesising knowledge of previous weight loss programmes based on the use of digital devices.Design/methodology/approachFollowing the preferred reporting items for systematic reviews and meta-analyses approach, a systematic literature review through five databases was undertaken focussed on the assessment of studies oriented towards diet change that incorporated digital devices including computers, tablets, mobile phones, portable and non-portable tracking devices. In total, 15 empirical studies (2004–2018) were identified and examined for efficacy and presence of theory and behaviour change techniques.FindingsDigital devices supporting weight loss programmes have evolved rapidly over the past 15 years, from reminders using the short message system to self-quantification through mobile applications. Nine studies show a significant difference between conditions, in favour or one (or more) intervention arm. The remaining studies failed to find significance between conditions but were using a comparison with an active intervention, potentially indicating equivalent efficacy. A low level of theory use and use of behavioural techniques was evident.Research limitations/implicationsThe literature review is limited to studies that have scientifically evaluated the (potential) weight loss associated with the weight loss intervention. This review could be put into perspective with other complementary research, in particular, qualitative research aimed at exploring participants’ motivations to use (or not) digital devices to lose weight.Social implicationsGiven their low cost and the size of the overweight population, it appears that public health policies could integrate digital devices more strongly in their efforts to combat obesity. Social marketing can add its expertise to medical-based programmes which in return bring their need for more quantitative evaluation of the efficacy of the interventions.Originality/valueFew previous reviews have examined the extent of the efficiency in digital diet change programmes. The review shows that, in general, digital interventions can support weight loss for adults; however, more studies are required to provide a strong evidence base for efficacy. Given their low cost and the size of the overweight population, public health policies could integrate these devices more strongly in their efforts to combat obesity. A theory-driven social marketing perspective could enhance development ensuring interventions are effective and valued by users.

Evaluation of Text Message Reminders to Encourage Retesting for Chlamydia and Gonorrhea Among Female Patients at the Municipal Sexually Transmitted Disease Clinic in Seattle, Washington.

United States guidelines recommend retesting for chlamydia (CT) and gonorrhea (GC) approximately 3 months after treatment, but adherence to these guidelines is poor. In May 2016, the municipal sexually transmitted disease (STD) Clinic in Seattle, WA, integrated opt-in short message system (SMS) (text message) retesting reminders for female patients into our clinic's routine electronic intake. Women were asked if they wanted to receive an SMS reminder for retesting for GC/CT in 3 months. We used Fisher exact tests to compare the proportion who returned to the clinic for retesting and the proportion who retested GC/CT positive 3 to 6 months after their initial diagnosis. We used sexually transmitted disease surveillance data to ascertain repeat GC/CT diagnoses. From May 2016 to December 2017, 743 (36%) of 2067 women opted to receive an SMS reminder. Overall, 95 of these women tested positive for GC or CT and provided a valid phone number; 31 (33%) had opted into SMS reminders. The percentage of women who returned to the clinic 3 to 6 months after their initial GC/CT diagnosis did not significantly differ for women who did and did not opt in to receive SMS reminders (23% vs 9%; P = 0.11). Repeat GC/CT diagnosis 3 to 6 months after the initial GC/CT diagnosis was not significantly different between women who did and did not opt in (7% vs 3%; P = 0.58). Uptake of automated SMS reminders among women was low, and most women who received reminders did not return for retesting. Despite this, SMS reminders integrated into an existing clinic infrastructure may somewhat increase retesting among women with GC/CT.

A mixed methods investigation of implementation barriers and facilitators to a daily mobile phone sexual risk assessment for young women in Soweto, South Africa.

BackgroundThe HIV epidemiology in South Africa reveals stark age and gender disparities, with young women being the most vulnerable to HIV acquisition in 2017. Evaluation of HIV exposure is a challenge in HIV prevention research. Intermittent in-clinic interviewer-administered risk behaviour assessments are utilised but may be limited by social desirability and recall biases. We piloted a mobile phone application for daily self-report of sexual risk behaviour in fifty 18–25 year old women at risk of HIV infection enrolled in HIV Vaccine Trials Network 915 (HVTN 915) in Soweto, South Africa. Through a mixed-methods investigation, we explored barriers and facilitators to completing daily mobile phone surveys among HVTN 915 study participants and staff.MethodsWe analysed quantitative data on barriers and facilitators to mobile phone study completion collected during the larger HVTN 915 study as well as two post-study focus group discussions (FGDs) with fifteen former participants with a median age of 24 years (IQR 23–25) and six individual in-depth interviews (IDIs) with HVTN 915 staff. FGDs and IDIs utilised semi-structured interview guides, were audio-recorded, transcribed verbatim and translated to English. After coding, thematic analysis was performed.ResultsThe main facilitator for daily mobile phone survey completion assessed across 336 follow-up visits for 49 participants was the daily short message system (SMS) reminders (93%, 312/336). Across 336 visits, 31/49 (63%) retained participants reported barriers to completion of daily mobile phone surveys: forgetting (20%, 12/49), being too busy (19%, 11/49) and the survey being an inconvenience (15%, 9/49). Five main themes were identified during the coding of IDIs and FGDs: (1) facilitators of mobile phone survey completion, such as daily SMS reminders and follow up calls for non-completers; (2) barriers to mobile phone survey completion, including partner, time-related and technical barriers; (3) power of incentives; (4) response bias in providing sensitive information, and (5) recommendations for future mobile phone based interventions.ConclusionDespite our enthusiasm to use innovation to optimise sexual risk assessments, technical and practical solutions are required to improve implementation. We recommend further engagement with participants to optimise this approach and to further understand social desirability bias and study incentives in sexual risk reporting.

Design and analysis considerations for a sequentially randomized HIV prevention trial.

TechStep is a randomized trial of a mobile health interventions targeted towards transgender adolescents. The interventions include a short message system, a mobile-optimized web application, and electronic counseling. The primary outcomes are self-reported sexual risk behaviors and uptake of HIV preventing medication. In order that we may evaluate the efficacy of several different combinations of interventions, the trial has a sequentially randomized design. We use a causal framework to formalize the estimands of the primary and key secondary analyses of the TechStep trial data. Targeted minimum loss-based estimators of these quantities are described and studied in simulation.

Safety and security solution for school bus through RFID and GSM technologies

&lt;span style="font-size: 9pt; font-family: 'Times New Roman', serif;"&gt;All children throughout the world aged 4 to 17 are going to schools every weekdays. The most common transport used by children is school bus. In many countries accross the globe, most children uses school bus services to go to school and return back home especially to working parents. Although safety of their children is always the main concern of all parents especially the young ones, they have to rely on the bus services due to time constraints during working hours. Sometimes parents need to call the bus driver to ensure their children has reached home or school. This will create inconvenience to bus driver and may lead to other unwanted consequences. Realizing the root of this problem, a school bus safety and security system has been proposed. The school bus safety and security system is a solution based on Short Messaging System that notifies parents if their children have safely arrived at home or school. RFID and GSM technologies are the main technique proposed in this project. RFID is used for several purposes; to identify the children and parents’ contact number, and attendance monitoring through head count system. GSM is used as a commucation platform to inform parents’ on their children’s movement via SMS. Several tests have been conducted to analyse the overall performance of the developed hardware prototype. From the results, it can be concluded that the developed project is successfully identify the children based on their unique ID, send a text message through SMS to parents with required information; and additional feature of attendance checker. The hardware prototype was successfully tested for children’s identification, attendance and SMS notifications to parents. As a consequence, this project could increase the safety and security solution for children travelling with school bus transportation and give parents peace of mind.&lt;/span&gt;

The GECAM and its payload

<p indent="0mm">The Gravitational wave high-energy Electromagnetic Counterpart All-sky Monitor (GECAM) monitors gamma-ray bursts (GRBs) coincident with gravitational wave events over the whole sky. It also monitors other burst events, such as the high-energy radiation of fast radio bursts, various GRBs, and magnetar bursts. GECAM can measure the energy spectra, light curves, and location of all kinds of bursts. GECAM consists of two small satellites which operate in the same low earth orbit but in opposite geocentric directions. To obtain an all-sky field of view, the two satellites operate in opposite orbital phases. The GECAM payload includes two kinds of detectors: charged particle detector (CPD) and gamma-ray detector (GRD). Each GRD module consists of a LaBr₃:Ce scintillator and a SiPM array, and its gamma-ray detection range is <sc>5 keV–5 MeV.</sc> GECAM retrieves the locations of events such as GRBs through analyzing the data of the multiple GRDs on both satellites. Meanwhile, the CPD consists of a plastic scintillator and a SiPM array that detects charged particles of energies from <sc>300 keV</sc> to <sc>5 MeV.</sc> The GECAM distinguishes the charged particle burst events in space by jointly analyzing the GRD and CPD data. The payload electronic box (EBOX) provides in-flight trigger and burst localization. The trigger and burst location data are transmitted by a BeiDou Short Message system, which allows GECAM to guide other telescopes to do follow-up observations.

Design and Development of an Incident Reporting Mobile Application

Reporting actual incidents through short messaging systems and telephone calls are tedious,prone to errors and misinterpretations. Developing a mobile application that can be utilized totransmit incident type, location, and images among other details can provide assistance inemergency situations. The software development method followed in this study was theprototyping model, where initial versions of the software were shown to the end users for it tobe refined to their needs. The target users of the mobile application are a group of 38Adventist motorcycle riders from Silang, Cavite, Philippines who are trained to be firstresponders. Interviews with end users and benchmarking on related systems were conductedto meet results. The end users’ feedback on the developed application can be summarized ashaving high accuracy, less prone to errors, and ease-of-use. Through Global PositioningSystems available on modern smart phones, reporting a specific incident location can be asaccurate as within five meters. The report receiver can view the location in a map.Minimizing text entry and utilizing control elements not only improve reporting time but alsoreduce chances of committing errors. Further, the application can provide map location andcontact information of the emergency facilities near the incident site. Reported information isalso centrally stored for references to improve response processes. Once substantial data isgathered from this system, it can be data-mined to predict possible hotspots, peak times andother information on the occurrences of incidents. To implement the system to a largergeographical territory, the proponents suggest employing artificial intelligence which canautomatically identify and request help from the nearest possible medical facilities.

Estimating the economic value of climate services for strengthening resilience of smallholder farmers to climate risks in Ethiopia: A choice experiment approach

This study estimated the economic value of agricultural climate services for strengthening the resilience of smallholder farmers to climate variability and risks in Ethiopia. Using a choice experiment approach, the study introduced a hypothetical package of improved climate services to 600 randomly selected smallholder farmers in three districts across three different agro-ecological zones in the Oromia Regional State. A generalized multinomial logit (G-MNL) model was used to estimate preferred attributes of climate services and willingness-to-pay (WTP) values. The results show that the preferred bundle of improved climate services among smallholder farmers was one that could be communicated in short text message system, provided along with credit facility, and market information and one that favors participatory decision making by smallholders. The results further reveal that the WTP value exhibited high implicit price for participatory decision-making. The study sheds light on important characteristics of agricultural climate services that may improve their acceptability and usability among smallholders. It also highlights the importance of packaging additional services including digital and ICT-based solutions, financial and market information along with climate services to promote demand-driven last mile delivery systems. Engaging smallholder farmers in a participatory manner in the decision-making process can help them make informed decision.

An Analysis of A Bidirectional School Nurse-Led Text-Messaging Service

Aim: To analyse a school nurse led bi-directional text messaging service provided to young people aged 11–19 in two inner London boroughs. Background: School nurses play a key role in providing early advice and support to the school-aged population. The ability to access a school nurse has been recognised by young people as something that needs to improve and suggestions of being able to text a school nurse have been made. ChatHealth is a bi-directional text messaging system that allows young people aged 11–19 to ask a school nurse for advice and support via an anonymous short messaging system (SMS). Arguably, ChatHealth offers more opportunities than traditional access methods to reach more young people. However, due to the relatively new concept, there is a limited evidence base regarding its effectiveness. Methods: An audit of documentary data was completed to analyse the uptake and outcomes of ChatHealth in the local area. Content analysis was carried out analysing 26 conversation transcripts and a staff questionnaire was distributed to gain a better understanding of the role of the school nurse delivering ChatHealth. Findings: The ChatHealth service appears to be proactive in offering an efficient response to a variety of physical, emotional, sexual health and appointment queries, additionally, the uptake of the service has supplemented the established face-to-face contacts. In the local area, emotional health is the most common type of query being received from young people and the topic school nurses feel least confident in responding to. School nurses identify the benefits of ChatHealth in improving young people's access and in enhancing the visibility of the school nursing service and did not identify it as an inconvenience to their current workload.