SMS Reminders Research Articles

The Impact of Mobile Health (mHealth) Interventions on Malaria Diagnosis and Treatment Adherence among Pregnant Women: A Comprehensive Review

Malaria in pregnancy (MiP) poses a significant public health threat, particularly in sub-Saharan Africa, contributing to maternal anemia, preterm birth, low birth weight, and maternal and infant mortality. Early diagnosis and strict adherence to antimalarial treatments are essential to reduce these risks, yet access to timely care and consistent treatment adherence remain major challenges. Mobile health (mHealth) interventions, utilizing mobile technologies such as SMS reminders, diagnostic applications, and telemedicine platforms, have emerged as innovative tools to address these barriers. This comprehensive review examined the impact of mHealth interventions on malaria diagnosis and treatment adherence among pregnant women in malaria-endemic regions. Through case studies from Kenya, Nigeria, and Tanzania, we explore the effectiveness of mHealth solutions in improving maternal health outcomes by ensuring timely diagnosis and promoting adherence to treatment. Methodologically, the review drew on empirical studies, program evaluations, and case reports from peer-reviewed literature. Despite promising outcomes, challenges such as technological barriers, cultural resistance, and scalability concerns persist. Future research should focus on integrating emerging technologies like AI and machine learning to enhance mHealth’s effectiveness while prioritizing equitable access to digital health solutions. Policymakers must also prioritize the integration of mHealth into national health systems to ensure long-term sustainability. Keywords: mHealth interventions, Malaria in pregnancy (MiP), Treatment adherence, Malaria diagnosis, Sub-Saharan Africa

Patient Satisfaction with Primary Health Care Services in Qatar: A Quality Improvement Study in a Government Staff Clinic

Introduction: Patient satisfaction (PS) is a crucial measure of healthcare quality to ensure effective healthcare systems. Most previous studies focused on PS in primary health care centers, tertiary hospitals, or other settings while only a few addressed PS in staff/employee clinic settings. This study aimed to measure PS and identify factors affecting PS in a government staff clinic in Qatar. Methods: A cross-sectional quantitative research design based on a self-administered validated questionnaire was employed. The study population consisted of employees who visited the “Primary Health Care Corporation” staff clinic for a “physical” consultation between January and November 2023. Phone numbers were extracted from 942 patients’ electronic medical records. SMS texts containing links to the online questionnaire were sent. SMS and telephone reminders were conducted to reach a sufficient sample size. Results: 262 participants yielded a 28% response rate. 92% were satisfied with the overall primary health care services with aspects involving clinic accessibility (86%), physicians’ skills (84%), consultation duration (90%), condition explanation (87%), screening recommendations (80%), and shared decision-making (86%). These variables correlated significantly with the overall PS. Multivariate logistic regression analysis identified two key predictors of PS in the staff clinic: satisfaction with overall GP performance (OR=5.00; 95% CI=1.27–19.78; p=0.022) and satisfaction with overall nursing care (OR=27.88; 95% CI=5.83–133.27; p<0.001). Conclusion: The primary health care services provided in the staff clinic exceeded expectations across structural, clinical, and technical aspects. These results align with the “Qatar National Vision 2030” to foster a mentally and physically resilient population.

The Effectiveness of Dental Health Education Programs in Reducing Dental Caries Prevalence among Indonesian Adolescents

Dental caries is a significant public health issue among adolescents in Indonesia, exacerbated by limited access to preventive dental care and oral health education. This study aims to assess the effectiveness of Dental Health Education (DHE) programs in reducing the prevalence of dental caries among Indonesian adolescents. Using a qualitative research approach with secondary data analysis, the study reviews findings from existing literature and reports. The findings indicate that well-implemented DHE programs can reduce dental caries prevalence by 30% to 35%, with significant improvements in oral hygiene behaviors. However, factors such as geographic location, socioeconomic status, and cultural beliefs impact the success or failure of these programs. Rural and low-income communities face additional challenges in accessing dental care and educational resources. Technological innovations, including mobile health platforms, interactive apps, and SMS reminders, have shown promise in enhancing the delivery and effectiveness of DHE programs by making them more accessible and engaging. In conclusion, the success of DHE programs depends on addressing contextual barriers and incorporating technological solutions to improve reach and sustainability.

P018 IMPLEMENTATION CONSIDERATIONS FOR SMS REMINDERS TO IMPROVE ANTIHYPERTENSIVE MEDICATION ADHERENCE IN BANGLADESH AND ETHIOPIA: A QUALITATIVE EVALUATION

Background: Poor medication adherence remains a significant barrier to hypertension control, particularly in resource-limited settings. Objective: To qualitatively explore the feasibility and acceptability of SMS reminders to support antihypertensive medication adherence and identify local nuances of barriers, facilitators, and implementation considerations in resource-limited settings. Methods: Patients with hypertension and providers in primary care clinics in Ethiopia and Bangladesh were interviewed to assess perceptions and experiences with SMS reminders. Interviews were transcribed and translated, an inductive codebook was developed, thematic content analysis was used to identify key implementation considerations. The Consolidated Framework for Implementation Research (CFIR) constructs of innovation, outer, inner settings, individual-level factors were used to synthesize findings. Results: Fifty patients (mean age 53.1±13.1 years, 28(56%) female, 28(56%) from Ethiopia) and 50 providers (mean age 32±7.5 years, 24(48%) female, 27(54%) from Ethiopia) were interviewed. Facilitators included the perceived value of SMS reminders for adherence (patients) and improved patient-provider communication (providers). Patients and providers generally viewed SMS reminders as valuable for supporting adherence (innovation). However, concerns were raised about the timing of message delivery and the potential for missed messages. Unreliable network infrastructure was identified as a potential barrier, particularly in rural areas (outer setting). The absence of electronic medical and pharmacy records in many clinics was a reported challenge for automating reminders; providers highlighted the need for dedicated IT support and staff (inner setting). Focusing on the highest-need patients was suggested as a practical approach to begin implementation. Patient's access to mobile phones, literacy levels, and receptiveness to reminders were key individual-level factors that could influence engagement with SMS reminders. Providers emphasized that reminders may not be effective for all patients (Table). Conclusions: SMS reminders can potentially improve antihypertensive medication adherence in resource-limited settings, but several implementation barriers need to be addressed. Tailoring SMS reminders to patient needs, strengthening infrastructure, and providing adequate IT and staff support are essential for successful implementation.

Enhancing COVID-19 booster vaccination among the elderly through text message reminders

ABSTRACT The BOOST (Booster promotion for older outpatients using SMS text reminders) program at Taipei Veterans General Hospital assessed the effectiveness of text message reminders in enhancing COVID-19 booster vaccination rates among the elderly, guided by the Health Belief Model (HBM). Targeting patients aged 65 and above, eligible yet unvaccinated for a COVID-19 booster, this cohort study sent personalized reminders a week prior to their scheduled appointments between April 18, 2022, and May 12, 2022, acting as cues to action to enhance vaccination uptake by overcoming perceived barriers and raising awareness of benefits. Over 5 weeks, the study observed a 38% increase in vaccination rate among 3,500 eligible patients, markedly surpassing the concurrent national rate increase of 4% for the same demographic. The majority of vaccinations occurred within two weeks after the reminder, illustrating the effectiveness of the strategy. Cox regression analysis identified age and time since last vaccination as significant predictors of responsiveness, with those aged 65–74 and 75–84 showing higher uptake, particularly when reminders were sent within 4 months after the last dose. A single reminder proved to be effective. The findings of this study demonstrate the potential of SMS reminders to promote COVID-19 vaccination among the elderly through the strategic use of HBM principles, suggesting a feasible and effective approach to public health communication.

Patterns of daily oral HIV PrEP adherence among people who inject drugs in Ukraine: an analysis of biomarkers.

Daily oral HIV pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC) is recommended for people who inject drugs (PWID) but coverage is low. The real-life effectiveness of PrEP among PWID is unknown as previous studies were conducted in controlled settings and mainly relied on self-report. Analysis of PrEP metabolites-tenofovir diphosphate (TFVdp) and emtricitabine triphosphate (FTCtp)-offers an objective measure of adherence. To analyse longitudinal patterns of PrEP adherence among PWID in Ukraine, we used data from a community-based implementation trial conducted in Kyiv between July 2020 and March 2021 to test the efficacy of SMS reminders to improve adherence. Among 199 enrolled participants, 156 (78.4%) were retained through 6 months. Based on TFVdp/FTCtp levels assessed at 3 and 6 months, we identified groups with various adherence patterns (adherent at ≥2 doses/week, improved, worsened, non-adherent). Correlates of adherence were analysed using multinomial logistic regression. Most participants (53.8%, n = 84/156) had no detectable metabolites at both assessments; 7.1% (n = 11/156) were consistently taking ≥2 doses/week; 1.3% (n = 2/156) were consistently taking ≥4 doses/week; 13.5% (n = 21/156) exhibited improved and 21.8% (n = 34/156) had worsened adherence at 6 compared to 3 months. "White coat compliance" (increased dosing prior to assessment) was common. Consistent adherence was associated with SMS reminders, younger age, employment, lower income, longer injection drug use duration, recent high-risk injecting (receptive syringe sharing, using pre-filled syringe, back- or front-loading, container sharing), absence of overdose in the past 6 months, perceived HIV risk through sexual intercourse and higher PrEP self-efficacy. Alcohol consumption was associated with inconsistent PrEP use. Groups with improved and worsened adherence did not differ. Daily oral PrEP may not achieve the desired effectiveness among PWID as a standalone intervention, calling for testing of alternative PrEP formulations and innovative integrated risk reduction strategies, especially in the context of HIV epidemics associated with injection drug use in eastern Europe and central Asia and the public health crisis in Ukraine caused by the war with Russia. SMS reminders may be effective among PWID who prioritize PrEP. Our findings offer practical guidance in identifying PWID who are likely to benefit from PrEP and those who need additional support.

Acceptability of a Digital Adherence Tool Among Patients With Tuberculosis and Tuberculosis Care Providers in Kilimanjaro Region, Tanzania: Mixed Methods Study.

The World Health Organization has recommended digital adherence tools (DATs) as a promising intervention to improve antituberculosis drug adherence. However, the acceptability of DATs in resource-limited settings is not adequately studied. We investigated the acceptability of a DAT among patients with tuberculosis (TB) and TB care providers in Kilimanjaro, Tanzania. We conducted a convergent parallel mixed methods study among patients with TB and TB care providers participating in our 2-arm cluster randomized trial (REMIND-TB). The trial aimed to investigate whether the evriMED pillbox with reminder cues and adherence feedback effectively improves adherence to anti-TB treatment among patients with TB in Kilimanjaro, Tanzania. We conducted exit and in-depth interviews among patients as well as in-depth interviews among TB care providers in the intervention arm. We conducted a descriptive analysis of the quantitative data from exit interviews. Translated transcripts and memos were organized using NVivo software. We employed inductive and deductive thematic framework analysis, guided by Sekhon's theoretical framework of acceptability. Out of the 245 patients who completed treatment, 100 (40.8%) were interviewed during exit interviews, and 18 patients and 15 TB care providers were interviewed in-depth. Our findings showed that the DAT was highly accepted: 83% (83/100) expressed satisfaction, 98% (98/100) reported positive experiences with DAT use, 78% (78/100) understood how the intervention works, and 92% (92/100) successfully used the pillbox. Good perceived effectiveness was reported by 84% (84/100) of the participants who noticed improved adherence, and many preferred continuing receiving reminders through SMS text messages, indicating high levels of self-efficacy. Ethical concerns were minimal, as 85 (85%) participants did not worry about remote monitoring. However, some participants felt burdened using DATs; 9 (9%) faced difficulties keeping the device at home, 12 (12%) were not pleased with receiving daily reminder SMS text messages, and 30 (30%) reported challenges related to mobile network connectivity issues. TB care providers accepted the intervention due to its perceived impact on treatment outcomes and behavior change in adherence counseling, and they demonstrated high level of intervention coherence. DATs are highly acceptable in Tanzania. However, some barriers such as TB-related stigma and mobile network connectivity issues may limit acceptance. RR2-10.1186/s13063-019-3483-4.

Effectiveness of patient reminders on influenza vaccination coverage among adults with chronic conditions: A feasibility study in Australian general practices

BackgroundInfluenza vaccination is recommended for Australians 18+ years old with medical risk factors, but coverage is suboptimal. We aimed to examine whether automatic, opportunistic patient reminders (SMS and/or printed) before appointments with a general practitioner increased influenza vaccination uptake. MethodsThis clustered non-randomised feasibility study in Australian general practice included patients aged 18–64 years with at least one medical risk factor attending participating practices between May and September 2021. Software installed at intervention practices identified unvaccinated eligible patients when they booked an appointment, sent vaccination reminders (SMS on booking and 1 h before appointments), and printed automatic reminders on arrival. Control practices provided usual care. Clustered analyses adjusted for sociodemographic differences among practices were performed using logistic regression. ResultsA total of 12,786 at-risk adults attended 16 intervention practices (received reminders = 4066; ‘internal control’ receiving usual care = 8720), and 5082 individuals attended eight control practices. Baseline influenza vaccination uptake (2020) was similar in intervention and control practices (∼34%). After the intervention, uptake was similar in all groups (control practices = 29.3%; internal control = 30.0%; intervention = 31.6% (p-value = 0.203). However, SMS 1 h before appointments increased vaccination coverage (39.3%, adjusted OR = 1.65; 95%CI 1.20;2.27; number necessary to treat = 13), especially when combined with other reminder forms. That effect was more evident among adults with chronic respiratory, rheumatologic, or inflammatory bowel disease. ConclusionThese findings indicate that automated SMS reminders delivered at proximate times to appointments are a low-cost strategy to increase influenza vaccination among adults at higher risk of severe disease attending Australian general practices.

Intervensi yang Efektif dalam Peningkatan Skrining Kanker Serviks pada Perempuan Usia Subur

This study aims to review the literature on effective interventions to increase the uptake of cervical cancer screening in women of childbearing age. The method used is a systematic review through searching for articles according to the formulation of research questions using the PIO formula in the Proquest, Pubmed, Sage Journal, Science Direct, and Scopus databases. The search keywords used are ((technology[Title/Abstract]) OR (innovation[Title/Abstract])) OR (intervention[Title/Abstract])) OR (method[Title/Abstract])) AND (increase cervical cancer screening[Title/Abstract])) OR (improve cervical cancer screening[Title/Abstract]). The results showed that from 10 articles reviewed, relevant interventions were found to increase screening uptake, including the provision of SMS (education and reminder) and eVouchers, self-sampling of HPV sent by post, FCHV visits to provide education and counseling using flipchart media and booklets as well as talk shows and peer discussions by CHW. CHW conducts education using video clips and brochures, Conclusions, and relevant interventions to increase the uptake of cervical cancer screening are the provision of reminder messages and eVouchers, self-sampling of HPV sent by post, mentoring interventions by FCHV or CHW for education and counseling. Keywords: Technology Intervention, Cervical Cancer Screening, Women of Childbearing Age

Early Intervention in Psychosis and Management of First Episode Psychosis in Low- and Lower-Middle-Income Countries: A Systematic Review.

People with first-episode psychosis (FEP) in low- and lower-middle-income countries (LMIC) experience delays in receiving treatment, resulting in poorer outcomes and higher mortality. There is robust evidence for effective and cost-effective early intervention in psychosis (EIP) services for FEP, but the evidence for EIP in LMIC has not been reviewed. We aim to review the evidence on early intervention for the management of FEP in LMIC. We searched 4 electronic databases (Medline, Embase, PsycINFO, and CINAHL) to identify studies describing EIP services and interventions to treat FEP in LMIC published from 1980 onward. The bibliography of relevant articles was hand-searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search strategy produced 5074 records; we included 18 studies with 2294 participants from 6 LMIC countries. Thirteen studies (1553 participants) described different approaches for EIP. Pharmacological intervention studies (n = 4; 433 participants) found a high prevalence of metabolic syndrome among FEP receiving antipsychotics (P ≤ .005). One study found a better quality of life in patients using injectables compared to oral antipsychotics (P = .023). Among the non-pharmacological interventions (n = 3; 308 participants), SMS reminders improved treatment engagement (OR = 1.80, CI = 1.02-3.19). The methodological quality of studies evidence was relatively low. The limited evidence showed that EIP can be provided in LMIC with adaptations for cultural factors and limited resources. Adaptations included collaboration with traditional healers, involving nonspecialist healthcare professionals, using mobile technology, considering the optimum use of long-acting antipsychotics, and monitoring antipsychotic side effects.

Factors Affecting Treatment Adherence Among Patients with Tuberculosis in Indonesia: Literature Review

Introduction: Tuberculosis (TB) is the leading cause of death from infectious diseases in the world and Indonesia is the second largest contributor to TB cases after India. Treatment adherence problems are a major obstacle to TB elimination. The purpose of this Literature Review is to determine the factors that affect treatment adherence among TB patients in Indonesia.
 Methods: Literature obtained from Science Direct, PubMed, and Google Scholar; published from 2018 – 2023, research from reputable international journals and from national journals at least with SINTA 3, located in Indonesia. Indonesian and English with full text of all types of research designs. Article selection was carried out using the method "Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and analyzed using descriptive analysis techniques.
 Results: A total of 225 articels were deemed appropriate for the topic, but only 15 articles were included based on inclusion criteria. It was found that there are several factors that affect treatment adherence in tuberculosis patients in Indonesia, namely: predisposing factors as many as 11 articles (age, education, occupation, knowledge, self-efficacy, concordance, health behavior, motivation, marital status, income level, drug side effects, already feeling cured, and duration of treatment). Reinforcing factors as many as 2 articles (family support). Enabling factors as many as 5 articles (the role of officers, reminder SMS messages from officers, health counseling, and distance of residence to health services).
 Conclusion: The most dominant factor affecting treatment adherence among tuberculosis patients in Indonesia is the Predesposising factors, namely education and sefl-efficacy.

Educational interventions to combat anemia in pregnant women: nursing perspective

Anemia during pregnancy is a common condition that can cause serious consequences for the mother and fetus, including premature delivery and low birth weight. Nursing plays a crucial role not only in the clinical management of anemia, but also in its prevention through education and continuous monitoring. Nurses educate pregnant women about the importance of proper nutrition, adherence to iron and folic acid supplementation, and early identification of symptoms of anemia. Educational and community programs have been shown to improve knowledge and adherence to nutritional recommendations, thereby reducing the incidence of anemia. Technological interventions, such as the use of SMS reminders and m-Health support, have also been shown to be effective. It is essential that nurses continue to develop and participate in these strategies to improve maternal and perinatal health by identifying and managing risk factors and ensuring consistent and personalized follow-up.

Impact of a pharmacist-led patient-centred care intervention along with textmessage reminders, on the management of newly diagnosed tubercular patients: A protocol for a randomized controlled trial.

Non-adherence to tuberculosis (TB) treatment is the leading cause of the increase in drug resistance cases. This study will determine the effectiveness of pharmaceutical-care-based interventions coupled with short messages delivered by a pharmacist on treatment outcomes and adherence among TB patients. The study will be conducted in TB Control Center of Pakistan Institute of Medical Sciences Hospital, Islamabad and District Bannu TB Control Center time period will be from August 2019 to September 2021. The patients will be included into the control group (usual care) or the intervention group pharmaceutical care and SMS reminder. The primary outcome includes a change in mean score from baseline in treatment outcomes and adherence, measured by Morisky Medication Adherence Scale, and clinic appointment attendance registration. Secondary outcomes include health-related quality of life of patients, disease knowledge, and patient satisfaction with the intervention. The major issues in patients with TB are cure rate and medication adherence. The method anticipated in this manuscript could set the foundation of pharmaceutical care and mobile SMS for the future provision of care to improve TB treatment outcomes. The study will make available fundamental information about the influence of the patient centered program on the adherence and clinical outcomes of patients with TB.Trial status and registration: Clinical Trials.gov assigned Identifier NCT04645836.

Low daily oral PrEP adherence and low validity of self-report in a randomized trial among PWID in Ukraine

BackgroundThe efficacy of daily oral pre-exposure prophylaxis (PrEP) in preventing HIV transmission among people who inject drugs (PWID) was demonstrated over a decade ago. However, only a few studies among PWID have since measured PrEP adherence using laboratory markers. MethodsIn this trial, we randomized recently injecting PWID in Kyiv, Ukraine, to receive daily oral TDF/FTC with or without SMS reminders. Enrollment and PrEP initiation took place at an HIV clinic. Subsequent visits at months 1, 3, and 6 were conducted at a community harm reduction center and included a structured interview, adherence counseling, PrEP dispensing, and dried blood spot collection. PrEP adherence was assessed using standard self-reported measures and TDF/FTC biomarkers. ResultsA total of 199 PWID (99 SMS, 100 No-SMS) were enrolled, of whom 24 % were women, with a median age of 37. At month 6, 79.4 % (158/199) of participants were retained, with 84 % (133/158) reporting opioid injection and 20 % (31/158) reporting stimulant injection in the past 30 days. 77 % (122/158) reported taking >95 % of PrEP doses in the past month, and 87 % reported taking the last dose within 2 days. Tenofovir diphosphate was detected in 17 % (28/158) of participants, and emtricitabine triphosphate was detected in 25 % (40/158). Only 3 % (5/158) had metabolite levels indicative of consistent PrEP uptake at 4+ doses per week. There was no association between the SMS intervention and TDF/FTC metabolite detection. ConclusionAdherence to daily oral PrEP among actively injecting PWID, without daily supervision or incentives, was extremely low, despite supportive counseling and SMS reminders. We also observed a high rate of discordance between self-report and classification by a validated biomarker of adherence. Given the scarcity of evidence and emerging data suggesting low oral PrEP adherence among PWID, additional implementation studies with TDF/FTC biomarkers are needed to study whether a sufficient level of adherence to daily PrEP is attainable among PWID, especially as long-acting injectable PrEP offers a promising alternative.

The feasibility, acceptability, and preliminary impact of real-time monitors and SMS on tuberculosis medication adherence in southwestern Uganda: Findings from a mixed methods pilot randomized controlled trial.

We conducted a pilot randomized controlled trial among patients initiating treatment for drug-sensitive tuberculosis (TB). Participants received real-time electronic adherence monitors and were randomized (1:1:1) to: (i) daily SMS (reminders to TB patients and notifications to social supporters sent daily for 3 months, then triggered by late or missed dosing for 3 months); (ii) weekly SMS (reminders to TB patients and notifications to social supporters sent weekly for 3 months, then triggered by late or missed dosing for 3 months); or (iii) control (no SMS). Feasibility was mainly verified by the technical function of the intervention at Month 6. The primary outcome was percent adherence as ascertained by the real time monitor. Quantitative feasibility/acceptability data were summarized descriptively. Percentage adherence and adherence patterns were assessed and compared by linear regression models. Qualitative acceptability data was collected through interviews and analyzed using content analysis. Among 63 participants, the median age was 35 years, 75% had no regular income, and 84% were living with HIV. Feasibility was demonstrated as most of the daily [1913/2395 (80%)] and weekly [631/872 (72%)] SMS reminders to TB patients were sent successfully. Also, most of the daily [1577/2395 (66%)] and weekly [740/872 (85%)] SMS notifications to social supporters and adherence data (96%) were sent successfully. Challenges included TB status disclosure, and financial constraints. All patients perceived the intervention to be useful in reminding and motivating them to take medication. Median adherence (IQR) in the daily SMS, weekly SMS, and control arms was 96.1% (84.8, 98.0), 92.5% (80.6, 96.3), and 92.2% (56.3, 97.8), respectively; however, differences between the intervention and control arms were not statistically significant. Real-time monitoring linked to SMS was feasible and acceptable and may have improved TB medication adherence. Larger studies are needed to further assess impact on adherence and clinical outcomes. Trial registration. ClinicalTrials.gov registration number: NCT03800888. https://ichgcp.net/clinical-trials-registry/NCT03800888.

An SMS and animated video intervention to increase uptake of breast cancer screening: a randomised controlled trial

BackgroundBreast cancer screening attendance in the UK has fallen, and London has the lowest uptake nationally. This study tested the impact of a behavioural science-informed reminder SMS, and animated video intervention on screening uptake. MethodsThis three-armed randomised controlled trial took place in two screening services in London (each service operated across a range of static sites such as hospitals, and mobile sites). We included participants who were registered with GP as female, aged 50–70 years, and not screened in the past 3 years. We excluded those who had opted out of screening messages or were in care. Participants were assigned into three groups via the final two digits of their NHS number (ratio 34:33:33): control group (received usual care reminder), behavSMS group (behavioural science-informed SMS reminder addressing reducing negative emotions and information on health consequences), or behavSMS+video group (behavioural SMS plus link to animation). Researchers were masked to allocation. The SMS and video were co-designed with stakeholders using the Behaviour Change Wheel. Invitation processes changed during the COVID-19 pandemic, and therefore, we did separate analyses for those receiving a timed appointment (n=9027), and an open invitation to book an appointment (n=25 020). Messages were sent 7 days and 1 day before the appointment, plus 7 days after the open invitation letter. Group differences in the primary outcome of attendance within 3 months of invitation (and secondary outcome of booking for open invites) were assessed using χ2, and logistic regression controlling for age, ethnicity, deprivation, and first invitation. This trial is registered with ClinicalTrials.gov, NCT05395871. FindingsRecruitment took place between July 18, and Oct 21, 2022. For timed invitations, 3094 participants were assigned to the control group, 2952 to the behavSMS group, and 2981 to the behavSMS+video group. For open invitations groups sizes were 8654, 8095, and 8271 respectively. Median age was 59 years for participants who received a timed appointment, and 58 years for those who received an open invitation. There were no attendance differences for timed appointments (intention-to-treat analysis): 71·9% (2225/3094) in control group; 69·9% (2064/2952) in behavSMS group; 71·7% (2137/2981) in behavSMS+video group (χ2(2)=3·47, p=0·176), even when controlling for covariates. There were no attendance differences for open invitations either: 7·4% (4104/8654) in control group, 8·3% (3909/8095) in behavSMS group, 48·1% (3978/8271) in behavSMS+video (χ2(2)=1·40, p=0·497), including when controlling for covariates. However, in the per-protocol analysis (of those with valid mobile numbers), intervention groups were more likely to book an appointment: 44·7% (3238/7274) in control group, 46·3% (3121/6744) in behavSMS group, and 46·3% (3199/6910) in behavSMS+video group (χ2(2)=6·01, p=0·050). InterpretationDespite positive stakeholder feedback during co-design, the SMS or SMS+video interventions did not increase breast screening attendance compared with the usual SMS reminder. A limitation is that only 5·8% participants followed the video link. Links within SMS are unlikely to be an effective way to disseminate video content, and alternative options are being explored. FundingNHS England and National Institute for Health and Care Research (NIHR).

Health Monitoring System for Medical Staff based on STM32 MCU

With the development of society, the work health monitoring of medical staff has gradually become an important issue. Long hours of continuous work, high intensity of physical and psychological pressure bring physical health problems for medical staff. In view of this phenomenon, a new type of health monitoring equipment for medical staff is developed, aiming at providing comprehensive health monitoring services. The medical monitoring system uses STM32 single chip microcomputer as the core controller, which has the functions of heart rate monitoring, step statistics, temperature measurement, alarm reminder, SMS reminder and so on. Worn on places such as a healthcare worker's wrist, the device can monitor their heart rate changes in real time and record their steps. This provides health care workers with convenient health data to help them understand their physical condition. The device has the advantages of simple operation, complete functions and beautiful appearance design. The intelligent device can provide comprehensive and accurate health monitoring services for medical personnel, and has a good market prospect.

Text Messages to Incentivise Response in a Web-First Sequential Mixed-Mode Survey

This article reports research exploring the benefits of adding text messages to the contact strategy in the context of a sequential mixed-mode design where telephone interviewer administration follows a web phase. In a web-first mixed-mode survey, supplementing the contact strategy with text messages can help increase the response rate at the web phase and, consequently, reduce fieldwork efforts at the interviewer-administered phase. We present results from a survey experiment embedded in wave 11 of Understanding Society in which the usual contact strategy of emails and letters was supplemented with text messages. Effects of the text messages on survey response and fieldwork efforts were assessed. In addition, we also investigated the impact of SMS on the device selected to complete the survey, time to response, and sample balance. The results show a weak effect of the SMS reminders on response during the web fieldwork. However, this positive effect did not significantly reduce fieldwork effort.

Feasibility of Using Research Electronic Data Capture (REDCap) to Collect Daily Experiences of Parent-Child Dyads: Ecological Momentary Assessment Study.

Intensive longitudinal data collection, including ecological momentary assessment (EMA), has the potential to reduce recall biases, collect more ecologically valid data, and increase our understanding of dynamic associations between variables. EMA is typically administered using an application that is downloaded on participants' devices, which presents cost and privacy concerns that may limit its use. Research Electronic Data Capture (REDCap), a web-based survey application freely available to nonprofit organizations, may allow researchers to overcome these barriers; however, at present, little guidance is available to researchers regarding the setup of EMA in REDCap, especially for those who are new to using REDCap or lack advanced programming expertise. We provide an example of a simplified EMA setup in REDCap. This study aims to demonstrate the feasibility of this approach. We provide information on survey completion and user behavior in a sample of parents and children recruited across Canada. We recruited 66 parents and their children (aged 9-13 years old) from an existing longitudinal cohort study to participate in a study on risk and protective factors for children's mental health. Parents received survey prompts (morning and evening) by email or SMS text message for 14 days, twice daily. Each survey prompt contained 2 sections, one for parents and one for children to complete. The completion rates were good (mean 82%, SD 8%) and significantly higher on weekdays than weekends and in dyads with girls than dyads with boys. Children were available to respond to their own survey questions most of the time (in 1134/1498, 75.7% of surveys submitted). The number of assessments submitted was significantly higher, and response times were significantly faster among participants who selected SMS text message survey notifications compared to email survey notifications. The average response time was 47.0 minutes after the initial survey notification, and the use of reminder messages increased survey completion. Our results support the feasibility of using REDCap for EMA studies with parents and children. REDCap also has features that can accommodate EMA studies by recruiting participants across multiple time zones and providing different survey delivery methods. Offering the option of SMS text message survey notifications and reminders may be an important way to increase completion rates and the timeliness of responses. REDCap is a potentially useful tool for researchers wishing to implement EMA in settings in which cost or privacy are current barriers. Researchers should weigh these benefits with the potential limitations of REDCap and this design, including staff time to set up, monitor, and clean the data outputs of the project.

Developing contents for a digital adherence tool: A formative mixed-methods study among children and adolescents living with HIV in Tanzania.

Optimal adherence (>95%) to antiretroviral treatment (ART) remains a challenge among children and adolescents living with HIV (CALHIV). Digital adherence tools (DAT) with reminder cues have proven feasible among adult people living with HIV (PLHIV), with some concerns about the risk of HIV status disclosure. We aimed to assess the needs, contents and acceptability of an SMS-based DAT among CALHIV. We first conducted a survey to understand potential barriers to using DAT among CALHIV, then tested the DAT intervention among purposively selected participants. The DAT intervention included using the Wisepill device, receiving daily reminder SMS and receiving adherence reports on how they had taken medication in the past month. The content of the reminder SMS differed over time from asking if the medication was taken to a more neutral SMS like "take care". Afterwards, we conducted exit interviews, in-depth interviews, and focus-group discussions. We analysed quantitative findings descriptively and used thematic content analysis for qualitative data. We included 142 children and 142 adolescents in the survey, and 20 of each used the intervention. Eighty-five percent (121/142) of surveyed participants indicated they would like to receive reminder SMS. Most of them (97/121-80%) of children and 94/121(78%) of adolescents would prefer to receive daily reminders. Participants who used the DAT mentioned to be happy to use the device. Ninety percent of them had good experience with receiving reminders and agreed that the SMS made them take medication. However, 25% experienced network problems. Participants preferred neutral reminder SMSs that did not mention the word 'medication', but preserved confidentiality. The provided adherence reports inspired participants to improve their adherence. None of the participants experienced unwanted disclosure or stigmatisation due to DAT. However, 5% of adolescents were concerned about being monitored daily. This study showed that DAT is acceptable and provided insight of the needed SMS content for a customized DAT for CALHIV.