JMIR Publications

ABSTRACT

The quest to find the next innovative technology to solve health problems facing the world has been vexing health researchers for decades. Unfortunately, the next “shiny” advanced technology is often more the focus than the end-user experience or the health behaviour change that it is designed to address. Text messages or short message service (SMS), are one example of an established technology still used by consumers, but, with more advanced technologies available, are often overlooked by many researchers and funders as part of the mobile health (mHealth) toolbox. Text message programs have underpinned a large proportion of the successful mHealth work to date. This low technology platform has demonstrated significant positive health outcomes in the areas of smoking cessation, medication adherence, chronic disease care and vaccinations. Text messaging as an intervention modality has taught researchers substantial lessons about tailored, interactive and scalable health communication, reach and engagement particularly in low resource settings, and embedding of behaviour change models into digital health. In the mHealth arena there is no lack of proven solutions but a lack of implementation. With the introduction of newer technologies that excite developers and funders more - smartphone apps, chat bots, wearables with more "bling" – text messages are often disregarded as "not sexy enough" despite providing proven effective interventions internationally. While it may be argued that the evidence in text messaging is more substantial given its time in the research market, this is potentially false economy. If something is known to be effective, we should be learning from its implementation while working on the research evidence for the next big shiny thing – just like in other areas of medical research. Many other technologies suffer from poor long-term engagement, digital divide within society, and low health and technology literacy of users. Incorporating the learnings and lessons from text message interventions will strengthen our way forward in the quest for the next big thing.