JMIR Publications

ABSTRACT

Background:

The use of digital communication platforms to improve health behaviors has increased dramatically in the last decade. Public health practitioners have adopted digital communication technologies such as text messages, mobile applications, and social media to reach diverse populations. However, the effectiveness of different digital communication platforms employed by community-serving agencies remains unclear, and patterns of engagement and acceptability of different platforms have not been studied.

Objective:

This review aimed to identify types of digital communication strategies utilized by community-serving organizations to promote healthy behaviors and to describe the degree of consumer engagement with and acceptability of the strategies. The population of interest included low-income pregnant women, parents of young children, and adolescents.

Methods:

A systematic review was conducted according to the PRISMA guidelines using PubMed, Scopus, Web of Science, CINAHL, and APA PsycInfo covering research conducted from 2009-2022. Studies were included if they examined the use of digital communication (i.e., texting, mobile apps, and/or social media) to promote healthy behaviors among the target population. Risk of bias and strength of evidence were assessed using the EPHPP Risk of Bias tool and criteria from AHRQ, respectively.

Results:

23 peer reviewed research studies published between 2012 to 2022 conducted in the US, UK and Australia were included in the review. The sample comprised studies exploring the use of texting (12), apps (6), social media (3), and multiple platforms (e.g., texting and mobile app) (2). Targeted health behaviors included: healthy diet, physical activity, obesity prevention, healthy pregnancy, breastfeeding, vaccine utilization, smoking cessation, and WIC benefit redemption. The sample included 8 randomized controlled trials, 6 pre/post-tests, 3 mixed methods studies, 2 pilot studies, 1 feasibility study, 1 prospective cohort study, 1 descriptive study, and 1 cross-sectional study. The median sample size was 77.5. There were moderate to high levels of engagement and high levels of acceptability across digital platforms. Engagement was moderate with texting and mobile app campaigns and low with social media campaigns. All three platforms demonstrated high acceptability including when combined, with no differences in acceptability between the platforms.

Conclusions:

Low-income pregnant women, parents of young children, and adolescents demonstrated moderate levels of engagement with and high levels of acceptability of digital media health campaigns conducted by community serving agencies. The effectiveness of these strategies in improving health behaviors was inconclusive. Additional rigorous studies with increased sample sizes are needed to investigate the use of these platforms to improve health behaviors. In addition, more research is needed to consistently measure and report on participant engagement within and across platforms. Digital communication platforms are a critical tool for public health practitioners, and future investigations of the effectiveness of these platforms in engaging clients and improving health behaviors will maximize client services. Clinical Trial: This review was not registered, and a review protocol was not prepared.