JMIR Publications

ABSTRACT

Background:

Short Message Service (SMS) via mobile phones are a common means of interpersonal communication. SMS surveys are gaining traction in healthcare and research due to their feasibility and patient acceptability. However, challenges arise in implementing SMS surveys, especially when targeting marginalised populations, due to barriers with accessing phone, data as well as communication difficulties. In primary care, traditional surveys (paper and online) often face low response rates that are particularly pronounced among disadvantaged groups due to financial limitations, language barriers, and time constraints. Addressing these obstacles demands innovative strategies to ensure equitable participation.

Objective:

This study investigates the potential of SMS-based patient recruitment and surveys within the general practice setting with a focus on socioeconomically disadvantaged patients. This study was nested within the REACH project that aimed to reduce alcohol-related harm through screening in Australian general practice. Several general practices in lower-income communities participated in SMS-based surveys.

Methods:

This study follows a two-step SMS data collection process. An initial SMS with an online survey link was sent to patients, followed by subsequent surveys every three months for consenting participants. Interviews were conducted with local primary health network organisation staff and participating practice staff and clinicians. The qualitative data was analysed using constructs from the Consolidated Framework for Implementation Research (CFIR).

Results:

While initial SMS responses were limited, later surveys showed improved engagement, highlighting the effectiveness of two-way SMS communication for sustained interaction. There were barriers to engaging marginalised groups including limited smartphone access, language barriers, literacy issues, mental health conditions, and physical limitations. Practice managers and clinicians suggested strategies to overcome these barriers, including using paper-based surveys in trusted spaces and offering assistance during survey completion.

Conclusions:

SMS-based surveys offer a feasible and cost-effective approach to research data collection. Yet, reaching marginalised populations necessitates a tailored approach. While SMS surveys are apt for the broader population, additional efforts are required to ensure representation and involvement of marginalised groups. Clinical Trial: Australian New Zealand Clinical Trials Registry ACTRN12622000959774; retrospectively registered; 7 July 2022.