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Texting 4 Public Health - Things U Should Know

This news item is the seventh in a 10-part series on public health communication. This installment focuses on SMS text message campaigns.

This news item is the seventh in a 10-part series on public health communication. This installment focuses on SMS text message campaigns.

Short message service (SMS) text messages are 160-character messages (or 70-character messages for languages like Chinese or Korean that use double-width characters) that are sent over a cellular control channel. Data is not sent directly from phone to phone, but rather stays on the channel until the other phone is ready to receive the message. This attribute allows the communication method to be more reliable, but it is also limited by the fact that the control channels do not support pictures, files, or video.

At least 87 percent of Americans own cell phones, and nearly two-thirds of cell-phone owners text. This technological evolution presents a great opportunity for social marketers and communicators, especially in the field of public health. Text messaging for public health has received national attention, and your organization may want to think about how to use this technology to fill communications gaps with your audiences.

There are many benefits to text messaging in public health settings, including the following:

Equity and Social Justice

Though there are some small, untapped communities with lower cell phone and text message adoption rates, text messages have shown great potential for reaching vulnerable populations. A survey performed by researchers at Public Health - Seattle & King County identified several refugee populations that might benefit from public health text messages. Other studies, including one by the Pew Research Center, found that text messaging is most common among younger, non-white populations. As your organization attempts to address issues of social equity, consider the potential benefits of a text message campaign.

Emergency Outreach

During natural disasters, text messages can be transmitted when traditional modes of communication no longer function. This capability can allow you to communicate your messages to the public during a crisis and potentially receive information in return, allowing you to better identify areas of need. This method was used during the earthquake in Haiti where it helped connect stranded victims with public health aid.


In 2012, 80 percent of Americans cell phone owners sent or received text messages, and that number has continued to grow. Cell phone owners generally carry their phones at all times, which means that by sending a text message, you can mitigate the risk of missing someone or being in the wrong place. Researchers have shown that 98% of text messages are opened, a number that outshines e-mails and social media updates.

Before you pursue a text-messaging program, your organization should consider a few logistical factors. These details aren't meant to discourage you, but rather to allow you to properly plan and implement a plan that works best for you.

Text Message Method

How you decide to facilitate text messaging between your organization and its constituents depends on the scope of your project. You may decide that you can send texts from an organization-owned cell phone, especially if you have a smaller group of people to reach. However, there are many web-based platforms that allow you to manage text messages and recipients online, without running the risks inherent to typing messages on a phone keyboard. It's important to note that these platforms can be costly.

Who's the Boss?

As with social media, campaigns, it is important that someone within your organization takes ownership over the text messaging program. Texts will need to be approved and regulated, and a policy dictating processes and chain-of-command should be established before you begin. This may require hiring additional staff or training existing employees.

It's HIPAA to Text

Communications experts at Public Health - Seattle & King County are examining how public health organizations can text and remain compliant with HIPAA regulations. While not disallowed by the Security Rule within HIPAA, your organization's risk is elevated if personal health information is sent via text message. However, the definition of personal health information is not always clear. Identifiers like phone numbers, websites, and provider addresses may compromise patient confidentiality, and should be reviewed by a legal expert.

NWCPHP is fortunate to be connected with some of the leaders in text messaging for public health practice. Should you have any questions about how to begin program implementation, feel free to .


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