Text Messaging for Public Health Emergencies

Overview

Text messaging could be an effective way to convey public health emergency information to a variety of populations, both before and after a disaster strikes. Texting may be particularly effective for groups that have been difficult to reach using traditional communication channels. These include certain age, ethnic and special needs groups (such as young adults, Latinos, and deaf people) among whom texting is increasingly popular. But is it feasible for public health agencies to implement texting systems? And will avid texters necessarily sign up to receive emergency messages from public health agencies?

These are some of the questions that NWPERRC researchers are exploring.  They are looking at how and why people use texting, and whether message source makes a difference. The groups they are studying include urban, rural, Latino and Native American young adults, and deaf and hard of hearing people of all ages. In addition, the researchers are identifying the logistical, legal, fiscal, and technical implications of setting up a text messaging system at Public Health - Seattle & King County (PHSKC). The findings of this work will be shared with public health agencies that are interested in using text messaging to reach targeted populations.

This five-year project was funded in 2008 by the Centers for Disease Control and Prevention. It is being led by researchers at PHSKC.

Methods

Researchers are using a variety of methods to understand how and why people use texting. These methods include a phone survey, key informant and focus group interviews, and a Q Sort, in which study participants are asked to rank order statements about texting. To identify important text message system requirements, researchers are interviewing legal, technology, and policy experts. Researchers are also conducting pilot projects to gain practical knowledge about implementing texting programs.

One pilot explored whether the source of a message affects whether people opt in to receive text messages. Researchers partnered with Entre Hermanos, an organization that serves the LGBTQ Latino community. Messages sent to members of this community from Entre Hermanos and from PHSKC appeared to be equally effective.

A second pilot explored whether texting is a viable way to remind people to return for the second dose of a 2-dose vaccine. Of parents whose children needed a second dose of vaccine, 84% opted in to the texting program. In addition to testing public acceptability of such reminders, this pilot allowed careful analysis of legal, technical and logistical issues related to sending health information by text message

Tools You Can Use

• Video series: Recently, researchers completed a new video series that provides key information for organizations considering implementing text messaging within their public health programs.
• Legal findings: Researchers worked with the University of Washington’s Center for Information Assurance and Cybersecurity to conduct a risk analysis of sending protected health information via SMS. Findings from this analysis will be available in 2012.
• Cost analysis: Researchers conducted a cost analysis of sending mass text messages using outside vendors versus building a system internally. They also developed a handout with key questions to ask text messaging vendors.
• Work group: Another way researchers are sharing their learning is by convening a working group of local and state health departments interested in legal issues related to public health text message systems. Please contact the researchers if you would like to participate in the calls.
• Marketing texting programs: Within each study population, NWPERRC researchers identified different “texter types” and implications for public health departments wanting to market texting programs to their communities. Please contact NWPERRC researchers for more details about texter types.

Researchers

Mark Oberle, MD, MPH, Principal Investigator
Hilary Karasz, PhD, Co-Investigator
Meredith Li-Vollmer, PhD, Co-Investigator
Sharon Bogan, MPH, Project Manager

For questions about this project, please contact Sharon Bogan at sharon.bogan@kingcounty.gov, and Hilary Karasz at hilary.karasz@kingcounty.gov.