Developing and Pretesting a Text Messaging Program for Health Behavior Change: Recommended Steps

Lorien C Abroms, Robyn Whittaker, Caroline Free, Judith Mendel Van Alstyne, Jennifer M Schindler-Ruwisch, Lorien C Abroms, Robyn Whittaker, Caroline Free, Judith Mendel Van Alstyne, Jennifer M Schindler-Ruwisch

Abstract

Background: A growing body of evidence demonstrates that text messaging-based programs (short message service [SMS]) on mobile phones can help people modify health behaviors. Most of these programs have consisted of automated and sometimes interactive text messages that guide a person through the process of behavior change.

Objective: This paper provides guidance on how to develop text messaging programs aimed at changing health behaviors.

Methods: Based on their collective experience in designing, developing, and evaluating text messaging programs and a review of the literature, the authors drafted the guide. One author initially drafted the guide and the others provided input and review.

Results: Steps for developing a text messaging program include conducting formative research for insights into the target audience and health behavior, designing the text messaging program, pretesting the text messaging program concept and messages, and revising the text messaging program.

Conclusions: The steps outlined in this guide may help in the development of SMS-based behavior change programs.

Keywords: SMS; behavior change; behavior modification; mHealth; telemedicine; text messaging.

Conflict of interest statement

Conflicts of Interest: The George Washington University/Dr Lorien Abroms have licensed the Text2Quit and Quit4Baby programs to Voxiva Inc. Dr Lorien Abroms has stock options in Voxiva Inc.

Figures

Figure 1
Figure 1
Steps for developing a text messaging program.
Figure 2
Figure 2
Logic model for Text2Quit, a smoking cessation SMS text messaging program based on social cognitive theory.

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