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Systematic review and meta-analyses

Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials

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Pages 397-416 | Received 06 Jan 2014, Accepted 22 Feb 2015, Published online: 28 May 2015
 

Abstract

Healthy behaviour, such as smoking cessation and adherence to prescribed medications, mitigates illness risk factors but health behaviour change can be challenging. Mobile phone short-message service (SMS) messages are increasingly used to deliver interventions designed to enhance healthy behaviour. This meta-analysis used a random-effects model to synthesise 38 randomised controlled trials that investigated the efficacy of SMS messages to enhance healthy behaviour. Participants (N = 19,641) lived in developed and developing countries and were diverse with respect to age, ethnicity, socioeconomic background and health behaviours targeted for change. SMS messages had a small, positive, significant effect (g = 0.291) on a broad range of healthy behaviour. This effect was maximised when multiple SMS messages per day were used (g = 0.395) compared to using lower frequencies (daily, multiple per week and once-off) (g = 0.244). The low heterogeneity in this meta-analysis (I 2 = 38.619) supports reporting a summary effect size and implies that the effect of SMS messaging is robust, regardless of population characteristics or healthy behaviour targeted. SMS messaging is a simple, cost-effective intervention that can be automated and can reach any mobile phone owner. While the effect size is small, potential health benefits are well worth achieving.

Acknowledgments

The authors would like to thank David Norman for independently coding the 121 articles short-listed for the meta-analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental material

Supplemental material for this article can be accessed here: http://dx.doi.org/10.1080/17437199.2015.1022847

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