RU Healthy? Public Health Efforts Take on Text Messaging: Campaigns Adapting to New Technology

By Krisberg, Kim | The Nation's Health, March 2009 | Go to article overview

RU Healthy? Public Health Efforts Take on Text Messaging: Campaigns Adapting to New Technology


Krisberg, Kim, The Nation's Health


With A few quick thumb swipes, San Francisco youth literally have health information at their fingertips. They can receive the information anywhere, anytime without having to log into a computer, make a phone call or pick up a pamphlet. For Bay area youth, getting the "411" on sexual health is as easy as hitting "send" on their cell phones.

Thanks to today's texting trend, the youth are getting answers from SexInfo, a public health text messaging service that was launched in 2006. The service received 4,500 sexual health inquiries in just its first 25 weeks of service, with broken condoms, pregnancy and sexually transmitted diseases topping the subject list. The effort came after local health officials spotted rising rates of gonorrhea and chlamydia among black teens in one of the city's low-income neighborhoods, according to Deb Levine, MA, executive director and founder of Internet Sexuality Information Services Inc., which developed Sex-Info in partnership with the San Francisco Department of Public Health. While the initial idea was to create a new Web site, both Levine and colleague Jacqueline McCright, MPH, a community-based STD services manager at the public health department, decided it was time to think outside the box. While visiting high schools for inspiration, the new idea walked right in front of their faces: After the school bell rang, students filed out with cell phones in hand. But they weren't talking--they were typing.

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"That's when we knew we were on to something," Levine told The Nation's Health. While San Francisco's health workers could be considered pioneers in text messaging, public health has been taking advantage of mobile communication devices to improve surveillance and the delivery of health interventions for some time, said Jay Bernhardt, PhD, MPH, director of the National Center for Health Marketing at the Centers for Disease Control and Prevention. But because text messaging is "multidirectional"--in other words, because users can send and receive information in real time--it can be a "real game-changer in public health both domestically and especially globally," said APHA member Bernhardt, who added that CDC took a "big step" last year when it co-sponsored the first Texting4Health conference at Stanford University. Mobile communication platforms, he said, are "the next wave of public health communication and surveillance."

While new communication technologies offer great opportunities for public health, Bernhardt noted, lack of access to tools such as the Internet can be a significant barrier, particularly on the global front. Cell phones, however, are the first interactive communication devices cutting across economic, educational and social divides, he said. In turn, text messaging can be used on a number of health fronts, from delivering information to managing chronic diseases to treatment adherence.

"Today, effective public health requires us to provide our information and interventions to our communities where, when and how they need them," Bernhardt told The Nation's Health. "Our communities are using social media and mobile technology as an important part of their lives and if we want to reach them and help them, then we need to communicate with them the way they communicate with each other."

In San Francisco, Levine, McCright and colleagues knew young people were texting each other, but were unsure if youth wanted to receive text messages from their local health department. Fortunately, in focus groups of young black men and women, participants liked the text messaging idea. However, they were insistent that they be the ones initiating the process, Levine said. The resulting SexInfo service allows youth--or anyone interested--to text the word "SexInfo" to a five-digit number to receive a message back with codes telling them to text, for example, "B2 if u think ur pregnant," "D4 to find out about HIV" or "F8 if ur not sure u want to have sex. …

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