Pilot study of psychotherapeutic text messaging for depression

2016 ◽  
Vol 23 (7) ◽  
pp. 665-672 ◽  
Author(s):  
Paul N Pfeiffer ◽  
Jennifer Henry ◽  
Dara Ganoczy ◽  
John D Piette

Background Text messaging services could increase access to psychotherapeutic content for individuals with depression by avoiding barriers to in-person psychotherapy such as cost, transportation, and therapist availability. Determining whether text messages reflecting different psychotherapeutic techniques exhibit differences in acceptability or effectiveness may help guide service development. Objectives We aimed to determine: (1) the feasibility of delivering a psychotherapy-based text messaging service to people with depression identified via the internet, (2) whether there is variation in satisfaction with messages according to the type of psychotherapeutic technique they represent, and (3) whether symptoms of depression vary according to receipt of each message type and participants’ satisfaction with the messages they received. Methods For this study 190 US adults who screened positive for a major depressive episode (Patient Health Questionnaire (PHQ-9) score ≥10) were recruited from online advertisements. Participants received a daily psychotherapy-based text message 6 days per week for 12 weeks. Text messages were developed by a team of psychiatrists, psychologists, and social workers to reflect three psychotherapeutic approaches: acceptance and commitment therapy (ACT), behavioural activation, and cognitive restructuring. Each week the message type for the week was randomly assigned from one of the three types, allowing for repeats. Participants were asked daily to rate each message. On the 7th day of each week, participants completed a two-item depression screener (PHQ-2). Web-based surveys at baseline, 6, and 12 weeks were used as the primary measure of depressive symptoms (PHQ-9). Results Of the 190 participants enrolled, 85 (45%) completed the 6-week web survey and 67 (35%) completed the 12-week survey. The mean baseline PHQ-9 score was 19.4 (SD 4.2) and there was a statistically significant mean improvement in PHQ-9 scores of −2.9 (SD 6.0; p < 0.001) at 6 weeks and −4.8 (SD 6.6; p < 0.001) at 12 weeks. Mean satisfaction ratings did not vary across message types. There was generally no association between the number of weeks in which participants received a given message type and PHQ-9 scores at follow-up. However, among individuals with more severe depression at baseline (PHQ-9 ≥ 20; n = 30), the number of weeks of behavioural activation messages received was associated with less symptom improvement (ρ = 0.37; p = 0.04) at 12 weeks. Participants who gave higher satisfaction ratings to messages regardless of type had greater reductions in PHQ-9 scores at 6 weeks. Conclusions Study participants exhibited borderline clinically significant improvement in depressive symptoms at 12 weeks suggesting the effects of the intervention, if any, were small. Although there was no overall variation in changes in PHQ-9 according to users’ exposure to the three message types, effectiveness among severely depressed participants could potentially be improved by tailoring towards fewer behavioural activation messages. Controlled studies to determine effectiveness of texting interventions such as this one are indicated considering that even small effects may be cost effective given the low cost of delivering text messages.

2019 ◽  
Author(s):  
Megan Partch ◽  
Cass Dykeman

Mental health treatment providers seek high-impact and low-cost means of engaging clients in care. As such, text messaging is becoming more frequently utilized as a means of communication between provider and client. Research demonstrates that text message interventions increase treatment session attendance, decrease symptomology, and improve overall functioning. However, research is lacking related to the linguistic make up of provider communications. Text messages were collected from previously published articles related to the treatment of mental health disorders. A corpus of 39 mental health treatment text message interventions was composed totaling 286 words. Using Linguistic Inquiry and Word Count (LIWC) software, messages were analyzed for prevalence of terminology thought to enhance client engagement. Clout, demonstrating the writer’s confidence and expertise, and positive Emotional Tone were found to be at a high level within the corpus. Results demonstrated statistical significance for five linguistic variables. When compared with national blog norms derived from Twitter, Clout, Emotional Tone, and use of Biological terminology were found to be at higher rates than expected. Authenticity and Informal terminology were found at significantly lesser rates.


2020 ◽  
pp. 001789692095936
Author(s):  
Katherine L Cox ◽  
Sabine M Allida ◽  
Maree L Hackett

Objective: In this systematic review and meta-analysis, we aimed to quantify the effects of text messaging interventions to reduce depressive symptoms and identify variables that might influence the effectiveness of the intervention. Design: Electronic databases including EMBASE, CENTRAL, MEDLINE, CINAHL, PsycINFO and SCOPUS, as well as Clinicaltrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) were searched for randomised controlled trials that sent one or more text messages with health-related content to adults who had been identified by a healthcare provider. Results: Seven trials (nine comparisons), with 1,918 participants, were included in the review, and the pooled analysis revealed a borderline statistically significant reduction in depressive symptom scores between the text messaging intervention and control groups (standardised mean difference [SMD], −0.27; 95% confidence interval [CI], −0.54 to 0.00; p = .00) favouring intervention at the end. Statistically significant reductions were shown in important subgroups, for example, where the primary aim of the messages was to reduce depressive symptoms; in those using the Beck Depression Inventory (BDI) or 9-item Patient Health Questionnaire (PHQ-9) questionnaires; where text message content was targeted at mental well-being, mood improvement and cognitive behavioural therapy information; and when the message frequency was ⩾2 times per week. Conclusion: Text messaging has potential to reduce depressive symptoms. The results of this review should be interpreted with caution, however, due to the methodological limitations of included trials. More research is required before recommendations can be made about the routine use of text messaging for the management of depressive symptoms.


Author(s):  
Patricia Wiseman ◽  
Kathie Records

The Advisory Committee on Immunization Practice recommends all children be vaccinated annually against Influenza. Given the increased use of technology as a strategy to increase immunization coverage, theory-based text messaging may result in higher vaccination rates than traditional vaccine reminders. This article describes the development of theory-based text messages for parents of 5 to 8-year-old children that can be implemented in primary care settings. The development of the text messages was guided by constructs from the Health Belief Model. A pilot study was conducted with community pediatric vaccine health care providers (n = 6), and parents of 5 to 8-year-old children (n = 8) to evaluate the text message content for clarity, internal consistency, and content validity. The evaluation results indicated that our intervention was successful in creating a low cost, theory-based educational intervention that garnered community investment and met the cultural relevance and literacy needs of the priority population.


2015 ◽  
Vol 2 (1) ◽  
pp. e4 ◽  
Author(s):  
Matthew A Broom ◽  
Amy S Ladley ◽  
Elizabeth A Rhyne ◽  
Donna R Halloran

Background Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face. Objective Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression. Methods Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey. Results In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US $777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%). Conclusions Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression.


Author(s):  
Joy Waughtal ◽  
Phat Luong ◽  
Lisa Sandy ◽  
Catia Chavez ◽  
P Michael Ho ◽  
...  

Abstract Almost 50% of patients with cardiovascular diseases face challenges in taking medications and increased morbidity and mortality. Text messaging may impact medication refill behavior and can be delivered at scale to patients by texting mobile phones. To obtain feedback from persons with chronic conditions on the design of interactive text messages and determine language of message for making messages that can motivate patients to refill medications on time. We purposively sampled 35 English and Spanish speaking patients with at least one chronic condition from three large healthcare delivery systems to participate in N-of-1 video-based synchronous interviews. Research assistants shared ideas for theory-informed text messages with content intended to persuade patients to refill their medication. We transcribed recorded interviews and conducted a content analysis to identify strategies to employ generating a dynamic interactive text message library intended to increase medication refill. Those interviewed were of diverse age and race/ethnicity and typical of persons with multiple chronic conditions. Several participants emphasized that personally tailored and positively framed messages would be more persuasive than generic and/or negative messages. Some patients appreciated humor and messages that could evoke a sense of social support from their providers and rejected the use of emojis. Messages to remind patients to refill medications may facilitate improvements in adherence, which in turn can improve chronic care. Designing messages that are persuasive and can prompt action is feasible and should be considered given the ease with which such messages can be delivered automatically at scale.


10.2196/22047 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e22047
Author(s):  
Vincent Israel Opoku Agyapong ◽  
Marianne Hrabok ◽  
Wesley Vuong ◽  
April Gusnowski ◽  
Reham Shalaby ◽  
...  

Background With the emergence of the COVID-19 pandemic, providing counseling to people with drug or alcohol addiction while maintaining physical distance has been challenging. This protocol describes the use of text messaging (as used in the Text4Hope-Addiction Support program) as a convenient, evidence-based, cost-effective, and accessible population-level mental health intervention with high user satisfaction proven in prior research. Objective The project goal is to implement a program of daily supportive text messaging (Text4Hope-Addiction Support) to reduce drug or alcohol cravings as well as anxiety and depression, typically associated with alcohol and substance use disorders. The aim of this study is to evaluate the prevalence of cravings, anxiety, and depressive symptoms; demographic correlates of the same; and the outcomes of the Text4Hope-Addiction Support intervention in mitigating cravings, anxiety, and depressive symptoms. Methods Self-administered, anonymous, online questionnaires will be used to assess cravings for the primary substance of addiction (Brief Substance Craving Scale), anxiety (Generalized Anxiety Disorder-7), and depressive symptoms (Patient Health Questionnaire-9). Data will be collected at baseline (onset of receiving text messages), program midpoint (6 weeks), and program end (12 weeks). Results As of October 2020, data collection is in progress; and it is expected to be completed by fall 2021. Data analysis will include parametric and nonparametric techniques, focusing on primary outcomes (ie, cravings, anxiety, and depressive symptoms) and metrics of use, including the number of subscribers and user satisfaction. Conclusions This Text4Hope-Addiction Support project will provide key information regarding the prevalence rates of cravings, anxiety, and depressive symptoms among persons with alcohol and substance use disorders; demographic correlates of cravings, anxiety, and depression; and outcome data related to this scalable population-level intervention. Information from this study will be valuable for addiction care practitioners; it will inform the policy and decision making regarding population-level addiction treatment and support during emergencies. International Registered Report Identifier (IRRID) DERR1-10.2196/22047


2021 ◽  
Author(s):  
Reham Shalaby ◽  
Marianne Hrabok ◽  
Pamela Spurvey ◽  
Rabab M. Abou El-Magd ◽  
Michelle Knox ◽  
...  

BACKGROUND Peer support (PS) is emotional, social, and practical help that is provided by non-professionals to assist others in sustaining health behaviours. PS is valued in recovery-oriented models of mental health and is becoming implemented increasingly at the organizational level. Text messaging is a relatively low cost, high impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users. OBJECTIVE This study aims to evaluate the effect of an innovative peer support system plus supportive text messaging program on the recovery of discharged patients from acute psychiatric care. METHODS This is a prospective, rater-blinded, pilot randomized controlled trial, including 180 patients discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages, peer-support only, or peer-support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale; RAS) was completed at baseline, six weeks, three months, and six months. Descriptive analysis, One-Way ANOVA, and repeated measures MANCOVA were deployed to examine the changes in RAS among the study groups and over the follow-up time points. RESULTS Sixty-five patients completed assessments at each time-point. For the overall sample, higher scores were found for the peer-support plus text message condition compared to the text message only and treatment as usual condition on several scales (i.e., Willingness to ask for help and Personal Confidence and Hope) and total score on the RAS. CONCLUSIONS Peer support plus supportive text messaging results in improved recovery compared to other interventions. It is advisable to incorporate the two interventions as a part of routine practice for patients with psychiatric disorders upon their hospital discharge. CLINICALTRIAL The study received ethical approval from the Health Ethics Research Board of the University of Alberta (Ref # Pro00078427) and operational approval from the Alberta Health Services regional health authority. All patients provided written informed consent. The study was registered with clinicaltrials.gov (Trial registration number NCT03404882).


Author(s):  
Beverly Plester ◽  
Clare Wood ◽  
Samantha Bowyer

The authors present three investigations into pre-teen children’s text message language and measures of their standard literacy abilities. The children translated sentences, from standard English into text, and from text into standard English , and wrote text messages appropriate to a set of scenarios. They categorised text abbreviations used and calculated the proportion of abbreviations to total words. The children completed a questionnaire about their mobile phone use. Text messaging facility was positively associated with verbal reasoning, vocabulary, school achievement in English, and reading ability across the three studies. Texting provides opportunity for children to communicate in writing without the constraints of standard English, and we propose that the playful variants on words that they use in texting, and their ability to encode spoken slang graphically, show not a lack of knowledge of English, but a light hearted use of phonological and alphabetic decoding principles that also underpin standard English.


Author(s):  
Nishal Anthony ◽  
Jennifer Molokwu ◽  
Ogechika Alozie ◽  
Diego Magallanes

Introduction: Attendance to clinic appointments and compliance with treatment plans are essential components of HIV/AIDS care. Compliance is especially important in young and minority individuals living with HIV/AIDS. We assessed the effectiveness of a text-based reminder system compared with usual care in improving the attendance to clinic and social work appointments at a Ryan White-funded clinic based in an academic institution. Methods: Convenience sample looking at 2 periods, 6 months before initiation of text messages and 6 months after initiation of text messages. Results: Following a 6-month postintervention period, we found a statistically significant reduction in our no-show rates (individuals failing to keep scheduled appointments) of 24.8% versus 17.7%, P value .05. Conclusion: Using an inexpensive online text messaging system, we were able to significantly decrease no-show rates in a primarily younger, low-income, and uninsured population.


2019 ◽  
Vol 45 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Michaeline Jensen ◽  
Andrea M. Hussong

The ubiquity of digital communication within the high-risk drinking environment of college students raises exciting new directions for prevention research. However, we are lacking relevant constructs and tools to analyze digital platforms that serve to facilitate, discuss, and rehash alcohol use. In the current study, we introduce the construct of alcohol-talk (or the extent to which college students use alcohol-related words in text messaging exchanges) as well as introduce and validate a novel tool for measuring this construct. We describe a closed-vocabulary, dictionary-based method for assessing alcohol-talk. Analyses of 569,172 text messages from 267 college students indicate that this method produces a reliable and valid measure that correlates as expected with self-reported alcohol and related risk constructs. We discuss the potential utility of this method for prevention studies.


Sign in / Sign up

Export Citation Format

Share Document