COVID-19 Pandemic: Gender difference in satisfaction with a daily supportive text message program (Text4Hope) and preference for technology-based health supports during emergencies (Preprint)

BACKGROUND During the unprecedented time of the COVID-19 pandemic, the need to support mental wellbeing is urgent. In March 2020, Text4Hope was provided as a community health service to Alberta residents. This free service aims to promote psychological resilience and alleviate pandemic-associated stress, anxiety, and depression symptoms. OBJECTIVE This study aimed to evaluate Text4Hope subscribers’ experience, satisfaction, and perspectives related to technology-based support during crisis or emergency situations, such as the COVID-19 pandemic, by gender. METHODS Individuals self-subscribe to Text4Hope to receive daily supportive text messages for three months. Subscribers were invited to complete an online survey at six weeks to collect service satisfaction related information. Overall satisfaction was assessed on a scale from 0 to 10 using the one sample t-test and Likert scale satisfaction responses were used to assess various aspects of the Text4Hope program. Gender differences were measured by using One-Way ANOVA test and Chi-Square analysis. RESULTS Overall service satisfaction was high (8.55/10 (SD=1.78) and more than 70% of subscribers agreed that Text4Hope helped them to cope with stress and anxiety, feel connected to a support system, manage COVID-19 related issues, and improve mental wellbeing. Similarly, subscribers agreed that messages were positive, affirmative, and succinct. Messages were read by 97.9% of respondents always or often and more than 20% returned to messages always or often. The majority of subscribers (89.3%) read the messages and either reflected upon them or took a positive action. Subscribers welcomed almost all technology-based services as part of their health care during crisis or emergency situations (70%). Text4Hope was more effective among females, who reported higher satisfaction rates and improved coping after receiving text messages. CONCLUSIONS Text4Hope successfully captured subscribers’ satisfaction and acceptance, during COVID-19 pandemic. Respondents affirmed the high quality of the messages with their positive feedback. Technology-based services can provide remotely accessible, cost-effective, and population-level interventions that align with recommended distancing practices during pandemics. Text4Hope subscriber feedback revealed high satisfaction and acceptance rates after six weeks of receiving daily messages. CLINICALTRIAL The study protocol was approved by the Research and Ethics Board of the University of Alberta (Pro00086163). INTERNATIONAL REGISTERED REPORT RR2-10.2196/19292

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Mental Health Outreach via Supportive Text Messages during the COVID-19 Pandemic: Improved Mental Health and Reduced Suicidal Ideation after Six Weeks in Subscribers of Text4Hope Compared to a Control Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042157 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2157

Author(s):

Vincent I. O. Agyapong ◽

Reham Shalaby ◽

Marianne Hrabok ◽

Wesley Vuong ◽

Jasmine M. Noble ◽

...

Keyword(s):

Mental Health ◽

High Stress ◽

Intervention Group ◽

Text Message ◽

Population Level ◽

Text Messages ◽

Self Report ◽

Control Group ◽

Effective Population ◽

Cross Sectional

Background: In March 2020, Alberta Health Services launched Text4Hope, a free mental health text-message service. The service aimed to alleviate pandemic-associated stress, generalized anxiety disorder (GAD), major depressive disorder (MDD), and suicidal propensity. The effectiveness of Text4Hope was evaluated by comparing psychiatric parameters between two subscriber groups. Methods: A comparative cross-sectional study with two arms: Text4Hope subscribers who received daily texts for six weeks, the intervention group (IG); and new Text4Hope subscribers who were yet to receive messages, the control group (CG). Logistic regression models were used in the analysis. Results: Participants in the IG had lower prevalence rates for moderate/high stress (78.8% vs. 88.0%), likely GAD (31.4% vs. 46.5%), and likely MDD (36.8% vs. 52.1%), respectively, compared to respondents in the CG. After controlling for demographic variables, the IG remained less likely to self-report symptoms of moderate/high stress (OR = 0.56; 95% CI = 0.41–0.75), likely GAD (OR = 0.55; 95% CI = 0.44–0.68), and likely MDD (OR = 0.50; 95% CI = 0.47–0.73). The mean Composite Mental Health score, the sum of mean scores on the PSS, GAD-7, and PHQ-9 was 20.9% higher in the CG. Conclusions: Text4Hope is an effective population-level intervention that helps reduce stress, anxiety, depression, and suicidal thoughts during the COVID-19 pandemic. Similar texting services should be implemented during global crises.

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Preferences for the format of text messages containing results of online screening for sexually transmitted infections: a service evaluation

International Journal of STD & AIDS ◽

10.1177/0956462418765274 ◽

2018 ◽

Vol 29 (10) ◽

pp. 1014-1016

Author(s):

Tom Nadarzynski ◽

Clare Scholfield ◽

Ynez Symonds ◽

Cynthia Graham ◽

Sally Kidsley

Keyword(s):

Positive Result ◽

Sexually Transmitted Infections ◽

Online Survey ◽

Text Message ◽

Service Evaluation ◽

Text Messages ◽

Sexually Transmitted ◽

Multiple Texts ◽

To Receive ◽

Additional Sample

We conducted an online survey to examine the preferences for receiving a text message with results of a test for sexually transmitted infections (STIs) as part of online self-sampling service at Solent NHS Trust. Findings showed that if all tests were negative, participants would prefer to receive one text message. However, in the event of a positive result, a large majority (86%) would prefer to receive a separate text with the name of the STI for which the test was positive. Similarly, three-quarters (74%) of participants would prefer to receive multiple texts indicating which test was inconclusive and required an additional sample. The results of this survey support a change of practice to sending multiple text messages with the results of online self-sampling that include the names of STIs.

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Understanding acceptability in the context of text messages to encourage medication adherence in people with type 2 diabetes

BMC Health Services Research ◽

10.1186/s12913-021-06663-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Y. Kiera Bartlett ◽

Cassandra Kenning ◽

Jack Crosland ◽

Nikki Newhouse ◽

Lisa M. Miles ◽

...

Keyword(s):

Online Survey ◽

Text Message ◽

Text Messages ◽

Health Interventions ◽

Mixed Methods Study ◽

Proof Of Concept ◽

Affective Attitude ◽

Potential Tool ◽

Surprising Finding

Abstract Background Acceptability is recognised as a key concept in the development of health interventions, but there has been a lack of consensus about how acceptability should be conceptualised. The theoretical framework of acceptability (TFA) provides a potential tool for understanding acceptability. It has been proposed that acceptability measured before use of an intervention (anticipated acceptability) may differ from measures taken during and after use (experienced acceptability), but thus far this distinction has not been tested for a specific intervention. This paper 1) directly compares ratings of anticipated and experienced acceptability of a text message-based intervention, 2) explores the applicability of the TFA in a technology-based intervention, and 3) uses these findings to inform suggestions for measuring acceptability over the lifespan of technology-based health interventions. Methods Data were obtained from a quantitative online survey assessing anticipated acceptability of the proposed text messages (n = 59) and a 12-week proof-of-concept mixed methods study assessing experienced acceptability while receiving the text messages (n = 48). Both quantitative ratings by return text message, and qualitative data from participant interviews were collected during the proof-of-concept study. Results The quantitative analysis showed anticipated and experienced acceptability were significantly positively correlated (rs > .4). The qualitative analysis identified four of the seven constructs of the TFA as themes (burden, intervention coherence, affective attitude and perceived effectiveness). An additional two themes were identified as having an important impact on the TFA constructs (perceptions of appropriateness and participants’ role). Three suggestions are given related to the importance of appropriateness, what may affect ratings of acceptability and what to consider when measuring acceptability. Conclusions The high correlation between anticipated and experienced acceptability was a surprising finding and could indicate that, in some cases, acceptability of an intervention can be gauged adequately from an anticipated acceptability study, prior to an expensive pilot or feasibility study. Directly exploring perceptions of appropriateness and understanding whether the acceptability described by participants is related to the intervention or the research - and is for themselves or others - is important in interpreting the results and using them to further develop interventions and predict future use.

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A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽

10.1027/0227-5910/a000017 ◽

2010 ◽

Vol 31 (2) ◽

pp. 109-112 ◽

Cited By ~ 35

Author(s):

Hui Chen ◽

Brian L. Mishara ◽

Xiao Xian Liu

Keyword(s):

Pilot Study ◽

Effective Means ◽

Text Message ◽

Text Messages ◽

Mobile Telephone ◽

Future Research ◽

Quick Method ◽

Suicide Attempters ◽

To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

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Text Messaging as a Mental Health Treatment Intervention: A Corpus-Based Study

10.31234/osf.io/gt73p ◽

2019 ◽

Author(s):

Megan Partch ◽

Cass Dykeman

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Text Messaging ◽

Low Cost ◽

Statistical Significance ◽

Text Message ◽

Treatment Session ◽

Text Messages ◽

Health Treatment ◽

Emotional Tone

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.

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Quantifying empathy levels among UK undergraduate medical students: an online survey

British Journal of General Practice ◽

10.3399/bjgp20x711293 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711293

Author(s):

Sarah Garnett ◽

Hajira Dambha-Miller ◽

Beth Stuart

Keyword(s):

Medical Students ◽

Health Outcomes ◽

Medical School ◽

Curriculum Design ◽

Online Survey ◽

Mental Wellbeing ◽

Reactivity Index ◽

Free Text ◽

Undergraduate Medical Students ◽

Cross Sectional

BackgroundEmpathy is a key health care concept and refers to care that incorporates understanding of patient perspective’s, shared decision making, and consideration of the broader context in which illness is experience. Evidence suggests experiences of doctor empathy correlate with improved health outcomes and patient satisfaction. It has also been linked to job satisfaction, and mental wellbeing for doctors. To date, there is a paucity of evidence on empathy levels among medical students. This is critical to understand given that it is a key point at which perceptions and practices of empathy in the longer term might be formed.AimTo quantify the level of empathy among UK undergraduate medical studentsMethodAn anonymised cross-sectional online survey was distributed to medical students across three universities. The previously validated Davis’s Interpersonal Reactivity Index was used to quantify empathy. The survey also collected information on age, sex, ethnicity, year of medical school training and included a free-text box for ‘any other comments’.ResultsData analysis is currently underway with high response rates. Mean empathy scores by age, sex, year of study and ethnic group are presented. A correlation analysis will examine associations between age and year of study, and mean empathy sores.ConclusionThese data will help to provide a better understanding of empathy levels to inform the provision of future empathy training and medical school curriculum design. Given previous evidence linking experiences of empathy to better health outcomes, the findings may also be significant to future patient care

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Efficacy and Impact of an mHealth Intervention to promote Mental Wellness for American Indian and Alaska Native Teens and Young Adults: A Randomized Controlled Trial of the BRAVE Study (Preprint)

10.2196/preprints.26158 ◽

2020 ◽

Author(s):

Stephanie Craig Rushing ◽

Allyson Kelley ◽

Sheana Bull ◽

David Stephens ◽

Julia Wrobel ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Young Adults ◽

Alaska Native ◽

Help Seeking ◽

Culturally Relevant ◽

Controlled Trial ◽

Text Message ◽

Text Messages ◽

Randomized Controlled ◽

Mental Wellness

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.

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Exploring the Frequency of Anxiety and Depression Symptoms in a Brazilian Sample during the COVID-19 Outbreak

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094847 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4847

Author(s):

Fabiana Silva Ribeiro ◽

Flávia H. Santos ◽

Luis Anunciação ◽

Lucas Barrozo ◽

Jesus Landeira-Fernandez ◽

...

Keyword(s):

Mental Health Professionals ◽

Online Survey ◽

Age Groups ◽

Health Sector ◽

Severe Depression ◽

Well Being ◽

Sociodemographic Factors ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Brazilian Sample

The COVID-19 pandemic is a public health emergency of international concern, and the main measures to contain the spread of the coronavirus causing COVID-19 were social distancing, quarantine, and self-isolation. Although these policies are effective in containing the spread of the virus, they might represent a challenge to psychological well-being, increasing levels of depressive and anxiety-related symptoms. Aims: We explored the frequency of anxiety and depression symptoms during COVID-19 restrictions and associations with sociodemographic factors in a Brazilian sample. Method: Data of a total of 936 Brazilian adults (68.2% women) aged 18 to 77 years old (M = 38.95, SD = 13.91) were collected through an online survey. Results: In general, we observed a frequency of 17.36% for severe anxiety and 66.13% for severe depression symptoms, in which younger participants (18–39 years old) and women showed higher scores in anxiety and depression scales compared to older age groups. Logistic regressions showed that women were more likely to present severe symptoms of anxiety (20.4%) compared to men (10.9%), as well as respondents in the educational sector (24.3%) compared to those in the health sector (10%). Conclusions: We highlight the importance of mental health professionals in developing strategies to help younger adults to mitigate the effects of social restriction.

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Shared-Task Worklists Improve Clinical Trial Recruitment Workflow in an Academic Emergency Department

Applied Clinical Informatics ◽

10.1055/s-0041-1727153 ◽

2021 ◽

Vol 12 (02) ◽

pp. 293-300

Author(s):

Kevin S. Naceanceno ◽

Stacey L. House ◽

Phillip V. Asaro

Keyword(s):

Clinical Trial ◽

Emergency Department ◽

Clinical Trials ◽

Clinical Research ◽

Substantial Reduction ◽

Text Message ◽

High Volume ◽

Text Messages ◽

Shared Task ◽

Clinical Research Coordinators

Abstract Background Clinical trials performed in our emergency department at Barnes-Jewish Hospital utilize a centralized infrastructure for alerting, screening, and enrollment with rule-based alerts sent to clinical research coordinators. Previously, all alerts were delivered as text messages via dedicated cellular phones. As the number of ongoing clinical trials increased, the volume of alerts grew to an unmanageable level. Therefore, we have changed our primary notification delivery method to study-specific, shared-task worklists integrated with our pre-existing web-based screening documentation system. Objective To evaluate the effects on screening and recruitment workflow of replacing text-message delivery of clinical trial alerts with study-specific shared-task worklists in a high-volume academic emergency department supporting multiple concurrent clinical trials. Methods We analyzed retrospective data on alerting, screening, and enrollment for 10 active clinical trials pre- and postimplementation of shared-task worklists. Results Notifications signaling the presence of potentially eligible subjects for clinical trials were more likely to result in a screen (p < 0.001) with the implementation of shared-task worklists compared with notifications delivered as text messages for 8/10 clinical trials. The change in workflow did not alter the likelihood of a notification resulting in an enrollment (p = 0.473). The Director of Research reported a substantial reduction in the amount of time spent redirecting clinical research coordinator screening activities. Conclusion Shared-task worklists, with the functionalities we have described, offer a viable alternative to delivery of clinical trial alerts via text message directly to clinical research coordinators recruiting for multiple concurrent clinical trials in a high-volume academic emergency department.

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Psychosocial Effects and Use of Communication Technologies during Home Confinement in the First Wave of the COVID-19 Pandemic in Italy and The Netherlands

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052619 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2619

Author(s):

Sofia Bastoni ◽

Christian Wrede ◽

Achraf Ammar ◽

Annemarie Braakman-Jansen ◽

Robbert Sanderman ◽

...

Keyword(s):

The Netherlands ◽

Communication Technology ◽

Online Survey ◽

Digital Communication ◽

Psychosocial Support ◽

Psychosocial Impact ◽

Mental Wellbeing ◽

Communication Tool ◽

Psychosocial Effects ◽

Cross Sectional

(1) Background: The COVID-19 pandemic forced people from all around the globe to strongly modify their daily routines, putting a significant strain on the social aspects of daily lives. While the first wave of the pandemic was a very challenging time in all countries, it is still uncertain whether various lockdown intensities and infection rates differed regarding their psychosocial impact. This work therefore aimed to investigate (i) the psychosocial effects of home confinement in two European countries that underwent different lockdown intensities: Italy and the Netherlands and (ii) the role of communication technology in relation to feelings of loneliness. (2) Methods: A cross-sectional online survey inquiring about different psychosocial variables and the use of and satisfaction towards communication technology was circulated among the general public during the first wave of the COVID-19 pandemic. In total, 629 participants (66% female, 68% from the Netherlands) answered each question twice, referring to “before” and “during” the pandemic. (3) Results: We found significant negative effects of COVID-19 home confinement on depressive feelings (p < 0.001, %∆ = +54%), loneliness (p < 0.001, %∆ = +37.3%), life satisfaction (p < 0.001, %∆ = −19.8%) and mental wellbeing (p < 0.001, %∆ = −10.6%) which were accompanied with a significantly increased need for psychosocial support (p < 0.001, %∆ = +17.3%). However, the magnitude of psychosocial impact did not significantly differ between residents undergoing a more intense (Italy) versus a less intense (Netherlands) lockdown, although the decrease in social participation was found to be significantly different for both countries (z = −7.714, p < 0.001). Furthermore, our findings demonstrate that the increase in loneliness was associated with the adoption of new digital communication tools (r = 0.21, p < 0.001), and significantly higher for individuals who started to adopt at least one new digital communication tool during confinement than for those who did not (z = −4.252, p < 0.001). (4) Conclusions: This study highlights that, although COVID-19 home confinement significantly impacted psychosocial wellbeing during the first wave of the pandemic, this impact did not differ based on lockdown intensity. Recognizing the increasing adoption of digital communication technology in an attempt to reduce lockdown loneliness, future studies should investigate what is needed from the technology to achieve this effect.

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