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Study explores text message health service

Researchers join movement to increase access to care in underserved communities

Across the country, the mobile health movement — mHealth — seeks to provide medical attention to communities with restricted access to health care. But the desirability of some of these mobile health care tools remains unknown, spurring researchers to examine the prevention of adolescent mental health issues through a new text messaging program.

Published last month in the Journal of Adolescent Health, the findings of a new study confirmed patient and public demand for a text messaging intervention program for at-risk teens.

The study, conducted by Megan Ranney, assistant professor of emergency medicine at Alpert Medical School, focused on adolescent females checked into the emergency department.

Previous interventions in mHealth — a field in its infancy — have successfully aided patients with smoking cessation, HIV/AIDS medication adherence and weight loss.

The suggested program, designed for teenagers at risk for depression, aims to prevent further development of mental health issues. Participants in the study were extremely enthusiastic about and receptive to the idea of being a part of a program that would send a regular text message to their cellphones, according to the study.

The study explored the optimal language, structure and regularity of the text message intervention, as well as the feasibility of such a program. Several participants in the study suggested that the message be individually tailored to how subscribers were feeling on a particular day, Ranney said.

The mHealth movement also focuses on expanding access to care. While the text message program is designed to work within a larger health care network, it has potential even on its own to serve as a bandage or quick fix until patients are integrated into other systems of care, Ranney said.

“In an ideal world every kid would be hooked up to an ideal home” and would be linked to a health care network and its resources, Ranney said. But this support structure is absent for many adolescents due to issues of accessibility and health care coverage. The prevention service may reach underserved populations, Ranney said.

The study was unique in that it focused on how teens would want a text message-based intervention program to be structured. This step is essential in creating evidence-based solutions for patients, Ranney said. “Very few physicians are going to start prescribing mHealth programs without evidence that it changes behavior,” she added.

The University currently does not employ any forms of mHealth, said Sherri Nelson, director of Psychological Services. “Certainly we are open to other technological innovations, but that’s not something that’s immediately on our horizons,” Nelson said.

A program similar to the text messaging system explored by the study would be very helpful in “reaching a greater segment of the (student) population,” because “virtually all students” use cellphones, she said.

Raven Carson ’16, a student worker at Brown Health Education, said a program similar to the one proposed in the study would be a wonderful addition to the University’s existing network of resources.

Many students are hesitant to seek mental health services, but texting would be an easy way for students to “advocate for themselves and get a little bit of help,” Carson said.

“Knowing you’re not alone is healing,” Carson said, adding that a texting service for high-risk students could be “a life-saver.”

“I’m all for it — I think that in general, medicine is moving from curative to preventative,” said Jessi Haddad ’16.5, a psychology concentrator in the Program in Liberal Medical Education. Such a preventative program is a step toward improved care and would not be difficult to implement on a college campus, she added.

Health Education has two programs that send texts to subscribed students. One, called BWELL, sends updates about campus health events such as Heavy Petting. The other is offered by the Sexual Health Awareness Group, which offers “personalized, confidential answers to students’ sexual health and safer sex questions via text,” according to its website.

But there is no texting service available at the University that addresses mental health.

Future research must be done to ensure that such a program would be “acceptable and feasible,” Ranney said.


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