Text Messaging and Birth Control
Study after study points to the power of text messaging to connect health care providers to their patients, improving patient compliance with medications and appointments and giving medical professionals better data. A 2015 Johns Hopkins University study on birth control compliance in young women is no exception, demonstrating the potential texting holds to impact the often underserved area of women's health.
The study, published online in the Journal of Adolescent Health in May, recruited about 100 participants living in Baltimore. The participants, all young women between the ages of 13 and 21, were using the contraceptive injection. The "birth control shot," or Depo-Provera, is a safe and common form of hormonal birth control that requires a dose every three months to provide protection against pregnancy.
The study's participants were divided into two groups: a control group that received one standard automated phone call to their home phone before each appointment, and a group that received a text on each of the three days leading up to each appointment, to which they were asked to respond. The group that received text messages also received period text messages about STI prevention and healthy weight maintenance while on hormonal contraceptives, as well as general encouragement to consult a medical professional with any concerns. All participants received a personal phone call from a nurse.
Of all groups, 87% of the young women showed up for their first of three injections in the nine-month period. 77% returned for their second shot, and 69% also came back for the third and final injection for the study period. Because each participant received personal calls from a nurse, the study's results cannot attest to the difference in compliance between those who receive text messages and those who receive only standard automated phone calls. However, a notable difference appeared in the timeliness of the patients.
The group that received text messages was more likely to show up on time for their injections, with 68% of the experimental condition showing up on time for their first shot as opposed to 56% of the control condition. The differences diminished with each injection; 68% of the experimental condition was on time for their second cycle as compared with 62% of the control condition, and there was no significant difference between the two conditions for the third shot.
Timeliness may seem trivial, but with birth control, it is of the utmost importance. One dose of Depo-Provera only protects against pregnancy for three months, meaning that if a patient is late for an additional shot, they are likely not protected against pregnancy but may not realize it. This means that the group that received text messages was more likely to be fully protected against pregnancy.
While a study comparing the efficacy of such texts to automated phone calls would offer additional helpful information, the Johns Hopkins study provides important insight: text messages can indeed improve rates of perfect compliance with birth control among young women. The age group studied is also significant; while relatively few women under 21 plan pregnancies, almost three in ten young women will become pregnant at least once by the age of 20-- and we don't need an MTV show to tell us that unplanned teen pregnancies can be wrought with great difficulty. In short, text messaging can be a powerful way to improve contraceptive compliance among a demographic in which perfect birth control compliance is very important, and thus reduce the rate of teen pregnancy.
Text messaging is also an effective way to reach girls and young women from low-income families, a group that too often falls through the cracks of the health care system and may not have access to comprehensive, fact-based sex education in public schools. The need for informed access to contraceptives among this demographic is especially high because they face these shortcomings. Because texting enjoys great popularity among low-income communities as well as higher-income ones, the efficacy of text messages like the ones sent in the study may well extend into the demographic that most needs it. Further analysis or additional studies that assess income differences in the results may be of particular help in this area.
Regardless of what research stands to be done, the power of text messaging to improve health care compliance shines as clear as ever. SMS is a truly valuable tool for the practice of medicine and those who benefit from it.
About the Author -
NotePage, Inc. develops SMS, text messaging, wireless messaging and communication software solutions. https://www.notepage.net
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