Text Message for Your Health

Last Friday, I was eating Thai food in San Francisco with some friends of mine when I received a text message (SMS) on my phone. It was 10:10 p.m. and, after reading the message, I was a little surprised. Nevertheless, I got out of my seat and started reaching for my toes. I felt a little weird at first, but by the time I was done, a few people had lost some calories from laughing and I met my goal of stretching for that day.

The message I received ("Did you accomplish your goal today?") was part of a pilot experiment we're currently conducting in the Stanford University Persuasive Technology Lab to see if texting can be used as a mechanism to improve health in social groups. You'd be surprised how much mobile phones can persuade people to change their attitudes and behavior at any moment. In an upcoming book about texting for health featuring an array of experts in the field, our lab will present ten techniques for SMS health interventions. We hope by giving you a sneak peak, you might think of other ways that text messaging could improve yours and other people's lives.

The ten techniques we describe fall into five categories and are likely to flex over time:

Send Information
Last year alone, people in the United States sent 363 billion text messages, according to the National Center for Health Statistics. People are using text messaging and familiar with it. Organizations such as a county health department can capitalize on this fact and send educational information to residents ranging from a health tip of the day to an emergency notification.

Gather Information
The television show, American Idol, has really popularized text messaging. In one case, people from 22 countries cast 680 million text-message votes for their favorite idol candidate. This is just one example of being able to gather and quantify information from a large population. Transferred to the health community, texting is a great way for doctors and other healthcare professionals to get feedback from people. For example, with SMS, health researchers could send out a short survey and collect thousands of data points within minutes or even collect individual responses from patients when they experience an event as common as a migraine headache.

Get Answers
Until Google and other databases become more sophisticated at responding to our needs, humans can quickly respond to people through text messages. Similar to using e-mail or instant messenger, health organizations can use online services to send text message responses to people who have questions or need advice.

Connect People
Texting is a convenient way to have lightweight conversations with someone and leverage the motivational power of coaching and peer support to promote healthy behavior. Imagine receiving a text message of encouragement from your personal trainer to keep exercising just when you've started to lose your drive. 

Get Things Done
People around the world use text messages for doing everything from paying tolls to finding nearby restaurants. Health services can incorporate text messaging and let people do things like schedule appointments or order prescriptions.

Our week-long experiment focused on the category of connecting people, in our case, ten lab members. Using text messaging and a free and local Web 2.0 service called 3Jam, we supported each other's health goals, ranging from not eating popcorn to polluting less. Each day, a member of the lab sent the text message, "Did you accomplish your goal today?" at random times so that we wouldn't expect it.

The recipient of the message was then asked to respond. In my case, I replied with the text message, "stretching at thai restaurant in sf." Because of the online service we used, everyone in the group received my message. Knowing that other lab members would receive it motivated me to accomplish my goal.

While this trial has not proven anything statistically, it's a testament to how simple text messages can help change behavior. The future direction of our research will look into how micro-blogging and status updates from other free services like Twitter can sustain the long-term health goals of groups.

Enrique Allen is a student researcher with the Stanford University Persuasive Technology Lab with a background in Human Biology and Management Science and Engineering. His research focuses on mobile status sensing in social networks and is currently working with Venrock, a venture capital firm. For questions or feedback please e-mail Enrique.Allen@stanford.edu.