Deceptively Simple yet Profoundly Impactful: Text Messaging Interventions to Support Health

Abstract

This paper examines the development and impact of Text Message Interventions (TMIs) on health behaviors. Initially, it outlines the historical progress in research and the variety of funding from US government agencies. A narrative review follows, highlighting the effectiveness of TMIs in key health areas such as physical activity, diet and weight loss, mental health, and substance use, based on published meta-analyses. The discussion then shifts to crucial design elements, including communication strategies, psychological foundations, behavior change tactics, and advanced functionalities. Additionally, the paper delves into the emergence of chatbots and the potential for Large Language Models (LLMs) to improve user interaction. While TMIs have demonstrated significant potential, challenges in widespread implementation remain, primarily due to the absence of a dedicated commercial platform, privacy and security concerns with SMS technology, and difficulties integrating with Electronic Health Records (EHR) systems. Solutions to these obstacles are proposed to facilitate the broader application of TMIs. The paper aims to provide valuable insights for researchers and practitioners to fully utilize TMIs, with the overarching objective of improving health outcomes and reducing disparities in healthcare access, thereby effectively transitioning from theoretical exploration to meaningful, real-world health interventions.