Secondary Impact of Social Media via Text Message Screening for Type 2 Diabetes Risk in Kuwait: Survey Study (Preprint)

Abstract

BACKGROUND Diabetes mellitus can cause serious chronic medical comorbidities including heart and blood vessel disease, blindness, neuropathy, limp amputation, and kidney failure. Fortunately, this disease can be prevented or managed by following a healthy lifestyle. However, many healthcare systems fail to properly educate the public on disease prevention and to offer support in embracing behavioral interventions to prevent diabetes. OBJECTIVE To evaluate the feasibility, acceptability, and effectiveness of text message screening (TMS) using short message service (SMS) campaigns to detect people who might be at risk of developing type 2 diabetes mellitus (T2DM) in Kuwait. METHODS Five separate TMS campaigns were launched inviting recipients to answer 6 questions to determine risk of developing T2DM. If subjects agreed to participate, a link to the CDC prediabetes screening test was automatically transmitted to their mobile devices. Those identified as high risk were invited to participate in a diabetes prevention program. RESULTS A total of 180,000 SMSs were sent to 6% of the adult population in Kuwait. Of these, 260 individuals agreed to participate and 153 (58.8%) completed the screening. Surprisingly, additional surveys were completed by 367 individuals who were invited based on circulated SMS messages forwarded by family members and friends. One hundred twenty-one (N=121) qualified and agreed to participate in a diabetes prevention program. More women than men were forwarded the messages (p<0.001) and those who participated in the program were older, more overweight, and reported being less physically active (p<0.05). CONCLUSIONS Text messaging healthcare screening campaigns were found to have limited effectiveness alone but with increased reach through shared second-party social media messaging. Although a subpopulation who might be at risk of developing T2D can be reached using text messaging, most responders were informed about the screening campaign by family and friends. Future research designed to tap into the benefits of social media in health risk campaigns is encouraged.