Text Message Interventions in Adolescent Mental Health and Addiction Services: Scoping Review

Abstract

Background The vast majority of adolescent mental health and substance use disorders go undiagnosed and undertreated. SMS text messaging is increasingly used as a method to deliver adolescent health services that promote psychological well-being and aim to protect adolescents from adverse experiences and risk factors critical for their current and future mental health. To date, there has been no comprehensive synthesis of the existing literature on the extent, range, and implementation contexts of these SMS text message interventions. Objective The objective of this scoping review was to map and categorize gaps in the current body of peer-reviewed research around the use of SMS text messaging–based interventions for mental health and addiction services among adolescents. Methods A scoping review was conducted according to Levac’s adaptation of Arksey and O’Malley’s methodological framework for scoping reviews in six iterative stages. A search strategy was cocreated and adapted for five unique databases. Studies were screened using Covidence software. The PICO (patient, intervention, comparator, outcome) framework and input from multiple stakeholder groups were used to structure and pilot a data extraction codebook. Data were extracted on study methodology and measures, intervention design, and implementation characteristics, as well as policy, practice, and research implications. Results We screened 1142 abstracts. Of these, 31 articles published between 2013 and 2020 were eligible for inclusion. Intervention engagement was the most common type of outcome measured (18/31), followed by changes in cognitions (16/31; eg, disease knowledge, self-awareness) and acceptability (16/31). Interventions were typically delivered in less than 12 weeks, and adolescents received 1-3 messages per week. Bidirectional messaging was involved in 65% (20/31) of the studies. Limited descriptions of implementation features (eg, cost, policy implications, technology performance) were reported. Conclusions The use of SMS text messaging interventions is a rapidly expanding area of research. However, lack of large-scale controlled trials and theoretically driven intervention designs limits generalizability. Significant gaps in the literature were observed in relation to implementation considerations, cost, clinical workflow, bidirectionality of texting, and level of personalization and tailoring of the interventions. Given the growth of mobile phone–based interventions for this population, a rigorous program of large-scale, well-designed trials is urgently required.

Patients’ Expectations and Experiences With a Mental Health–Focused Supportive Text Messaging Program: Mixed Methods Evaluation

“…Overall, satisfaction with texting mental health services is well-accepted because texting is convenient, inexpensive, and remotely delivered [ 3 ]. According to a systematic review of 27 studies that used mobile phone apps and text messaging, the authors reported that the usability and feasibility along with satisfaction with mobile health services are highly rated by their users [ 41 ]. In accordance with this finding, we conclude that Text4Support was well-perceived by the patients who had received the service for 6 months after their discharge from the acute care units.…”

Acceptability of the Brushing RemInder 4 Good oral HealTh (BRIGHT) trial intervention: a qualitative study of perspectives of young people and school staff

“…This is in line with the findings of other studies which have reported on the acceptability of text message behaviour change interventions for young people. These have included interventions aimed at improving clinic attendance, oral hygiene, physical activity and weight management, contraception use, sun-protective measures or reducing smoking and alcohol misuse [ 17 – 19 ].…”

Acceptability, Engagement, and Effects of a Mobile Digital Intervention to Support Mental Health for Young Adults Transitioning to College: Pilot Randomized Controlled Trial

“…Fifth, MoST-MH was completely automated, allowing low-cost scalability. Although human interaction has been identified as an important component of digital mental health interventions [ 24 , 25 ] and the majority of text message interventions for adolescent mental health and substance abuse involve some human communication [ 26 ], it is not feasible in the current reimbursement landscape to expect mental health care to fund these personnel. Digital intervention science should focus on identifying features to optimize human-computer interaction.…”