Using Texting for STD Prevention
Potential Uses
I. Information Campaign
II. Helping DIS locate partners
III. Appointment Reminders
Background
1995
2000
2007
2011
Average of 0.4 texts per
month
Average of 35
texts per month
More texts than
phone calls
Average of 357
texts per month
http://www.tatango.com/blog/history-of-text-messaging-timeline-wide/
Information Campaign
o Target audience signs up for information about
topic using “short code”.
o A short code is a short telephone number, often
used for short message service (SMS) or text
messaging.
Short Codes
Shared
Dedicated
Shared short codes: use keywords
to identify their incoming
messages from each other.
o Exclusive use of the short
code
For example, pay to use short
code “55555”. For a minimal fee,
assign a “keyword” to this
number (e.g., “Chlamydia”,
“Safersex”, etc).
Disadvantage: same number with
the keyword “Burgers” get you
coupon from local diner.
o Can assign whatever key
words you want
o Disadvantage: more
expensive
Bulk Messaging/Alerts
o Encourage people to sign up to receive regular
text messages with news, healthy tips, etc.
Example, New Hampshire Tobacco Helpline:
When a client texts "QUITNOW"
to 22122, they receive a text
message response stating
that a quit coach will call
them within one business day.
Image: NCI’s Smokefree TXT Program
Example: New Hampshire Tobacco Helpline
Text Messaging Initiative
o Within this platform, messages are customized
based on a client’s stage of change (e.g., thinking
about quitting, want to set a quit date, already
quit) and type of tobacco use.
o Each client can potentially
receive up to 90 text
messages to assist him/her
throughout the quitting
process.
Image: Text2Stop Program Message
Example Vendors
Mobile Commons
http://www.mobilecommons.com
sumotext
http://www.sumotext.com
2ergo
http://www.2ergo.com/us/
We are not endorsing any vendors.
Using SMS for DIS
Multnomah County, Oregon wrote SMS Protocol for DIS in 2010:
o Already doing online partner notification (2006); easy transition
to mimic the same system.
o Had established track record of providing confidential services via
email.
o HIPAA officer wrote procedure.
o Procedures do not require opt-in when used for partner
notification.
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&ved=0CHMQFjAE&url=http%3A%2F%2Fsextech.org%2Fsites%2Fdefau
lt%2Ffiles%2Fpresentations%2F2012%2FDiaz_Edwin_THE_CUTTING_EDGE_OF_STD_TESTING_TREATMENT_AND_PARTNER_NOTIFICATION.ppt
&ei=BEC8T4buJu-e6wG84MRf&usg=AFQjCNHdg5R-W-m7Mf3CflTwr02IqEVwJg
5
TH Annual
ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH
The Procedures
April 1st - 3rd, 2012
San Francisco, CA
5
TH Annual
ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH
The Procedures, Continued.
o Text messaging are not secure!
o Subject to public records retention laws!
o Phone Call first!
o The purpose of sending a text message is to engage
the individual in a voice call or face-to-face
conversation.
o Protected health information (PHI) must never be
sent via text messaging.
April 1st - 3rd, 2012
San Francisco, CA
5
TH Annual
ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH
Comparison: 01/01-3/26
2011
2012
Cases
248
279
Texted
11%
29%
Responded
54%
78%
April 1st - 3rd, 2012
San Francisco, CA
Appointment Reminders
o Clients give permission to use cell phone
number
o Automatic texts from EMR to remind clients of
appointments
Do Text Messages for Appointment
Reminders Work?
o Acceptability of test message reminders has
been specifically demonstrated in the sexual
health context.
o 2009 Study in Family Planning Clinics in Maine
found that text messaging the least preferred
and least efficacious method compared to phone
and letters.
Kegg S, Natha M, Lau R. Communication
with patients: Are e-mail and text
messaging the answer? Int J STD AIDS
2004;15(46).
Maine Study
o For scheduling rescreening appointment, reminder
methods offered were text messaging, phone, mail or
no contact for confidential clients.
o Family planning staff explained that a generic message
“To Your Health” would be sent and the client was
instructed to call the clinic for an appointment.
o Not possible for the client to text back to schedule an
appointment.
o HIPAA laws and confidentiality concerns prohibited
offering an appointment via text messaging.
Results of Maine Study
188 Positive Test March 2009 – October 2009
Contact
option
Option
Appointment Appointment
scheduled
kept
Phone
44%
20%
94%
Mail
30%
10%
94%
Text
21%
15%
33%
STD Clinic in Peoria County, IL
Peoria City/County Health Department STD Clinic, 2010
o Text messaging among the target population (male/female 25 and
younger) is accepted communication practice.
o Majority preferred text messaging to phone calls -confirmed by
survey of clients.
o Among those clients proactively treated and who opted for text
message, 40% of them called the clinic to confirm their result
compared to 15% of clients who chose to call the clinic.
http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=731
Comparison of time to treatment before/after
texting implemented
2008
2009
Treated for GC
within 14 Days
76%
87%
Treated for CT
within 14 Days
74%
81%
http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=731
Thank You.