Objective: To examine responses to text-message reminders and associate responses with senders' characteristics and subsequent screening.Methods: Prospective cohort intervention. Text-message reminders to undergo colorectal cancer (CRC) screening, randomized into interrogative and declarative phrasing, sent to non-adherent women and men (40,000), aged 50 to 74, at CRC average-risk. Recipients' responses were analyzed by message type and recipients' characteristics; for content, the latter predicting subsequent CRC screening per program database. . This study applied an mHealth tool to enhance CRC screening: reminders (to screen) were worded as questions, not statements, and sent as text-messages via cellular-phones to a target audience of non-adherent individuals [4]. This is an account of recipient responses to the reminders, uncovering a change in less adherent population sectors invited for CRC screening.
ResultsThe short message service (SMS) emerged in 1992 and by 1995 it was a socially acceptable and widely used means of communication [3,5]. Since that time, textmessaging diffused from a personal means of communication among friends and colleagues to a tool used by organizations to contact and inform target audiences [6,7]. SMS has been used (as pre-or post-notification reminders) to improve response rates to mailed questionnaires; [8] In health, SMS has been used to enhance appointment attendance [9,10]; post-treatment risk reduction [11]; medication adherence [12], and to promote self-management and risk reduction among patients with cardiovascular, and coronary heart disease [13,14]. Reviews of these studies indicate SMS interventions are a robust means for effectively targeting health behavior change; effects have been small-tomoderate [12,15].
Statistical analysisFirst, Respondents were characterized by experimental condition (grammatical form and social context), demographic attributes and FOBT past performance (sporadic/never). Secondly, responses to the SMS interrogative conditions only, were coded for content and length. The content categories were grouped into two new variables: position towards CRC screening and