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iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.

Recommended Steps for Developing and Pretesting a Text Messaging Program for Health Behavior Change

1. What was the motivation behind your study?

A growing body of evidence demonstrates that text messaging medical apps and SMS digital platforms can help people modify health behaviors. Most of these programs have consisted of automated and, sometimes, interactive text messages that guide a person through the process of behavior change. However, for researchers hoping to develop new text messaging behavior change programs, few resources exist that describe the steps involved in developing such a program.

2. Describe your study.

Based on our collective experience designing, developing and evaluating text messaging programs and a review of the literature, we drafted specific guidance on how to develop text messaging programs aimed at changing health behaviors. Specially, the guidance includes information on designing the text messaging program, choosing the communication objectives and behavioral techniques, designing the framework for the program, writing the message library and pretesting the text messaging program.

3. What were the results of the study?

Guidance is provided on message frequency, message timing, types of interaction, message source, tailoring and privacy concerns for designing the program framework as well as tips for writing the message library. The steps outlined in this guide may help in the development of SMS-based behavior change programs.

4. What is the main point that readers should take away from this study?

The guide highlights an array of evidence-based SMS practices, related to message design, structure, and implementation of SMS programs. From the authors’ experiences of designing, developing, testing and implementing text message behavior change programs, it is important to have a good design process.

5. What was the most surprising finding from your study?

This paper was based on current evidence in the field, but those new to mhealth interventions may find it surprising how simple programs and technologies are now available for sending messages to participants once the program is designed.

6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affect R&D?

Evidence has demonstrated the great promise of mhealth interventions, particularly SMS programs, in changing user’s health behaviors across a variety of domains. Practitioners, researchers and other health professionals can make use of communication technologies to expand reach and dose of current activities. Effective SMS interventions can be integrated into routine practice and standard of care to enhance care and benefit a larger portion of the population.