Study: Low-Income Urban Patients Prefer Texting

By Christine Kern, contributing writer

Text messaging is not only acceptable and feasible but is the preferred method of collecting real-time survey data in a low-income urban African-American community.

The results of a new pilot study conducted among low-income African Americans in Detroit reveals their preferred method of contact by healthcare providers via text message on their mobile phones.

Published online by BioMed Central Public Health, the study was a collaboration among researchers at the University of Michigan Health System, VA Ann Arbor Healthcare System, the Detroit Community-Academic Urban Research Center, and non-profit Detroit organization, Friends of Parkside.

The 20 participants were asked hypothetical questions related to their health to evaluate how they would respond to leading reasons for urgent outpatient medical visits and also common primary care concerns. Examples included what they’d do if they needed a flu shot for a new job, had a four-day-old rash on their leg, or fell down the stairs and thought they’d broken a leg. On average, the response rate was 72 percent.

Researchers used a mixed methods approach including paper surveys, surveys administered by text message, and a focus group. Survey questions that included multiple choice, Likert-like scales, and open ended questions were administered by paper and sent via text message daily during varied times of day for six weeks.

“Our study shows great potential to connect with a population that’s traditionally difficult to reach. Texting is a simple technology that is already being used for everyday communication – it is something people from all backgrounds are very comfortable with,” said lead author Tammy Chang, M.D., an assistant professor in the department of family medicine at the University of Michigan Medical School.

Of the cohort participating in the study, Chang said, “This is a group whose attitudes and perceptions are incredibly important to understand, but who may not necessarily be taking online surveys or attending community meetings. We found that texting is not only acceptable and feasible but is the preferred method of collecting real-time information from low-income community members. Most importantly, texting may offer an efficient, inexpensive way to give a voice to people who aren’t often heard and whose needs aren’t always met.”

The study sample was 90 percent female, and 100 percent African American, with a median age of 30.7 years. Participants responded to 72 percent of all multiple choice questions sent by text message and 76 percent of the questions requiring responses on Likert-like scales. All of the participants reported in the focus group that they preferred text message surveys over other survey modalities they have used in the past (paper, phone, internet, in-person) due to ease and convenience.

The study ultimately concluded that text messaging is not only acceptable and feasible but is the preferred method of collecting real-time survey data in a low-income urban African-American community. Chang also said the results may offer insights into using text-based communications to open two-way communications with a traditionally hard-to-reach cohort of patients.

"Typically we have used cellular phone technology to push out information, not as much to collect opinions from people," she said. “However, this everyday technology may not only help researchers better understand under-represented perspectives, it can also help organizations quickly tap into their stakeholders' thoughts and opinions to get to the heart of significant issues.”