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      Short Message Service (SMS) Applications for Disease Prevention in Developing Countries

      research-article
      , MIH, MD 1 , 2 , , , MS, PhD 3 , , MPH, PhD 1 , 2
      (Reviewer), (Reviewer), (Reviewer), (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      Gunther Eysenbach
      Mobile health, developing countries, prevention, SMS, short message service

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          Abstract

          Background

          The last decade has witnessed unprecedented growth in the number of mobile phones in the developing world, thus linking millions of previously unconnected people. The ubiquity of mobile phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention efforts.

          Objective

          The aim of this review was to describe the characteristics and outcomes of SMS interventions for disease prevention in developing countries and provide recommendations for future work.

          Methods

          A systematic search of peer-reviewed and gray literature was performed for papers published in English, French, and German before May 2011 that describe SMS applications for disease prevention in developing countries.

          Results

          A total of 34 SMS applications were described, among which 5 had findings of an evaluation reported. The majority of SMS applications were pilot projects in various levels of sophistication; nearly all came from gray literature sources. Many applications were initiated by the project with modes of intervention varying between one-way or two-way communication, with or without incentives, and with educative games. Evaluated interventions were well accepted by the beneficiaries. The primary barriers identified were language, timing of messages, mobile network fluctuations, lack of financial incentives, data privacy, and mobile phone turnover.

          Conclusion

          This review illustrates that while many SMS applications for disease prevention exist, few have been evaluated. The dearth of peer-reviewed studies and the limited evidence found in this systematic review highlight the need for high-quality efficacy studies examining behavioral, social, and economic outcomes of SMS applications and mobile phone interventions aimed to promote health in developing country contexts.

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          Most cited references80

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          Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries?

          Background The ongoing policy debate about the value of communications technology in promoting development objectives is diverse. Some view computer/web/phone communications technology as insufficient to solve development problems while others view communications technology as assisting all sections of the population. This paper looks at evidence to support or refute the idea that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries. Methods A Web-based and library database search was undertaken including the following databases: MEDLINE, CINAHL, (nursing & allied health), Evidence Based Medicine (EBM), POPLINE, BIOSIS, and Web of Science, AIDSearch (MEDLINE AIDS/HIV Subset, AIDSTRIALS & AIDSDRUGS) databases. Results Evidence can be found to both support and refute the proposition that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries. It is difficult to generalize because of the different outcome measurements and the small number of controlled studies. There is almost no literature on using mobile telephones as a healthcare intervention for HIV, TB, malaria, and chronic conditions in developing countries. Clinical outcomes are rarely measured. Convincing evidence regarding the overall cost-effectiveness of mobile phone " telemedicine" is still limited and good-quality studies are rare. Evidence of the cost effectiveness of such interventions to improve adherence to medicines is also quite weak. Conclusion The developed world model of personal ownership of a phone may not be appropriate to the developing world in which shared mobile telephone use is important. Sharing may be a serious drawback to use of mobile telephones as a healthcare intervention in terms of stigma and privacy, but its magnitude is unknown. One advantage, however, of telephones with respect to adherence to medicine in chronic care models is its ability to create a multi-way interaction between patient and provider(s) and thus facilitate the dynamic nature of this relationship. Regulatory reforms required for proper operation of basic and value-added telecommunications services are a priority if mobile telecommunications are to be used for healthcare initiatives.
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            Mobile phone short message service messaging for behaviour modification in a community-based weight control programme in Korea.

            We conducted a community-based anti-obesity programme using mobile phone short message service (SMS) messaging. A total of 927 participants were recruited and visited a public health centre for initial assessment. Mobile phones were used to deliver short messages about diet, exercise and behaviour modification once a week. After a 12-week anti-obesity programme they visited the public health centre again. Four hundred and thirty-three subjects (47%) successfully completed their weight control programme. There were mean reductions of weight, waist circumference and body mass index of 1.6 kg (P < 0.001), 4.3 cm (P < 0.001) and 0.6 kg/m(2) (P < 0.001), respectively. Over two-thirds of the subjects had a reduction in waist circumference of 5-7.5 cm. A post-intervention survey showed that the majority of participants were satisfied with the weekly SMS messages and information brochures delivered by post. SMS messaging may be an effective method of behaviour modification in weight control and anti-obesity health education programmes when promoted by community health centres.
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              Cell phone short messaging service (SMS) for HIV/AIDS in South Africa: a literature review.

              The HIV/AIDS pandemic is one of the most serious threats to global health. HIV/AIDS is a chronic illness, requiring patient empowerment to enhance adherence to treatment regimes if it is to be managed effectively. While healthcare costs are rising, people still have expectations of high-quality care. This literature review-based study explored the use of cell phone (mobile phone) short messaging services (SMS) in health care, in particular for HIV/AIDS in South Africa. From an initial corpus of 212 papers, 28 were reviewed. The main findings include that SMS can improve service delivery through appointment reminders and improve communication between healthcare workers. It improves diagnosis, prevention, treatment and rehabilitation by supporting adherence to medication, and monitoring illness and medical interventions. SMS is useful in public health programmes, such as contact tracing and partner notification, therefore playing an important role in control of HIV/AIDS. As South Africa has one of the highest uptakes and demographic distributions of cellular technology in the world, SMS is feasible as a tool to deliver quality health care with low cost.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (JMIR Publications Inc., Toronto, Canada )
                1439-4456
                1438-8871
                Jan-Feb 2012
                12 January 2012
                : 14
                : 1
                : e3
                Affiliations
                [1] 1Department of Epidemiology and Public Health Swiss Tropical and Public Health Institute BaselSwitzerland
                [2] 2University of Basel BaselSwitzerland
                [3] 3Institute of Public Communication Faculty of Communcation Sciences Università della Svizzera italiana LuganoSwitzerland
                Article
                v14i1e3
                10.2196/jmir.1823
                3846341
                22262730
                50e12555-3cd1-41da-a386-5aaf182950c6
                ©Carole Déglise, L. Suzanne Suggs, Peter Odermatt. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.01.2012.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 01 April 2011
                : 23 April 2011
                : 03 October 2011
                : 05 October 2011
                Categories
                Review

                Medicine
                mobile health,developing countries,prevention,sms,short message service
                Medicine
                mobile health, developing countries, prevention, sms, short message service

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