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Evaluation of Text Messaging Effects on Health Goal Adherence in the Management of Participants With Chronic Diseases

Stagg, Sharon J. DNP, MS, MPH; Speroni, Karen Gabel PhD, BSN, MHSA, RN; Daniel, Marlon G. MPH, MHA; Eigenbrode, Melissa MSN, RN, RRT; Geisler, Lori MSN, RN

doi: 10.1097/NCM.0000000000000190

Purpose of the Study: The study purpose was to determine whether text messaging health-related messages, questions, and reminders to community case management participants with chronic diseases increased health goal adherence.

Primary Practice Setting: This study was conducted by a rural community case management, hospital-affiliated program.

Methodology and Sample: This pilot, quasiexperimental study measured health goal adherence, the degree to which an individual continues work toward self-identified health goals under limited supervision, before and after a text messaging intervention. All participants were receiving community case management services for chronic disease. Participants completed baseline and follow-up surveys regarding a text messaging intervention.

Results: Most participants were African Americans, had diabetes, with equal numbers by gender, an average age of 57.8 years, and had been in the community case management program for 3–5 years. Participants were sent a total of 1,654 messages/questions and 571 reminders. At follow-up, respondents who reported “Did you work on your health goals?” increased significantly (p = .0430). However, no differences were found for “Did you go to your health care appointments?” and “Did you take your medicines as you should?” No differences were noted in reported visits/hospitalizations overall or specifically at the research site. Lastly, study member visit/hospitalization numbers did not change significantly at follow-up.

Implications for Community Case Management Practice: Although text messaging is not meant to take the place of face-to-face interactions, it does provide community case managers with an additional modality of communication with patients to offer support and important care reminders, and to facilitate patient participation in his or her care.

Sharon J. Stagg, DNP, MS, MPH, works as a palliative care nurse practitioner. She was previously the director of a community case management program. She has over 36 years of experience in case management, occupational health, staff development, and surgical nursing.

Karen Gabel Speroni, PhD, BSN, MHSA, RN, provides research process and infrastructure consultation for hospitals and health care organizations. She has 30 years of experience in biomedical research, including leading hospital-based research programs, publishing, presenting, serving on Institutional Review Boards, consulting for Magnet organizations, and research-related university teaching.

Marlon G. Daniel, MPH, MHA, is a biostatistician and health services researcher with a focus on women's and minority health disparities. He has spent his career engaging in statistical consulting, university teaching, and health services research.

Melissa Eigenbrode, MSN, RN, RRT, is a community case specialist with over 11 years of nursing experience. She also has experience in outpatient cardiopulmonary rehabilitation, emergency nursing, and is a respiratory care practitioner.

Lori Geisler, MSN, RN, has 28 years of experience in critical care nursing and has worked in community case management for 5 years.

Address correspondence to Sharon J. Stagg, DNP, MS, MPH, University of Maryland Shore Regional Health, 219 S. Washington St, Easton, MD 21601 (

Sense Health, which provides technology to help health care providers communicate with their patients outside the office, furnished the text messaging platform and study participant monthly stipends free of charge.

The authors report no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.