Using Texting for STD Prevention

Potential Uses

I. Information CampaignII. Helping DIS locate partnersIII. Appointment Reminders

Background

1995Average of 0.4 texts per

month

2000Average of 35

texts per month

2007 More texts than

phone calls

2011 Average of 357 texts per month

http://www.tatango.com/blog/history-of-text-messaging-timeline-wide/

Information Campaign

o Target audience signs up for information about topic using “short code”.

o A short code is a short telephone number, often used for short message service (SMS) or text messaging.

Short Codes

Shared Shared short codes: use keywordsto identify their incomingmessages from each other.

For example, pay to use shortcode “55555”. For a minimal fee,assign a “keyword” to thisnumber (e.g., “Chlamydia”,“Safersex”, etc).

Disadvantage: same number withthe keyword “Burgers” get youcoupon from local diner.

Dedicatedo Exclusive use of the short

code

o Can assign whatever key words you want

o Disadvantage: more expensive

Bulk Messaging/Alertso Encourage people to sign up to receive regular

text messages with news, healthy tips, etc.

When a client texts "QUITNOW" to 22122, they receive a text message response stating that a quit coach will call them within one business day.

Example, New Hampshire Tobacco Helpline:

Image: NCI’s Smokefree TXT Program

Example: New Hampshire Tobacco Helpline Text Messaging Initiative

o Within this platform, messages are customized based on a client’s stage of change (e.g., thinking about quitting, want to set a quit date, already quit) and type of tobacco use.

o Each client can potentially receive up to 90 text messages to assist him/her throughout the quitting process.

Image: Text2Stop Program Message

Example Vendors

Mobile Commons http://www.mobilecommons.com

sumotext http://www.sumotext.com

2ergo http://www.2ergo.com/us/

We are not endorsing any vendors.

Using SMS for DIS

Multnomah County, Oregon wrote SMS Protocol for DIS in 2010:

o Already doing online partner notification (2006); easy transition to mimic the same system.

o Had established track record of providing confidential services via email.

o HIPAA officer wrote procedure.

o Procedures do not require opt-in when used for partner notification.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&ved=0CHMQFjAE&url=http%3A%2F%2Fsextech.org%2Fsites%2Fdefault%2Ffiles%2Fpresentations%2F2012%2FDiaz_Edwin_THE_CUTTING_EDGE_OF_STD_TESTING_TREATMENT_AND_PARTNER_NOTIFICATION.ppt&ei=BEC8T4buJu-e6wG84MRf&usg=AFQjCNHdg5R-W-m7Mf3CflTwr02IqEVwJg

5TH Annual ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH

April 1st - 3rd, 2012 San Francisco, CA

The Procedures

5TH Annual ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH

April 1st - 3rd, 2012 San Francisco, CA

The Procedures, Continued.

o Text messaging are not secure!

o Subject to public records retention laws!

o Phone Call first!

o The purpose of sending a text message is to engage the individual in a voice call or face-to-face conversation.

o Protected health information (PHI) must never be sent via text messaging.

5TH Annual ISIS CONFERENCE ON NEW MEDIA, YOUTH & SEXUAL HEALTH

April 1st - 3rd, 2012 San Francisco, CA

Comparison: 01/01-3/26

Cases

Texted

248

11%

54%

2011 2012

279

29%

78%Responded

Appointment Reminders

o Clients give permission to use cell phone number

o Automatic texts from EMR to remind clients of appointments

Do Text Messages for Appointment Reminders Work?

o Acceptability of test message reminders has been specifically demonstrated in the sexual health context.

o 2009 Study in Family Planning Clinics in Maine found that text messaging the least preferred and least efficacious method compared to phone and letters.

Kegg S, Natha M, Lau R. Communication with patients: Are e-mail and text messaging the answer? Int J STD AIDS 2004;15(46).

Maine Study

o For scheduling rescreening appointment, reminder methods offered were text messaging, phone, mail or no contact for confidential clients.

o Family planning staff explained that a generic message “To Your Health” would be sent and the client was instructed to call the clinic for an appointment.

o Not possible for the client to text back to schedule an appointment.

o HIPAA laws and confidentiality concerns prohibited offering an appointment via text messaging.

Results of Maine Study

188 Positive Test March 2009 – October 2009

Contact option

Option Appointment scheduled

Appointment kept

Phone 44% 20% 94%

Mail 30% 10% 94%

Text 21% 15% 33%

STD Clinic in Peoria County, IL

Peoria City/County Health Department STD Clinic, 2010

o Text messaging among the target population (male/female 25 and younger) is accepted communication practice.

o Majority preferred text messaging to phone calls -confirmed by survey of clients.

o Among those clients proactively treated and who opted for text message, 40% of them called the clinic to confirm their result compared to 15% of clients who chose to call the clinic.

http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=731

Comparison of time to treatment before/after texting implemented

Treated for GC within 14 Days

2008 2009

76%

Treated for CT within 14 Days 74% 81%

87%

http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=731

Thank You.