Texting Valuable for Engaging Low-Income Urban Patients

A new pilot study among low-income African-Americans in Detroit suggests they prefer being contacted by healthcare providers and researchers via text message on their mobile phones.


A new pilot study among low-income African Americans in Detroit suggests they prefer being contacted by healthcare providers and researchers via text message on their mobile phones.

The study, which appears online in BioMed Central Public Health, 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.

The answers gave researchers a glimpse into possible health needs in the community. One question, for example, asked people how they would respond if they couldn’t move their right arm or leg and suddenly couldn’t speak. Several participants didn’t realize those were signs of a stroke, answering that they would wait it out. The findings prompted local initiatives to better educate the community on telltale stroke warnings.

“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.”

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.”

The study is available here.

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