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Chances are, if you live in New Orleans, Detroit or Cincinnati and you're in danger of developing type 2 diabetes, you've gotten a text message directing you to a better lifestyle.
Roughly 60 percent of the population of New Orleans falls into that risk category, and since January they've been targeted by the federal Text4health mobile texting program. According to federal, state and local program officials, that program is seeing positive results.
"To date we've been pretty successful," said Nebeyou Adebe, project manager for the Louisiana Public Health Institute and one of the driving forces behind the Text4health program in New Orleans. He estimated the program is enrolling an average of 200 new participants per month.
Adebe was part of a seven-member panel that discussed the New Orleans program at last week's 4th Annual mHealth World Congress in Boston. The discussion focused on one of the three federally designated Beacon Communities that launched the program in January, and offered insights into the growth of one of the largest public health-based text messaging efforts in the country.
Developed by the American Diabetes Association in conjunction with the Centers for Disease Control and Prevention, the Office of the National Coordinator for Health Information Technology, the Beacon Community Program and the three targeted Beacon Communities, Text4health creates a customized texting program for anyone who enrolls, helping the individual manage his or her lifestyle by passing along daily reminders and tips and encouraging them to set fitness goals.
"Texting is the most personal way of engaging with people," said Paul Meyer, chairman and president of Voxiva, which helped to develop the program. He pointed out that 99 percent of all text messages are read, and 90 percent of them are read within three minutes of receipt, making the message almost instantaneous and effective.
Nebeyou said early surveys show the program is working. At least 80 percent of the 1,000+ people enrolled are obese or overweight, he said, so the program is reaching its target audience, and at least 70 percent have set personal weight loss goals, so the message is reaching them.
The program is especially significant in Louisiana, which has the highest per capita rate of diabetes in the nation (10.3 percent of the state's residents have been diagnosed, an increase of almost 70 percent since 1994) and the highest mortality rate related to diabetes as well. Anjum Khurshid, PhD, MBBS, director of health systems initiatives for the Louisiana Public Health Initiative, pointed out that the state is still recovering from two major catastrophes – Hurricane Katrina and the Gulf of Mexico oil spill – and is using projects like Text4health to redesign its health system to be more community-oriented, integrated and proactive.
Nebeyou credited the program's success to a 14-member community advisory group that helped develop a grass roots campaign to identify and notify target populations. He said the group's goal is to establish a corporate partnership program and make the effort a statewide one by 2013, when the Text4health program is due to conclude.
According to Pierce Graham-Jones, the U.S. Department of Health and Human Services' West Wireless Institute Innovator-in-Residence, HHS is using the Text4health program as a guide for future mHealth initiatives (it has already launched a smoking cessation program patterned after Text4health), and is looking to help more communities – Beacon or otherwise – take on the program.
Officials are hoping to conduct a few more surveys to see just how pervasive the program has been in getting people to adopt more lifestyles. Khurshid wondered how the program could be integrated into other healthcare channels, especially providers.
"How do you connect with the regular healthcare system? That's where you will find the outcomes," he said.
That type of integration – bringing providers into the loop – is the program's final goal, officials said.
Getting data from the program entered into an electronic medical record "would be closing the loop the way we'd all like it to be closed," said John Maginnis, vice president of corporate and eCommunications for Blue Cross and Blue Shield of Louisiana.
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