title: Community-level text messaging for 2009 H1N1 prevention in China.
abstract: BACKGROUND
  Although patients worldwide increasingly are using mobile phone text messaging (SMS) for clinical care, quality data are sparse on the community-level effectiveness of SMS to prevent and control disease.
  
  
  OBJECTIVE
  To determine SMS effectiveness in improving 2009 H1N1 knowledge, attitudes, behaviors, and self-reported outcomes and to assess community SMS acceptability.
  
  
  METHODS
  A program evaluation of Shanghai, China's SMS system using a single-blinded, randomized-controlled method was conducted in 2010 and results were analyzed in 2010-2011. Randomly selected community residents who agreed to participate were assigned to receive 3 weeks of either 2009 H1N1 prevention and control or tobacco-cessation messages. Assessments were made of 2009 H1N1 knowledge, attitudes, behaviors, and self-reported influenza-like illness before and after sending messages to participants. Acceptability of SMS also was assessed.
  
  
  RESULTS
  Of 1992 respondents, those receiving 2009 H1N1 messages had higher scores measuring 2009 H1N1 knowledge (4.2% higher) and desired attitudes (9.4% higher) (p<0.001); 1.77 times greater odds of new 2009 H1N1 vaccination (p<0.001); and 0.12 times smaller odds of reporting influenza-like illness (p<0.001) than those receiving tobacco messages. More than 95% of participants found the SMS program useful and trustworthy; nearly 90% would use it again.
  
  
  CONCLUSIONS
  SMS can improve self-reported uptake of short-term behaviors, such as vaccination, that can result in long-term prevention and control of disease. SMS can improve knowledge and influence attitudes about infection prevention and control and self-reported health outcomes. In Shanghai, health-based SMS is acceptable to users.
authors.affiliation: CDC, Atlanta, GA 30333, USA. schai@cdc.gov
authors.forename: Shua J
authors.initials: SJ
authors.lastname: Chai
authors.forename: Feng
authors.initials: F
authors.lastname: Tan
authors.forename: Yongcai
authors.initials: Y
authors.lastname: Ji
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Wei
authors.forename: Richun
authors.initials: R
authors.lastname: Li
authors.forename: Melinda
authors.initials: M
authors.lastname: Frost
mesh_terms: D000328:Adult; D002681:China; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D060145:Text Messaging / Q000706:statistics & numerical data*; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data