title: Acceptability of delivering and accessing health information through text messaging among community health advisors.
abstract: BACKGROUND
  Communication technologies can play a significant role in decreasing communication inequalities and cancer disparities by promoting cancer control and enhancing population and individual health. Studies have shown that technology, such as the mobile phone short message service (SMS) or text messaging, can be an effective health communication strategy that influences individuals' health-related decisions, behaviors, and outcomes.
  
  
  OBJECTIVE
  The purpose of this study was to explore usage of communication technologies, assess the acceptability of mobile technology for delivery and access of health information, and identify cancer and health information needs among Deep South Network for Cancer Control trained Community Health Advisors as Research Partners (CHARPs).
  
  
  METHODS
  A mixed-method design was used, and a triangulation protocol was followed to combine quantitative and qualitative data. Focus groups (4 focus groups; n=37) and self-administered surveys (n=77) were conducted to determine CHARPs mobile phone and text message usage. The objective was to include identification of barriers and facilitators to a mobile phone intervention.
  
  
  RESULTS
  All participants were African American (37/37, 100%), 11/37 (89%) were women, and the mean age was 53.4 (SD 13.9; focus groups) and 59.9 (SD 8.7; survey). Nearly all (33/37, 89%) of focus group participants reported owning a mobile phone. Of those, 8/33 (24%) owned a smartphone, 22/33 (67%) had a text messaging plan, and 18/33 (55%) and 11/33 (33%) received and sent text messages several times a week or day, respectively. Similar responses were seen among the survey participants, with 75/77 (97%) reporting owning a mobile phone, and of those, 22/75 (30%) owned a smartphone, 39/75 (53%) had a text messaging plan, and 37/75 (50%) received and 27/75 (37%) sent text messages several times a week or day. The benefits of a text messaging system mentioned by focus group participants included alternative form of communication, quick method for disseminating information, and privacy of communication. The main barriers reported by both groups to using mobile technology to receive health information were cost and not knowing how to text message. Ways to overcome barriers were explored with focus group participants, and education was the most proposed solution. Majority of CHARPs were in favor of receiving a weekly text message that would provide cancer/health information.
  
  
  CONCLUSIONS
  The findings from this study indicate that CHARPs are receptive to receiving text messages focusing on cancer/health information and would be likely to engage in mobile health research. These findings represent the first step in the development of an interactive mobile health program designed to provide cancer/health information and a support network for the Deep South Network Community Health Advisors as Research Partners (DSN CHARPs).
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, United States. yumeis@uab.edu.
authors.forename: Yu-Mei
authors.identifier: http://orcid.org/0000-0002-7877-7819
authors.initials: YM
authors.lastname: Schoenberger
authors.forename: Janice
authors.initials: J
authors.lastname: Phillips
authors.forename: Mohammed Omar
authors.initials: MO
authors.lastname: Mohiuddin
authors.forename: Patrick
authors.initials: P
authors.lastname: McNees
authors.forename: Isabel
authors.initials: I
authors.lastname: Scarinci
keywords: cancer; community health workers; mobile health; text messaging
references.citation: BMC Cardiovasc Disord. 2012 May 30;12:36
references.pmid: 22646848
references.citation: Fam Community Health. 2005 Jan-Mar;28(1):6-19
references.pmid: 15625502
references.citation: Int J Nurs Stud. 2007 Jul;44(5):687-92
references.pmid: 16618486
references.citation: J Med Internet Res. 2013 Jan 25;15(1):e17
references.pmid: 23353680
references.citation: Am J Health Promot. 2011 Jul-Aug;25(6):372-8
references.pmid: 21721962
references.citation: Oncol Nurs Forum. 1995 Nov-Dec;22(10):1559-66
references.pmid: 8577624
references.citation: Tob Control. 2005 Aug;14(4):255-61
references.pmid: 16046689
references.citation: J Med Internet Res. 2007 Apr 27;9(2):e7
references.pmid: 17478409
references.citation: J Health Commun. 1998;3 Suppl:109-20
references.pmid: 10977266
references.citation: J Med Internet Res. 2008 Jun 30;10(2):e20
references.pmid: 18653444
references.citation: J Health Commun. 2006;11 Suppl 1:147-56
references.pmid: 16641080
references.citation: J Health Commun. 2012;17 Suppl 1:44-53
references.pmid: 22548598
references.citation: Fam Community Health. 2005 Jan-Mar;28(1):28-40
references.pmid: 15625504
references.citation: Health Mark Q. 1994;12(1):23-36
references.pmid: 10139720
references.citation: Am J Prev Med. 2009 Feb;36(2):165-73
references.pmid: 19135907
references.citation: Cancer. 2006 Oct 15;107(8 Suppl):1971-9
references.pmid: 16921494
references.citation: Bull Med Libr Assoc. 1997 Apr;85(2):141-6
references.pmid: 9160150
references.citation: Diabetes Technol Ther. 2003;5(6):991-6
references.pmid: 14709202
references.citation: Diabetes Res Clin Pract. 2004 Dec;66 Suppl 1:S133-7
references.pmid: 15563964
references.citation: J Med Internet Res. 2007 Dec 31;9(5):e36
references.pmid: 18166525
references.citation: Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1701-8
references.pmid: 23045545
references.citation: Ethn Dis. 2005 Spring;15(2 Suppl 2):S14-6
references.pmid: 15822831
references.citation: Epidemiol Rev. 2010;32:56-69
references.pmid: 20354039
references.citation: J Telemed Telecare. 2007;13(8):416-20
references.pmid: 18078554
references.citation: Patient Educ Couns. 1999 Jul;37(3):273-82
references.pmid: 14528553
references.citation: Diabet Med. 2006 Dec;23(12):1332-8
references.pmid: 17116184
references.citation: Fam Community Health. 2005 Jan-Mar;28(1):41-50
references.pmid: 15625505