title: A Research Protocol to Test the Effectiveness of Text Messaging and Reminder Calls to Increase Service Use Referrals in a Community Engagement Program.
abstract: BACKGROUND
  Mobile phoned-based interventions have been increasingly used in clinical populations to improve health and health care delivery. The literature has shown that mobile phone-based text messages (short message service, SMS) are instantaneous, cost effective, and have less chance of being misplaced. Studies using mobile phone based-text messages have reported text messages as effective reminders that have resulted in increased appointment attendance, adherence to treatment, and better self-management. There have been no reports of adverse events when using text messaging in terms of misreading or misinterpreting data, transmitting inaccurate data, losing verbal or nonverbal communication cues, privacy issues, or failure or delay in message delivery. However, the literature has cited a need for personalized messages that are more responsive to individual needs. In addition, there has been a dearth of information on the use of reminders in nonclinical populations.
  
  
  OBJECTIVE
  The goal of this study is to assess the effectiveness of adding reminders in the form of text messaging versus reminder calls versus text messages and reminder calls to increase use of service referrals provided through community outreach.
  
  
  METHODS
  A total of 300 participants will be recruited for the study. Each participant will be randomized to one of three arms: a group that receives only reminder calls (CALLSONLY); a group that receives only text message reminders (TEXTONLY); and a group that receives both reminder calls and text messages (CALLS+TEXT). All groups will receive their reminder intervention on the 15th and 45th day after baseline when they receive medical and social service referrals from the community health workers (CHWs). A standard script will be used to administer the call and text reminders and a 15-item telephone-based satisfaction survey will be administered to assess the participant satisfaction with the process of receiving periodic reminders.
  
  
  RESULTS
  The study is in the recruitment and follow-up phase. The authors anticipate completion of recruitment, interventions, and data entry by July 2016. Preliminary results are expected to be available by September 2016.
  
  
  CONCLUSIONS
  This study will provide an opportunity to test the effectiveness of mobile-based interventions on nonclinical, community-recruited populations. In particular, such a protocol would increase the effectiveness of a community-based engagement program by instating a formal reminder system for all program members who receive social and/or medical service referrals during outreach in the community. Findings from this study would guide the development and implementation of reminder protocols for community-based engagement programs nationwide.
authors.affiliation: College of Public Health and Health Professions and College of Medicine, Department of Epidemiology, University of Florida, Gainesville, FL, United States. dvarma@ufl.edu.
authors.forename: Deepthi Satheesa
authors.identifier: http://orcid.org/0000-0003-1163-0377
authors.initials: DS
authors.lastname: Varma
authors.forename: Mark
authors.identifier: http://orcid.org/0000-0001-5253-5873
authors.initials: M
authors.lastname: Hart
authors.forename: Denise Sonya
authors.identifier: http://orcid.org/0000-0001-7703-7934
authors.initials: DS
authors.lastname: McIntyre
authors.forename: Evan
authors.identifier: http://orcid.org/0000-0001-8398-8429
authors.initials: E
authors.lastname: Kwiatkowski
authors.forename: Linda Bauer
authors.identifier: http://orcid.org/0000-0001-5643-8536
authors.initials: LB
authors.lastname: Cottler
keywords: community engagement; mHealth; referral use; reminder calls; text messaging