title: Cell phone-based health education messaging improves health literacy.
abstract: BACKGROUND
  The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education.
  
  
  OBJECTIVE
  To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China.
  
  
  METHODS
  A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups.
  
  
  RESULTS
  Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54.
  
  
  CONCLUSIONS
  SMS may be a useful tool for improving health literacy.
authors.affiliation: School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510000, Guangdong, China; Shenzhen Health Education and Promotion Center, Shenzhen 518000, Guangdong, China.
authors.forename: Runsen
authors.initials: R
authors.lastname: Zhuang
authors.affiliation: School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510000, Guangdong, China; The 181st Hospital of Chinese People's Liberation Army and Affiliated Hospital of Southern Medical University, Guilin 541000, Guangxi, China.
authors.forename: Yueying
authors.initials: Y
authors.lastname: Xiang
authors.affiliation: Shenzhen Health Education and Promotion Center, Shenzhen 518000, Guangdong, China.
authors.forename: Tieguang
authors.initials: T
authors.lastname: Han
authors.affiliation: Shenzhen Health Education and Promotion Center, Shenzhen 518000, Guangdong, China.
authors.forename: Guo-An
authors.initials: GA
authors.lastname: Yang
authors.affiliation: Shenzhen Health Education and Promotion Center, Shenzhen 518000, Guangdong, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040421:Cell Phone; D002681:China; D003362:Cost-Benefit Analysis; D005260:Female; D006266:Health Education / Q000191:economics / Q000379:methods*; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012959:Socioeconomic Factors; D060145:Text Messaging; D055815:Young Adult
keywords: Health literacy; cell phone; community residents; intervention; short message service