C-CHANGE
C-Channel:
Issue 33 | SEPTEMBER 2011
background gradient

Text Messaging and Interactive Games to Promote Health and Behavior Change

Of Interest…

As a recognized leader in information and communications technologies, FHI360-SATELLIFE has supported mHealth projects in 23 countries. In three hospitals in Port Elizabeth, South Africa, the Mobile Health Information System project piloted training for 50 nurses in the use of smart phones loaded with locally relevant information. The project is now scheduled for expansion to rural areas of the Eastern Cape. An article in the South African Medical Journal attested to its value.

C-Channel presents articles of particular interest to programs that communicate with young people: the use of interactive games and text messaging to promote health and behavior change. The first article examines whether and how health behavior theories have been applied to mobile interventions. The next three address text messaging on HIV prevention for specific audiences—young African American men, methamphetamine-using MSM, and secondary school students in Uganda. (See C-Channel 24 for other articles on text messaging.) Two articles are on serious video games for youth and how behavioral science and principles of cognitive behavior theory guided their development. The final article summarizes the literature on positive health effects of video games.

Under the USAID-funded PROGRESS project, FHI360 developed a research and implementation project called Mobile for Reproductive Health (m4RH). In Kenya and Tanzania, m4RH provides text messages that aim to improve the uptake, correct use, and continuation of family planning methods. Messages about nine different family planning methods are 160 characters or less and include the locations of family planning clinics and services.

 

In this issue

Text messaging

1. Mobile interventions: Are our theories up to the task?
ONLINE FULL TEXT

2. Development of HIV-prevention messaging for young African American men

3. Risk-reduction messaging for methamphetamine-using MSM
ONLINE FULL TEXT

4. Acceptability of HIV prevention messaging for youth in Uganda

Interactive games

5. How behavioral science guided the development of a serious video game

6. Video games in health care
ONLINE FULL TEXT

7. A game designed to improve mental health and wellbeing of young men
ONLINE FULL TEXT


Text messaging

1. Health behavior models in the age of mobile interventions: Are our theories up to the task?

Authors: Riley W 1; Rivera D 2; Atienza A 1; Nilsen W 1; Allison S 1; Mermelstein R 3
Institutions: 1 National Institutes of Health, USA; 2 School of Engineering, Arizona State University, USA; 3 University of Illinois at Chicago, USA
Source: Translational Behavioral Medicine Mar 2011; 1(1): 53-71.

ABSTRACT

Mobile technologies are being used to deliver health behavior interventions. The study aims to determine how health behavior theories are applied to mobile interventions. This is a review of the theoretical basis and interactivity of mobile health behavior interventions. Many of the mobile health behavior interventions reviewed were predominately one way (i.e., mostly data input or informational output), but some have leveraged mobile technologies to provide just-in-time, interactive, and adaptive interventions. Most smoking and weight loss studies reported a theoretical basis for the mobile intervention, but most of the adherence and disease management studies did not. Mobile health behavior intervention development could benefit from greater application of health behavior theories. Current theories, however, appear inadequate to inform mobile intervention development as these interventions become more interactive and adaptive. Dynamic feedback system theories of health behavior can be developed utilizing longitudinal data from mobile devices and control systems engineering models.

To link to the FREE full text of this article online, please click here. Access the journal website here.

Return To Top

2. Text messaging for HIV prevention with young black men: Formative research and campaign development

Authors: Wright E 1; Fortune T 2; Juzang I 2; Bull S 1
Institutions: 1 Colorado School of Public Health, University of Colorado, USA; 2 MEE Productions, Inc., Philadelphia, USA
Source: AIDS Care May 2011; 23(5): 534-541.

ABSTRACT

This article describes the formative research and campaign development for a pilot study to test the feasibility of using cell phone text messaging to promote HIV prevention for young African-American men. We conducted six focus groups with Black men aged 16-20 (N=43) in order to obtain feedback on the campaign content and how best to convey sexual health information via text message using cell phones. We present three main findings: (1) the participants' ideas for conducting this research and how to structure our campaign design; (2) how we broadened our theoretical perspective from an individual focus to an empowerment and social capital focus in order to best communicate a culturally relevant program; and (3) the young adult's specific suggestions for how best to operationalize theoretical constructs related to empowerment and social capital. We found that young Black men were receptive to the idea of receiving text messages for an HIV prevention campaign. As technology proliferates, this work offers specific ideas for how to capitalize on new technological modalities to deliver important communications on prevention.

To link to the website to purchase the full text of this article, please click here. Access the journal website here.

Return To Top

3. Developing a text messaging risk reduction intervention for methamphetamine-using MSM: Research note

Authors: Reback C 1; Ling D 1; Shoptaw S 2; Rohde J 3
Institutions: 1 Friends Research Institute, Inc., USA; 2 Department of Family Medicine, University of California at Los Angeles, USA; 3 Los Angeles County Department of Public Health, USA
Source: Open AIDS Journal 14 May 2010; doi: 10.2174/1874613601004030116. [Epub ahead of print; PubMed Central]

ABSTRACT

Men who have sex with men (MSM) who use methamphetamine experience high risks for HIV infection due to sexual transmission behaviors often engaged in when under the influence of methamphetamine. Methamphetamine-using MSM use various forms of information technology (IT) communication such as instant messaging, social networking sites, and websites to facilitate a sexual and/or drug "hook up." Given the acceptability of IT communication in their daily lives, an IT intervention represents an appropriate strategy to reach and intervene with out-of-treatment, methamphetamine-using MSM. The aim of this study was to conduct formative work to develop a text messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM, which involved conducting focus groups, community partners' meetings, and a pre-test intervention. These activities culminated in the development of a two-week, text-messaging intervention that delivered real-time electronic correspondence based on the behavioral change theories of Social Support Theory, Health Belief Model, and Social Cognitive Theory. The focus groups, community meetings, and pre-test were used to identify the IT communication device, the text messages that best support risk reduction and healthier behavioral choices, and logo, flyer and website development. The input and feedback from the target population and community partners were critical to the successful development of a culturally appropriate intervention. The knowledge gleaned from the formative work of this study will be vitally helpful in designing future IT studies.

To link to the FREE full text of this article online, please click here. Access the journal website here.

Return To Top

4. Cell phone usage among adolescents in Uganda: Acceptability for relaying health information

Authors: Mitchell K 1; Bull S 2; Kiwanuka J 3; Ybarra M 1
Institutions: 1 Internet Solutions for Kids, Santa Ana, CA, USA; 2 Colorado School of Public Health, University of Colorado at Denver, USA; 3 Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Uganda
Source: Health Education Research 2 May 2011; doi: 10.1093/her/cyr022.

ABSTRACT

The increase in cell phone use has manifested a growing interest in using this technology for health promotion. The portability and 'always on' features of the cell phone, along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years. Self-reported quantitative survey data from 1503 secondary school students in Mbarara, Uganda collected in 2008-2009 suggest that 27% currently have cell phones and about half (51%) of all students and 61% of those who owned a cell phone believe that they would access a text messaging-based HIV prevention program if it were available. Other forms of program delivery modality (e.g. Internet, religious organizations, schools) were preferred to text messaging however. We are in need of effective HIV prevention programs that can reach large audiences at low cost and are culturally relevant for the East African context. Researchers are encouraged to consider translation of effective HIV prevention programs for cell phone delivery in Africa.

To link to the website to purchase the full text of this article, please click here. Access the journal website here.

Return To Top

Interactive games

5. Serious video games for health: How behavioral science guided the development of a serious video game

Authors: Thompson D 1; Baranowski T 1; Buday R 2; Baranowski J 1; Thompson V 3; Jago R 4; Griffith M 1
Institutions: 1 Baylor College of Medicine, Houston, USA; 2 Archimage, Inc., Houston, USA; 3 University of Texas MD Anderson Cancer Center, Houston, USA; 4 University of Bristol, UK
Source: Simulation Gaming 1 August 2010; 41(4): 587-606. [PubMed Central]

ABSTRACT

Serious video games for health are designed to entertain players while attempting to modify some aspect of their health behavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specific actions that can be used to guide key game design decisions. This article reports how behavioral science guided the design of a serious video game to prevent Type 2 diabetes and obesity among youth, two health problems increasing in prevalence. It demonstrates how video game designers and behavioral scientists can combine their unique talents to create a highly focused serious video game that entertains while promoting behavior change.

To link to the website to purchase the full text of this article, please click here. Access the journal website here.

Return To Top

6. Reach Out Central: A serious game designed to engage young men to improve mental health and wellbeing

Authors: Burns J 1,2; Webb M 2; Durkin L 3; Hickie I 4
Institutions: 1 Department of Psychiatry, University of Melbourne, Australia; 2 Inspire Foundation, Melbourne, Australia; 3 Inspire Foundation, Sydney, Australia; 4 Brain & Mind Research Institute, University of Sydney, Australia
Source: Medical Journal of Australia 7 Jun 2010; 192(11S): S27-30.

ABSTRACT

Reach Out Central (ROC) is a serious game drawing on the principles of cognitive behaviour theory that has been designed to improve the mental health and wellbeing of young people, particularly men. ROC was developed over a 3-year period from 2003 to 2006, in consultation with young people aged 16-25 years who use the Reach Out mental health website (http://www.reachout.com). ROC was launched online in September 2007. A traditional and viral awareness campaign was designed to engage young men, particularly "gamers." In the first month after launch, ROC had 76 045 unique website visits, with 10 542 new members (52% male) joining Reach Out. An independent online evaluation involving 266 young people aged 18-25 years was conducted between August 2007 and February 2008 to examine psychological wellbeing, stigma and help seeking in ROC players. Overall results indicated that ROC was successful in attracting, engaging and educating young people. Young women reported reduced psychological distress and improved life satisfaction, problem solving and help seeking; however, no significant changes were observed for young men. Although ROC was successful in attracting young men, demonstrating that the concept resonates with them, the service failed to keep them engaged. Further research is needed to explore how (or what changes need to be made) to sustain young men's engagement in the game.

To link to the FREE full text of this article online, please click here. Access the journal website here.

Return To Top

7. Video games in health care: Closing the gap

Author: Kato P
Institution: University Medical Center, Utrecht, Netherlands
Source: Review of General Psychology Jun 2010; 14(2): 113-121.

ABSTRACT

Although a great deal of media attention has been given to the negative effects of playing video games, relatively less attention has been paid to the positive effects of engaging in this activity. Video games in health care provide ample examples of innovative ways to use existing commercial games for health improvement or surgical training. Tailor-made games help patients be more adherent to treatment regimens and train doctors how to manage patients in different clinical situations. In this review, examples in the scientific literature of commercially available and tailor-made games used for education and training with patients and medical students and doctors are summarized. There is a history of using video games with patients from the early days of gaming in the 1980s, and this has evolved into a focus on making tailor-made games for different disease groups, which have been evaluated in scientific trials more recently. Commercial video games have been of interest regarding their impact on surgical skill. More recently, some basic computer games have been developed and evaluated that train doctors in clinical skills. The studies presented in this article represent a body of work outlining positive effects of playing video games in the area of health care.

To link to the FREE full text of this article online, please click here. Access the journal website here.

Return To Top


USAIDC-CHANGEFHi 360 Satellife Center for Health Information and Technology


This publication is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of Agreement No. GPO-A-00-07-00004-00. The contents are the responsibility of C-Change, and do not necessarily reflect the views of USAID or the United States Government.

To contact us, please send an email to c-channel@healthnet.org.
Additional information about the project is available at the website
www.c-changeprogram.org/