Text message-based health interventions

Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).

  • This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
  • Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.

Program overview

  • Supporting improved health outcomes: Text message-based health interventions leverage text messaging software and smartphone applications to strengthen health promotion efforts or to help individuals manage chronic diseases. Such interventions are associated with a range of improved health outcomes, including reduced tobacco use, improved weight and chronic disease management, and increased uptake of healthy behaviors.

  • Applicable across multiple contexts: Text message-based health interventions may be used for a variety of purposes, such as providing patients with reminders or health education and supporting the self-management of a health condition. These text messages may be standardized (e.g., the language used in an appointment reminder) or tailored to specific patient needs or circumstances (e.g., educational content for new parents).

  • Integrated into a healthcare system: Typically, text message-based health intervention systems are operated by healthcare systems. Individual healthcare providers may interact with the system to activate or customize text messages for their patients. Often, the text message software or application used to send messages can be integrated into the healthcare system’s existing electronic health record.

Cost per Participant
Not available

Multiple studies with rigorous designs demonstrate that text message-based health interventions are a well-established strategy for improving a range of patient health outcomes.

  • Use an opt-in system: Healthcare systems should require patients to opt-in to receiving text messages instead of signing them up automatically. Relatedly, text messages should include information about how to unsubscribe from future messages.

  • Create standardized processes to sign up: Healthcare systems should integrate opportunities to sign up for text message-based health interventions into patient check in and/or patient visits with their provider. For example, patients could check a box indicating interest in receiving text message reminders for future appointments. By incorporating the sign up opportunity into existing processes, healthcare systems may see greater uptake of services.

  • Format and use messages appropriately: Text messages are best for sending information that is short and actionable. Messages should be kept under 160 characters, and sending multiple messages in a short period should be avoided. Other communication options, like email or phone calls, are more appropriate for longer messages.

  • Include safeguards in application design: When using a purpose-build smartphone application for messaging, healthcare systems should ensure they have methods to respond to emergency situations as well as systems to protect user privacy and secure information (e.g., HIPAA compliance, guarantee to not sell data to third parties). Involving researchers, patients, and medical providers during the app development process can help ensure that these safeguards address all possible concerns.