Design Considerations in Development of a Mobile Health Intervention Program: The TEXT ME and TEXTMEDS Experience
Open accessAbstract
BACKGROUND: Mobile health (mHealth) has huge potential to deliver preventative health services. However, there is paucity of literature on theoretical constructs, technical, practical, and regulatory considerations that enable delivery of such services. OBJECTIVES: The objective of this study was to outline the key considerations in the development of a text message-based mHealth program; thus providing broad recommendations and guidance to future researchers designing similar programs. METHODS: We describe the key considerations in designing the intervention with respect to functionality, technical infrastructure, data management, software components, regulatory requirements, and operationalization. We also illustrate some of the potential issues and decision points utilizing our experience of developing text message (short message service, SMS) management systems to support 2 large randomized controlled trials: TEXT messages to improve MEDication adherence & Secondary prevention (TEXTMEDS) and Tobacco, EXercise and dieT MEssages (TEXT ME). RESULTS: The steps identified in the development process were: (1) background research and development of the text message bank based on scientific evidence and disease-specific guidelines, (2) pilot testing with target audience and incorporating feedback, (3) software-hardware customization to enable delivery of complex personalized programs using prespecified algorithms, and (4) legal and regulatory considerations. Additional considerations in developing text message management systems include: balancing the use of customized versus preexisting software systems, the level of automation versus need for human inputs, monitoring, ensuring data security, interface flexibility, and the ability for upscaling. CONCLUSIONS: A merging of expertise in clinical and behavioral sciences, health and research data management systems, software engineering, and mobile phone regulatory requirements is essential to develop a platform to deliver and manage support programs to hundreds of participants simultaneously as in TEXT ME and TEXTMEDS trials. This research provides broad principles that may assist other researchers in developing mHealth programs.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Digital health technologies have the potential to deliver low-cost interventions aimed at supporting disease self-management.
“Digital health technologies have the potential to deliver low-cost interventions aimed at supporting healthier lifestyles [12] and disease self-management [13,14].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
U.S. Department of Health and Human Services
L.Maddex, R. (2006) · Encyclopedia of Sexual Behavior and the Law · doi:10.4135/9781452240107.n226 · Cited by 3,170 · see citing works
Text messaging as a tool for behavior change in disease prevention and management
Cole-Lewis, H., & Kershaw, T. (2010) · Epidemiologic Reviews · doi:10.1093/epirev/mxq004 · Cited by 1,190 · see citing works
Sitting time and all-cause mortality risk in 222,497 Australian adults
van der Ploeg, H. P. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.2174 · Cited by 884 · see citing works
Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis
Thakkar, J., Kurup, R., Laba, T.-L., Santo, K., Thiagalingam, A., Rodgers, A., Woodward, M., Redfern, J., & Chow, C. K. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.7667 · Cited by 685 · see citing works
Self-citationChow, C. K., Redfern, J., Hillis, G. S., Thakkar, J., Santo, K., Hackett, M. L., Jan, S., Graves, N., de Keizer, L., Barry, T., et al. (2015) · JAMA · doi:10.1001/jama.2015.10945 · Cited by 676 · see citing works
Self-citation(2005) · PubMed · Cited by 562 · see citing works
International Telecommunications Union
(1947) · International Organization · doi:10.1017/s0020818300006342 · Cited by 443 · see citing works
Goggin, G. M. (2006) · Routledge eBooks · doi:10.4324/9780203827062 · Cited by 317 · see citing works
Use of Mobile Phone Text Message Reminders in Health Care Services: A Narrative Literature Review
Kannisto, K. A., Koivunen, M. H., & Välimäki, M. A. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3442 · Cited by 302 · see citing works
A review of the use of mobile phone text messaging in clinical and healthy behaviour interventions
Wei, J., Hollin, I. L., & Kachnowski, S. (2011) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2010.100322 · Cited by 247 · see citing works
Redfern, J., Thiagalingam, A., Jan, S., Whittaker, R., Hackett, M. L., Mooney, J., de Keizer, L., Hillis, G. S., & Chow, C. K. (2012) · European Journal of Preventive Cardiology · doi:10.1177/2047487312449416 · Cited by 154 · see citing works
Self-citationKoivusilta, L. K., Lintonen, T., & Rimpelä, A. (2006) · Scandinavian Journal of Public Health · doi:10.1080/14034940600868721 · Cited by 129 · see citing works
Wald, D. S., Butt, S., & Bestwick, J. P. (2015) · The American Journal of Medicine · doi:10.1016/j.amjmed.2015.05.035 · Cited by 106 · see citing works
Chow, C. K., Redfern, J., Thiagalingam, A., Jan, S., Whittaker, R., Hackett, M. L., Graves, N., Mooney, J., & Hillis, G. S. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000606 · Cited by 74 · see citing works
Self-citationShaw, R. J., Bosworth, H. B., Hess, J. C., Silva, S. G., Lipkus, I. M., Davis, L. L., & Johnson, C. (2013) · JMIR mhealth and uhealth · doi:10.2196/mhealth.2343 · Cited by 64 · see citing works
Karasz, H. N., Eiden, A., & Bogan, S. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.300999 · Cited by 44 · see citing works
Thakkar, J. B., Karthikeyan, G., Purohit, G., Thakkar, S., Sharma, J., Verma, S., Parakh, N., Seth, S., Mishra, S., Yadav, R. K., et al. (2016) · Heart Asia · doi:10.1136/heartasia-2016-010789 · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [13]ANZ Clinical Trials Register 2016-10-29 Trial review. 2013 Jul 16. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364448
Cited by
Sorted by citations
Chow, C. K., Klimis, H., Thiagalingam, A., Redfern, J., Hillis, G. S., Brieger, D. B., Atherton, J. J., Bhindi, R., Chew, D. P., Collins, N. J., et al. (2022) · Circulation · doi:10.1161/circulationaha.121.056161 · Cited by 91 · see citing works
Self-citationAdu, M. D., Malabu, U. H., Callander, E. J., Malau‐Aduli, A. E. O., & Malau‐Aduli, B. S. (2018) · JMIR mhealth and uhealth · doi:10.2196/10115 · Cited by 60 · see citing works
Prinjha, S., Ricci-Cabello, I., Newhouse, N., & Farmer, A. (2020) · JMIR mHealth and uHealth · doi:10.2196/15789 · Cited by 34 · see citing works
“Digital health technologies have the potential to deliver low-cost interventions aimed at supporting healthier lifestyles [12] and disease self-management [13,14].”
BackgroundCheung, N. W., Redfern, J., Thiagalingam, A., Hng, T., Marschner, S. L., Haider, R., Faruquie, S., Huben, A. V., She, S., McIntyre, D., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/38275 · Cited by 29 · see citing works
Self-citationSingleton, A. C., Partridge, S. R., Raeside, R., Regimbal, M., Hyun, K. K., Chow, C. K., Sherman, K. A., Elder, E. E., & Redfern, J. (2019) · BMC Cancer · doi:10.1186/s12885-019-5886-8 · Cited by 28 · see citing works
Self-citationChow, C. K., Thiagalingam, A., Santo, K., Kok, C., Thakkar, J., Stepien, S., Billot, L., Jan, S., Joshi, R., Hillis, G., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019463 · Cited by 26 · see citing works
Self-citationSmart health and innovation: facilitating health-related behaviour change
Redfern, J. (2017) · Proceedings of The Nutrition Society · doi:10.1017/s0029665117001094 · Cited by 25 · see citing works
Self-citationFritsch, C. G., Ferreira, P. H., Prior, J., McLachlan, A. J., & Ferreira, M. L. (2020) · Pain · doi:10.1097/j.pain.0000000000001958 · Cited by 23 · see citing works
Fritsch, C. G., Ferreira, P. H., Prior, J., Vesentini, G., Schlotfeldt, P., Eyles, J. P., Robbins, S. R., Yu, S. P., Mills, K. A. G., Taylor, D., et al. (2021) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2021.100128 · Cited by 15 · see citing works
Self-citationAlmeida, A. M. P., Almeida, H., & Figueiredo‐Braga, M. (2018) · Procedia Computer Science · doi:10.1016/j.procs.2018.10.013 · Cited by 14 · see citing works
Redfern, J., Hyun, K. K., Singleton, A. C., Hafiz, N., Raeside, R., Spencer, L. M., Carr, B., Caterson, I. D., Cullen, J. S., Ferry, C., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-023863 · Cited by 12 · see citing works
Self-citationUmaefulam, V. O., & Premkumar, K. (2018) · Lecture notes in computer science · doi:10.1007/978-3-030-03649-2_11 · Cited by 7 · see citing works
Arnautovska, U., Ritchie, G., Soole, R., Menon, A., Korman, N., Milton, A., Varnfield, M., Kelly, J., Jansen, P., Baker, A., et al. (2025) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s513272 · Cited by 7 · see citing works
“The development process of SMART (depicted in Figure 1) was informed by recommendations on developing mHealth programs 31 and the Medical Research Council Framework for the development and evaluation of complex health interventions, 32–35 as per our previous self-management intervention development…”
Klimis, H., Thiagalingam, A., & Chow, C. K. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-036767 · Cited by 6 · see citing works
Self-citationTricarico, C., Peters, R., Som, A., Javaherian, K., & Ross, W. (2017) · JMIR Research Protocols · doi:10.2196/resprot.7223 · Cited by 10 · see citing works
Tsang, W. N., Lee, J. J., Yang, S. C., Poon, J. C. Y., & Lau, E. Y. Y. (2024) · Psychology Health & Medicine · doi:10.1080/13548506.2024.2332925 · Cited by 4 · see citing works
Development of text messages for primary prevention of cardiovascular disease in persons with HIV
McLaughlin, M. M., Hsue, P. Y., Lowe, D. A., Olgin, J. E., & Beatty, A. L. (2023) · Cardiovascular Digital Health Journal · doi:10.1016/j.cvdhj.2023.11.002 · Cited by 3 · see citing works
Patient-Physician Communication in Depression
Almeida, A. M. P., Figueiredo‐Braga, M., & Almeida, H. (2021) · International Journal of E-Services and Mobile Applications · doi:10.4018/ijesma.2021040105 · Cited by 2 · see citing works
Kazi, S., Truesdale, C., Ryan, P., Wiesner, G., Jennings, G., & Chow, C. K. (2023) · JMIR Cardio · doi:10.2196/43889 · Cited by 1 · see citing works
Self-citationTele-Dentistry Rising: The Apps of Pediatric Dentistry: An Up-ToDate Review
Karataban, P. K. (2021) · Open Access Journal of Dental Sciences · doi:10.23880/oajds-16000308
- Authors
- Thakkar, J., Barry, T., Thiagalingam, A., Redfern, J., McEwan, A. L., Rodgers, A., & Chow, C. K.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Chow, Clara K
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2016-11-15
- Volume
- 4
- Issue
- 4
- Pages
- e127
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5128723
- OpenAlex
- W2553105800
- Cited by
- 20
- References
- 17
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 2
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Physical Sciences › Computer Science › Information Systems › Mobile Learning in Education
- Keywords
- mobile health, text messaging, text messaging intervention, intervention development, medication adherence, tobacco cessation, physical activity promotion, data security, regulatory requirements, secondary prevention, randomized controlled trials
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
