Effect of receiving text messages on health care behavior and state anxiety of Thai pregnant women: A randomized controlled trial

Effect of receiving text messages on health care behavior and state anxiety of Thai pregnant women: A randomized controlled trial

Text messages are an accessible medium of communication for millions in the modern world. Receiving text messages is easily done and makes communication possible while navigating obstacles of time and distance. Associate Professor Dr. Piyanut Xuto, Assistant Professor Dr. Piyaporn Prasitwattanaseree and Clinical Prof. Dr. Punpilai Sriarporn, in collaboration with Dr. Kodama Toyohiko from the University of Occupational and Environmental Health in Fukuoka, Japan, wished to investigate how messaging services could be utilized to assist pregnant Thai women in the encouragement of healthy behavior and anxiety reduction during their pregnancies.

Dr. Piyanut was inspired when she visited Japan to supervise Thai exchange students where she learned about Dr. Toyohiko’s use of text messages as an intervention with people at risk of suicide. She realized the potential for utilizing this technique with pregnant women, to educate them on better health behavior as well as to reduce anxiety over the pregnancy period. Although pregnant women may have access to health care, internet information and people in their social circles, the intervention of text messages was something that could be made more frequent and be designed to be sent during the whole antenatal period while containing reliable, valid information. As part of the study protocol, participants were sent text messages twice a week, from week 13 to week 40 of the pregnancy period. Importantly, the content of these text messages was validated and modified by a panel of experts, and this content was also designed to match the physiological changes encountered by women during the pregnancy period.

For this study, data were collected using a range of instruments including ones for pregnancy outcomes, health care behavior, and state-trait anxiety. Key findings included the ability for this intervention to increase pregnant mother’s physical activity, as well as reduce anxiety during pregnancy. However, it was also notable that text messages worked well for information transfer, but less so for skill building. The researchers imagined that it may be useful to modify the text messages to include content, such as a short visual clip, which could promote skill-building in addition to the transfer of knowledge.

Dr. Piyanut feels that the use of programs based on pre-planned, scheduled text messaging can readily be designed and applied to a range of healthcare situations. For example, orthopedics could design text messaging for patients recovering from bone breaks or fractures, even allowing patients to choose the area of the body for which they need help. The potential for these programs to be designed once and then run automatically means that they are efficient and cost-effective, representing an excellent example of how research and technology combine to support and improve healthcare outcomes.

Clinical Prof. Dr. Punpilai Sriarporn Assoc. Prof. Dr. Piyanut Xuto