Response patterns to interactive SMS health education quizzes at two sites in Uganda: A cohort study

Abstract

Objective: The use of mobile phones can improve and strengthen (preventive) health care in low- and middle-income countries. We aimed to retrospectively assess the response patterns of participants in free SMS health education quizzes in Uganda. Methods: Study participants were employees of two companies and their community networks. We investigated how quickly individuals responded to quiz question(s) and assessed possible influencing factors. Cox regression and anova analyses were used. Results: Fifty percentage of responders answered within 50 min. The response chance declined with every additional day after sending an incentive via SMS (Hazard Ratio 0.993, CI 95% 0.981-0.984). Quiz topics influenced both participation rates and response time. Response time was shortest for questions on HIV and sexual behaviour. Response rates were high for HIV (79%) and malaria (78.4%), but only 37.4% for demographic topics. Network providers had a substantial effect on response behaviour. Conclusion: Interactive SMS programs are a fast method to reach the target population and incentives increase response rates. The most important factor influencing response time and participation rate is the network provider. Future research should focus on developing evidence-based guidelines for the design, implementation and evaluation of SMS-based interventions. © 2013 Blackwell Publishing Ltd.