Jemma Keat, Putu Novi Arfirsta Dharmayani, Seema Mihrshahi
Benchmarking the university campus food environment and exploring student perspectives about food insecurity and healthy eating: a case study from Australia
BMC public health
background longterm illnesses affect significant proportion population developed developing countries mobile phone messaging applications short message service sms multimedia message service mms may present convenient costeffective ways supporting selfmanagement improving patients selfefficacy skills instance medication reminders therapy adjustments supportive messages objectives assess effects mobile phone messaging applications designed facilitate selfmanagement longterm illnesses terms impact health outcomes patients capacity selfmanage condition secondary objectives include assessment user evaluation intervention health service utilisation costs possible risks harms associated intervention search methods searched cochrane central register controlled trials centralthe cochrane library 2009 issue 2 medline ovidsp january 1993 june 2009 embase ovidsp january 1993 june 2009 psycinfo ovidsp january 1993 june 2009 cinahl ebscohost january 1993 june 2009 lilacs january 1993 june 2009 african health anthology january 1993 june 2009 also reviewed grey literature including trial registers reference lists articles selection criteria included randomised controlled trials rcts quasirandomised controlled trials qrcts controlled beforeafter cba studies interrupted time series studies least three time points intervention selected studies possible assess effects mobile phone messaging independent technologies interventions data collection analysis two review authors independently assessed studies inclusion criteria disagreements resolved third review author study design features characteristics target populations interventions controls results data extracted two review authors confirmed third primary outcomes interest health outcomes result intervention capacity selfmanage longterm conditions also considered patients providers evaluation intervention perceptions safety health service utilisation costs potential harms adverse effects included studies heterogeneous type condition addressed intervention characteristics outcome measures therefore metaanalysis derive overall effect size main outcome categories considered justified findings presented narratively main results included four randomised controlled trials involving 182 participants primary outcome health outcomes including physiological measures moderate quality evidence two studies involving people diabetes showing statistical difference text messaging interventions compared usual care email reminders glycaemic control hba1c frequency diabetic complications body weight moderate quality evidence one study hypertensive patients mean blood pressure proportion patients achieved blood pressure control significantly different intervention control groups statistically significant difference mean body weight groups moderate quality evidence one study asthma patients receiving text messaging intervention experienced greater improvements peak expiratory flow variability mean difference md 1112 95 confidence interval ci 1956 268 pooled symptom score comprising four items cough night symptoms sleep quality maximum tolerated activity md 036 95 ci 056 017 compared control group however study found significant differences groups impact forced vital capacity forced expiratory flow 1 second primary outcome capacity selfmanage condition moderate quality evidence one study diabetes patients receiving text messaging intervention demonstrated improved scores measures selfmanagement capacity selfefficacy diabetes score md 610 95 ci 045 1175 diabetes social support interview pooled score md 439 95 ci 285 592 show improved knowledge diabetes moderate quality evidence three studies effects treatment compliance one study showed increase hypertensive patients rates medication compliance intervention group md 890 95 ci 018 1762 compared control group another study statistically significant effect rates compliance peak expiratory flow measurement asthma patients text message prompts diabetic patients initially also resulted higher number blood glucose results sent back 460 email prompts 235 secondary outcome participants evaluation intervention low quality evidence two studies patients receiving mobile phone messaging support reported perceived improvement diabetes selfmanagement wanted continue receiving messages preferred mobile phone messaging email method access computerised reminder system secondary outcome health service utilisation low quality evidence two studies diabetes patients receiving text messaging support made comparable number clinic visits calls emergency hotline patients without support asthma patients total number office visits higher text messaging group whereas number hospital admissions higher control group small number trials included low overall number participants reviewed outcomes quality evidence best considered moderate authors conclusions found albeit limited indications certain cases mobile phone messaging interventions may provide benefit supporting selfmanagement longterm illnesses however significant information gaps regarding longterm effects acceptability costs risks interventions given enthusiasm socalled mhealth interventions currently implemented research issues needed