Summary of findings for the main comparison. Effect of mobile phone messaging interventions for preventive health care.
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Patient or population: Various (pregnant women; daily smokers aged 16 and older; university students; children aged 5‐13) Settings: Various (antenatal clinics and postpartum wards in Thailand; outpatient settings in New Zealand, Canada and the USA) Intervention: Information and support for healthy behaviours delivered by mobile phone messaging Control: Usual care | |||
| Outcomes | Impact | No of Participants (studies) | Quality of the evidence (GRADE) |
| Health outcomes | |||
| Satisfaction, anxiety and confidence during pregnancy | Women who received mobile phone messages with information relating to abnormal symptoms during pregnancy showed significantly higher satisfaction scores in the antenatal and perinatal period. In the antenatal period their confidence level was also higher and their anxiety level lower, although in the perinatal period these differences were no longer statistically significant. | 61 (1 study) | ⊕⊕⊕⊝ moderate1 |
| Pregnancy outcomes | Mobile phone messages with information relating to abnormal symptoms during pregnancy had no statistically significant impacts on gestational age at birth, infant birth weight, frequency of preterm delivery or route of delivery. | 61 (1 study) | ⊕⊕⊝⊝ low1,2 |
| Health behaviour outcomes | |||
| Smoking cessation | Mobile phone messaging support for smoking cessation resulted in a significant increase of quit rates at 6 weeks (RR 2.20, 95% CI 1.79 to 2.70) and 12 weeks follow‐up (RR 1.55, 95% CI 1.30 to 1.84). The effect persisted at 26 weeks if last values were carried forward (RR 1.28, 95% CI 1.11 to 1.48). Continuous abstinence at 26 weeks, allowing three or fewer ‘lapses’ of two or fewer cigarettes per lapse, was also higher in the intervention group (RR 1.64, 95% CI 1.12 to 2.42), whereas there was no impact on continuous complete abstinence (RR 1.4, 95% CI 0.92 to 2.44). | 1705 (1 study) | ⊕⊕⊕⊕ high |
| Vitamin C adherence | Participants receiving mobile phone messaging reminders to take vitamin C tablets for preventive reasons showed significantly higher self‐reported adherence, and a marginal reduction in the number of missed tablets in the last 7 days compared to those who did not receive any reminders (MD ‐0.80, 95% CI ‐1.55 to ‐0.05). | 99 (1 study) | ⊕⊕⊕⊝ moderate1 |
| Healthy behaviour in children | Tracking of healthy behaviours in children using mobile phone messages did not result in any significant differences on their level of physical activity, consumption of sugar‐sweetened beverages or screen time, compared to tracking using a paper diary or no tracking at all. | 32 (1 study) | ⊕⊝⊝⊝ very low1,3 |
| User evaluation of the intervention | |||
| Acceptability | Children and their parents who used mobile phone messaging to track healthy behaviours in children reported no differences in acceptability of the intervention compared to groups using either paper diary reporting or no tracking. | 32 (1 study) | ⊕⊝⊝⊝ very low1,3 |
| Adverse effects of the intervention | |||
| Adverse effects | A mobile phone messaging intervention to support smoking cessation did not have any significant impact on the rates of pain in the thumb or finger joints (RR 1.08, 95% CI 0.74 to 1.59), or on car crash rates (RR 0.88, 95% CI 0.58 to 1.35) at 26 weeks of follow‐up. | 1705 (1 study) | ⊕⊕⊕⊝ moderate4 |
| Other outcomes | |||
| Health service utilisation | None of the included studies report on the impact of the intervention on health services utilisation | ||
| Cost | None of the included studies report on the cost or cost‐effectiveness of the intervention | ||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||
1 Low number of participants.
2 It is unlikely that the intervention would impact pregnancy outcomes such as gestational age, birth weight or duration of gestation. Although it is similarly unlikely that the intervention would directly impact emergency cesarean section rates, it is feasible that prenatal support would influence women's decision for mode of delivery.
3 Moderate risk of bias.
4 Very low number of adverse events reported in both groups.