Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, NC, United States.
JMIR Mhealth Uhealth. 2015 Nov 4;3(4):e100. doi: 10.2196/mhealth.4651.
mHealth interventions that incorporate text messages have great potential to increase receipt of preventive health services such as colorectal cancer screening. However, little is known about older adult perspectives regarding the receipt of text messages from their health care providers.
To assess whether older adults would value and access text messages from their physician's practice regarding colorectal cancer screening.
We conducted four focus groups with 26 adults, aged 50 to 75 years, who had either recently completed or were overdue for colorectal cancer screening. A trained moderator followed a semistructured interview guide covering participant knowledge and attitudes regarding colorectal cancer screening, potential barriers to colorectal cancer screening, attitudes about receiving electronic communications from a doctor's office, and reactions to sample text messages.
Participant responses to three primary research questions were examined: (1) facilitators and barriers to colorectal cancer screening, (2) attitudes toward receiving text messages from providers, and (3) characteristics of appealing text messages. Two themes related to facilitators of colorectal cancer screening were perceived benefits/need and family experiences and encouragement. Themes related to barriers included unpleasantness, discomfort, knowledge gaps, fear of complications, and system factors. Four themes emerged regarding receipt of text messages from health care providers: (1) comfort and familiarity with technology, (2) privacy concerns/potential for errors, (3) impact on patient-provider relationship, and (4) perceived helpfulness. Many participants expressed initial reluctance to receiving text messages but responded favorably when shown sample messages. Participants preferred messages that contained content that was important to them and were positive and reassuring, personalized, and friendly to novice texters (eg, avoided the use of texting shorthand phrases and complicated replies); they did not want messages that contain bad news or test results. They wanted the ability to choose alternative options such as email or phone calls.
Older adults are receptive to receiving cancer screening text messages from health care providers. Sharing sample messages with patients may increase acceptance of this tool in the clinic setting. Supportive tailored text messaging reminders could enhance uptake of colorectal cancer screening by enhancing patient self-efficacy and providing cues to action to complete colonoscopy or fecal occult blood testing.
包含文本信息的移动医疗干预措施具有很大的潜力，可以增加预防性健康服务的获取，例如结直肠癌筛查。然而，对于老年患者从医疗保健提供者那里接收短信的看法，人们知之甚少。
评估老年患者是否会重视并获取来自医生诊所的有关结直肠癌筛查的短信。
我们对 26 名年龄在 50 至 75 岁之间的成年人进行了四项焦点小组讨论，这些成年人最近完成或超过了结直肠癌筛查的时间。一位经过培训的主持人按照半结构化访谈指南进行了访谈，涵盖了参与者对结直肠癌筛查的知识和态度、结直肠癌筛查的潜在障碍、对从医生办公室接收电子通信的态度以及对示例短信的反应。
我们对三个主要研究问题的参与者回答进行了检查：（1）结直肠癌筛查的促进因素和障碍；（2）对从提供者那里接收短信的态度；（3）有吸引力的短信的特征。与结直肠癌筛查的促进因素相关的两个主题是感知到的益处/需求和家庭经历与鼓励。与障碍相关的主题包括不愉快、不适、知识差距、对并发症的恐惧和系统因素。与从医疗保健提供者那里接收短信相关的四个主题出现：（1）对技术的舒适和熟悉感；（2）隐私问题/出错的潜在风险；（3）对医患关系的影响；（4）感知的有用性。许多参与者最初对接收短信表示不愿意，但在看到示例消息后表示欢迎。参与者更喜欢包含对他们重要的内容且积极、令人安心、个性化且对新手发短信友好的消息（例如，避免使用短信缩写短语和复杂的回复）；他们不希望消息包含坏消息或测试结果。他们希望能够选择其他选项，例如电子邮件或电话。
老年患者愿意从医疗保健提供者那里接收癌症筛查短信。在临床环境中与患者分享示例消息可能会增加对该工具的接受程度。支持性的定制短信提醒可以通过增强患者的自我效能感并提供行动提示来完成结肠镜检查或粪便潜血检测，从而提高结直肠癌筛查的接受率。
