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Cell phone-based health education messaging improves health literacy.

BACKGROUND
The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education.


OBJECTIVE
To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China.


METHODS
A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups.


RESULTS
Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54.


CONCLUSION
SMS may be a useful tool for improving health literacy.