Communications for change: How to use text messaging as an effective behavior change campaigning tool

Produced by FrontlineSMS and Text to Change – February 2012

Available online at: 

SMS can be an extremely effective campaigning tool, helping to drive positive social change by increasing awareness of key issues and giving people the information they need to take their well- being into their own hands. SMS is ideal for these types of campaigns in many ways: it is immediate and intimate, coming straight to a device you carry with you most of the time. It works even in places where other digital communications channels fail; and, if received at the right time, it can provide an incredibly meaningful intervention. 

SMS can also be sent to many people at once, using aggregators and other service providers

However, getting SMS campaigns right is not simple. The right content, delivered at the right time in the right context, is critical. Adding the right kind of interaction to campaigns can make them more engaging, and increase their power in encouraging positive change. 

Case Study: –FrontlineSMS and Georgetown University’s Institute for Reproductive Health

FrontlineSMS, an open source software for sending and receiving SMS (short message service), to provide a rapid prototype of a new mHealth service.

This service — called CycleTel™ — empowers women by providing them with accessible reproductive health information through SMS. CycleTel facilitates the use of the Standard Days Method® (SDM) of family planning, which is a simple fertility awareness-based method of family planning that teaches a woman to identify her fertile days each menstrual cycle and avoid unprotected sex on these days to prevent pregnancy.

By making this fertility information accessible via SMS, CycleTel helps women take charge of their reproductive health and use an effective family planning method. 

Text to Change
Text to Change sets up interactive SMS campaigns, together with NGOs and companies, focused on improving healthcare and education, stimulating economic development and creating awareness on environmental issues. Moreover, all basic phones are able to receive SMS.
To overcome the illiteracy barriers they make use of Interactive Voice Response services (IVR) as well.

• Text to Change:

• FrontlineSMS: 

Assessing the mobile environment:

Factors affecting the suitability of SMS and mobile for communicating with disaster-affected communities 



The Interdisciplinary Health Communication blog from the University of North Carolina School of Journalism and Mass Communication recently posted a blog about the US’s Center’s for Disease Control and Prevention’s new HIV outreach efforts through comic books (Take That, Evildoers! The CDC Fights HIV With Comics). In an attempt to reach 15- to 24-year-olds with HIV prevention information, the CDC awarded funding to a comic book maker to create digital comics that resonate with that audience. The hope is that such an effort will jump-start more health communication interventions for that age group.

This got me thinking about what innovate projects are being done across the region to reach that age group, since the HIV rate among this age group has been rising.When an organization or government agency plan a communication strategy, do they segment their population, or is the approach more of general HIV prevention information? If money was of no concern, what would you like to see being done to reach youths with HIV/STD behavior change information?


There have been so much negative press about the amount of time people spend online and in virtual environments and the effects on psychological and physiological processes that when a new study comes out espousing the positive qualities of virtual worlds such as Second Life, it has to make news right?

Today, BBC Health is reporting that researchers at Indiana University compared participants in a 12-week weight loss program-one real, one online-and that they lost almost the same around of weight. For the intervention, the researchers recruited overweight and obese people who met four hours a week in either the online or offline environment.

So, how much did the groups lose? The average weight loss was 10 pounds. Healthy for a 12-week program.

“However, when the groups were surveyed on whether their overall behaviour had changed, those using Second Life appeared to have made more changes towards healthy eating and physical activity, suggesting that they might fare better in the future.”

This is a really good step for intervention research in in any world. And I’m sure prevention scientists are also considering this news, especially in light of the finding that those in Second Life experienced overall behavior change.

There has been a move towards tailored health communication and health interventions in the past few years. Beyond the real and the virtual, this article did not report on whether the researchers tailored the interventions to specific needs of different groups. That might have been one of the study’s limitations.

Another limitation is that many of these studies and interventions can–for now–only be done in certain countries. Many of the world’s overweight and obese people are in the developing world. What impact, if any, would a study such as this have on them? Can something similar be done in our region? Do we have enough people visiting online worlds to really put money towards an intervention such as this? What other ways can this be done? Though online community boards where islanders congregate? Would you use Second Life or another virtual environment to help you lose weight?



I’m always intrigued by the intersection of new media/new technology and public health. And this past week, leading to the 30th anniversary of the first reports AIDS case, Emory University unveiled a new website: Using data from local HIV testing sites, county, state and national HIV data, the website shows an interactive map of the United States with county-level HIV rates for adults/adolescents per 100,000.

One weakness of the site is that there is no information for Puerto Rico and the U.S. Virgin Islands. However, there is hope that the site will include such information at a later date. Additionally, the interactive map has potential to be a global resource with the inclusion of surveillance data from across the Caribbean and the world. My health communication professor at the University of Southern California espoused the importance of data representation for public health and healthcare. Seeing this website, I am better able to understand why he strongly believes that any data communicated should be done in such a way that is not only informative but that can be easily digested by the lay public.

So, what’s the importance of this map for Caribbean audiences? It’s important because one can look at the map to see where Caribbean populations live and try to extrapolate the rate of HIV in that area. As the website noted, caution should be taken when interpreting this map because it included the prison populations–reported at the country level–which may increase the rate on that county. Nevertheless, the ability of the map to communicate the who and where people are affected in there.

What do you think of this interactive tool? How else can this technology be used?


Public eHealth is an inclusive term that encompasses all of the possible applications of information and communication technologies (ICTs) to public health and related disciplines. Public eHealth includes both traditional applications, such as management information systems, databases, and data sharing networks, and more recent and innovative ones, such as those supported by Web 2.0 solutions.

The project seeks to unite and strengthen the principles of transparency, ethics, and equity through the innovative use of ICTs to enable better health care delivery and access, particularly among undeserved populations.

The eSAC project integrated approach includes:

  • the introduction of various types of incentives to stimulate innovation;
  • support to communication and networking activities;
  • capacity development opportunities;
  • the evaluation of solutions based on information and communication technologies (ICTs) that address priority public health challenges in the region; and
  • activities aimed at informing and sensitizing policy makers.
Additional information on the program, it’s significance and how to apply can be found at: