背景:通过手机发送的SMS文本消息是人际交往的一种常见手段。SMS文本消息调查由于其可行性和患者可接受性而在医疗保健和研究中获得了吸引力。然而,在实施短信调查时出现了挑战,尤其是针对边缘化人群时,由于访问电话和数据的障碍以及通信困难。在初级保健中,传统调查(纸质和在线)往往面临低回应率,这在弱势群体中特别明显,由于经济限制,语言障碍,和时间限制。
目的:本研究旨在调查基于SMS短信的患者招募和调查在社会经济较低地区的一般实践中的潜力。这项研究是嵌套在减少酒精伤害的一般实践项目,旨在减少酒精相关的伤害,通过筛选在澳大利亚一般实践。
方法:本研究遵循2步SMS文本消息数据收集过程。向患者发送了带有在线调查链接的初始SMS短信,随后每3个月对同意的参与者进行调查。采访了当地基层卫生网络组织工作人员,参与实践的工作人员,和临床医生。使用实施研究综合框架的结构对定性数据进行了分析。
结果:在6种一般做法中,4人能够向患者发送SMS短信。向8333名患者发送了最初的SMS文本消息,并收到了702个回复(8.2%),其中大多数不是来自低收入群体。这种低的初始反应与正在进行的3个月SMS短信调查的改善的反应率相反(55/107,3个月时为51.4%;29/67,6个月时为43.3%;44/102,9个月时为43.1%)。我们采访了4名全科医生,4名护士,和4名行政人员来自5种不同的做法。定性数据揭示了参与边缘化群体的障碍,包括有限的智能手机接入,有限的财务能力(电话,互联网,和Wi-Fi信用),语言障碍,识字问题,心理健康状况,和身体限制,如手动灵活性和视力问题。实践经理和临床医生提出了克服这些障碍的策略,包括在受信任的空间中使用纸质调查,在完成调查期间提供援助,并提供酬金支持参与。
结论:虽然针对初级保健研究的SMS短信调查可能对更广泛的人群有用,需要作出更多努力,以确保边缘化群体的代表性和参与。更密集的方法,如亲自收集数据,可能更适合在初级保健研究中捕捉低收入群体的声音。
■RR2-10.3399/BJGPO.2021.0037。
BACKGROUND: SMS text messages through mobile phones are a common means of interpersonal communication. SMS text message
surveys are gaining traction in health care and research due to their feasibility and patient acceptability. However, challenges arise in implementing SMS text message surveys, especially when targeting marginalized populations, because of barriers to accessing phones and data as well as communication difficulties. In primary care, traditional surveys (paper-based and online) often face low response rates that are particularly pronounced among disadvantaged groups due to financial limitations, language barriers, and time constraints.
OBJECTIVE: This
study aimed to investigate the potential of SMS text message-based patient recruitment and
surveys within general practices situated in lower socioeconomic areas. This
study was nested within the Reducing Alcohol-Harm in General Practice project that aimed to reduce alcohol-related harm through screening in Australian general practice.
METHODS: This
study follows a 2-step SMS text message data collection process. An initial SMS text message with an online survey link was sent to patients, followed by subsequent surveys every 3 months for consenting participants. Interviews were conducted with the local primary health network organization staff, the participating practice staff, and the clinicians. The qualitative data were analyzed using constructs from the Consolidated Framework for Implementation Research.
RESULTS: Out of 6 general practices, 4 were able to send SMS text messages to their patients. The initial SMS text message was sent to 8333 patients and 702 responses (8.2%) were received, most of which were not from a low-income group. This low initial response was in contrast to the improved response rate to the ongoing 3-month SMS text message surveys (55/107, 51.4% at 3 months; 29/67, 43.3% at 6 months; and 44/102, 43.1% at 9 months). We interviewed 4 general practitioners, 4 nurses, and 4 administrative staff from 5 of the different practices. Qualitative data uncovered barriers to engaging marginalized groups including limited smartphone access, limited financial capacity (telephone, internet, and Wi-Fi credit), language barriers, literacy issues, mental health conditions, and physical limitations such as manual dexterity and vision issues. Practice managers and clinicians suggested strategies to overcome these barriers, including using paper-based surveys in trusted spaces, offering assistance during survey completion, and offering honoraria to support participation.
CONCLUSIONS: While SMS text message surveys for primary care research may be useful for the broader population, additional efforts are required to ensure the representation and involvement of marginalized groups. More intensive methods such as in-person data collection may be more appropriate to capture the voice of low-income groups in primary care research.
UNASSIGNED: RR2-10.3399/BJGPO.2021.0037.