A Mobile Phone Text Messaging Intervention to Manage Fatigue for People With Multiple Sclerosis, Spinal Cord Injury, and Stroke: Development and Usability Testing

JMIR Formative Research, 2022 · DOI: 10.2196/40166 · Published: December 21, 2022

Healthcare Rehabilitation Telehealth & Digital Health

Simple Explanation

This study developed and tested a mobile phone-based SMS text messaging intervention for managing fatigue in people with multiple sclerosis, spinal cord injury, and stroke. The intervention targets patient activation, which means increasing knowledge, skills, and confidence for self-management of fatigue. The study involved developing an initial library of SMS text messages, reviewing and modifying them with experts and consumer feedback, integrating the content into a digital platform, and testing its usability.

Study Duration

12 Weeks

Participants

6 CAB participants (2 with Multiple Sclerosis, 2 with Spinal Cord Injury, and 2 who had a Stroke)

Evidence Level

Not specified

Key Findings

1
CAB participants rated SMS text messages covering 9 domain areas of fatigue self-management with good clarity (mean ratings=3.5-5.0 out of 5) and relevance (mean ratings=3.2-5.0 out of 5).
2
SMS text messaging content was reported by CAB participants as helpful, clear, and well suited for a mobile health intervention.
3
The usability of the intervention was high, with 55 (83%) out of 66 responses endorsing the highest rating.

Research Summary

This study demonstrates a step-by-step process for developing a fatigue self-management SMS text messaging intervention for persons with disabilities. For this population, whose access to health services is often limited, this intervention provides an alternative delivery model to increase access to fatigue information and deliver content that aligns with the person’s needs. With input and support from a medical expert, persons with disabilities, and the technology vendor, we developed an intervention delivered through technology to people with various disabilities at different patient activation levels.

Practical Implications

Increased Access to Information

The SMS text messaging intervention provides an alternative delivery model to increase access to fatigue information for individuals with disabilities who may have limited access to health services.

Personalized Content

The intervention delivers content that aligns with the person’s needs, suggesting the importance of tailoring interventions to individual requirements.

Patient Activation

By providing patient activation-based health tips, the intervention aims to increase self-management knowledge and skills, empowering individuals to manage their fatigue more effectively.

Study Limitations

1
A potential limitation is that our SMS text messaging intervention included SMS text messages from 9 domain areas.
2
It is unclear which domain areas are most effective.
3
We anticipate that not all content will benefit all participants at one point in time.

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