Effectiveness of text messages in the adherence to COVID-19 prevention practices: a quasi-experimental study.
Vinicius Lino de Souza Neto, Sheila Coelho Ramalho Vasconcelos Morais, Rafaela Batista Dos Santos Pedrosa and 5 others
PMID 41379189WHAT IT FOUND
WhatsApp messages with images about masks, hand hygiene and distancing coincided with higher self-reported adherence over seven weeks, especially in weeks six and seven.
Because no control group was used, this cannot prove the messages caused the change.
Key findings
01Self-reported adherence scores rose progressively over the evaluations, with improvement in the last two weeks compared with baseline.
02Some specific behaviours improved at different times, starting with keeping one metre distance from others when leaving home in the first week.
03Four measures did not show significant change: wearing a mask when leaving home, washing the mask with soap and water at home, wearing a mask on public transport or in a car with another person, and hand hygiene after touching objects outside the home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study had no control group or randomisation, so changes cannot be separated from other pandemic-related information or behaviour trends. 391 of 820 participants were lost, and only completers were analysed, so results may reflect a more motivated group. Participants were recruited through WhatsApp contacts and needed Internet access and Portuguese literacy. This limits generalisability. Adherence was self-reported, and the paper does not say whether participants read the messages. The adherence instrument was developed for the study, was not validated with the target population before use, and relied on expert refinement. Age, education, income and changing public policies were not controlled.
Declared interests
The study was financed in part by CAPES, Finance Code 001, Brazil, and was extracted from a doctoral dissertation. The supplied text does not state any competing interests.
The easy way to misread this
Do not conclude that text messages caused improved adherence. The study had no control group, 391 of 820 participants were lost, and adherence was self-reported, so other pandemic-related changes could explain the observed rise.