Mobile phone texting: new research on health benefits

Vodafone Group published a report last week that shows how mobile technology can increase productivity, improve patient health and enable greater access to healthcare. Richard Cross, Guest Author reports.


The Vodafone Mobile Phone in Healthcare Report

The report is a culmination of a 12 month rigorous research programme by Imperial College and partners demonstrates, with charts galore, how ‘staying in touch’ can have quantified business and personal benefits.

It looks at the healthcare sector but Vodafone see the report more broadly than that, claiming that the insights can be extended to any customer-centric, communications-intensive business or or service. With rising patient expectations, financial deficits and alarming costs Health services in Europe and the UK are headline news. In the context of the report the healthcare sector is a role model example of how mobile can improve the efficiency of business and service sector communications. The research in the report looks rigorous, comprehensive, and naturally ‘evidence based’ with a focus on ‘outcomes’.

The report is a cornucopia of case studies that illustrate the efficiency benefits that mobile can provide. There is one study in Scotland of a cohort of 32 young adult asthma Patients. There they used SMS text messages written in ‘txtspk’ from a fictitious friend ‘Max’ (e.g. “yo dude, it’s max reminding U2take ur inhaler”), accompanied by a stream of celebrity gossip and horoscope messages. It was reported to be successful, with participants describing the service as acceptable, and some saying that they had developed a rapport with the fictitious character.

Texting can reinforce positive behavior

A study of Diabetes in teenagers stands out. It explored the impact of SMS-enabled behavioural support with intensive therapy in a difficult-to-reach young age group. The study used ‘Sweet Talk’, a behavioural and social intervention for young people delivered using SMS text messaging system.

The Sweet Talk system involved the application of Bandura’s cognitive theory “the setting and written contracting of agreed personal self-management goals during the diabetes consultation.’ Based on these goals and patient’s profiles for age, sex and diabetes regimen, the Sweet Talk system scheduled the automated delivery of a series of appropriately tailored messages, including daily messages to reinforce their personal self management goal, and a weekly reminder of their specific goal.”

Imagine what might happen to coaching or group norms, for example if Sales managers or Project Managers were to adapt Bandura’s cognitive therapy in a ‘coaching by text framework’!

Text messaging has been used widely too in Australia, New Zealand, Spain and the UK to provide health education, to campaign against smoking and to behaviour. In a randomised control trial in New Zealand which assessed the effectiveness of text messaging in smoking cessation programmes found that the number of people who stopped smoking was significantly higher in the intervention group than in the control group which did not receive SMS text message based support. Add this to the Action on Smoking findings five years ago and there is a real case for hailing mobile phone effectiveness in limiting smoking amongst Teenagers.

Action against Smoking and an associated British Medical Journal research noticed a correlation between a sharp rise in mobile phone ownership among teenagers in the mid-1990s and the first real decline in teen smoking." Many aspects of mobile phone use provide teenagers with the same functions offered by smoking while offering an alternative for spending money," the group argued. "The mobile phone is an effective competitor to cigarettes in the market for products that offer teenagers adult-style."

Texting produces other benefits too

Certainly it is true (for adults and teenagers alone) mobile phones offer openings for conversations as well as ways of keeping up appearances by looking busy, appearing confident, popular, or relieving meeting boredom. And phones, like smoking, can be used as a defence mechanism, attention speaking behaviour as well as a way to stand out from the ‘Lonely Crowd’

Richard Harper, senior researcher at Microsoft, a sociologist by background perspective emphasises that aspects of mobile communications can be akin to a gift. They are treasured by users, and texts and images are looked at again and again. He also pointed out that users pay premium prices or attention for things that are really important to them. This concept of the mobile as an ‘intimate channel’ of communication was also emphasised in Dr Sadie Plant’s provocative Motorola study on the effects of mobiles on social and individual life.

Speaking at the forum to outline the research the Vodafone Strategy Director, Alan Harper stated that ‘we have all forgotten how inconvenient life was before mobile phones. The benefits of mobile to the individual are obvious we have all experienced them!’ Though a contender for the Mandy Rice-Davies prize for predictable self-justification, the evidence in the health context seems favourable at both an individual and business level.

But not all texting effects are positive

In other business settings, say where virtual teams are involved or complex business issues are to be explored there is a dark side, the vices to the virtues described in the report. One downside is where weighty business issues are diverted to the ‘intimate’ channel. John Seely Brown, former Chief Scientist at Xerox Parc has even coined a name for it – he calls it ‘Berrybite', merging Blackberry with soundbite.

We are all aware of communications by soundbite in the media, according to Brown. Blackberries and Treos exert a similar pressure, both on the sender and the receiver. The keyboards on these devices are minimalist. Anyone seeking to send a long message may develop – “thumb fatigue”. Similarly, trying to read a long message is a recipe for reading glasses. On both sides, the pressure is on to keep it simple and keep it short.

On the other hand, because mobile devices can receive attachments to messages sometimes short circuits occur as messages and channels are mixed inappropriately. ‘Rarely does a document speak for itself’ as Richard Harper’s seminal research into the ‘Myth of the Paperless Office’ discovered. The penchant for attachments is where one danger occurs, according to Seely Brown's colleague John Hegel.

As strategic consultants par excellence they cite experiences where documents sent were read by people on a Blackberry or Treo. They weren’t long documents –the equivalent of two or three pages. As a classic case of context supplanting content, the recipients were initially highly critical of the material. When pressed to read the documents again, the recipients came back after reading them more carefully on a PC or in print form and apologized for their initial reactions. They said the material was excellent and they didn’t really understand why they had such a negative initial reaction.

The Blackberry, Treo and most mobile devices encourage immediacy, butterfly attention and skimming. It also doesn’t help too that they subject messages and people to ‘constant partial attention’ as documents on these devices are typically accessed in environments with lots of distractions – trains, planes, cars, bars and meetings etc. – making it difficult to focus on the message (or task) at hand.

The Berrybite phenomenon, where technology bites back isn’t confined to more sophisticated mobile devices. A number of years ago there was some enlightening research in the Text capital of the world, about a group of Filipino SMS users arranging a social occasion. In one case a plan was proposed by an individual to the group – many texts, they are the fastest thumbs in the East after all and two hours later - nothing about that original plan had changed, nor did anyone turn up!

This word of caution resonates with a previous article, The short message phenomenon challenged, which questions whether texting and other forms of mobile phone interaction are actually a useful form of communication?


Undoubtedly as the Vodafone report emphasises there are tremendous opportunities for other industries to use the mobile technology of today to develop new ways of assessing their customer base. The application of mobile technology has also been of undisputed help to the Health sector in the Developing World. Yet as Australian Professor Tara Brabazon has pointed in a paper called’ Corporate Commandos and Mobile Phone Behaviour’ the consequences of ‘Dancing in the Distraction Factory’ will only be revealed in the longer term.

About the author


Richard Cross is Managing Partner of MCHGlobal and can be contacted at

Richard specialises in strategic organisational change and corporate transformation. A behavioural scientist by background, as director of MCHglobal he has consulted in over 30 countries with corporate and governmental clients in helping them achieve peak performance.

On the editorial board of Inside Knowledge since inception, Richard perspective on the impact of the Knowledge Economy will feature in the forthcoming book 14 Champions of the New Order. Richard's core interests are in helping organisational adapt to the organic and dynamic business environment of today where intangible dimensions and 'soft' variables such as interpretations, intentions, and relationships yield concrete results.

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