Lung Support Service: Implementation of a Nationwide Text Message Support Program for People with Chronic Respiratory Disease during the COVID-19 Pandemic

Rebecca Raeside (), Anna C. Singleton, Allyson Todd, Stephanie R. Partridge, Karice K. Hyun, Helen Kulas, Sally L. Wootton, Marita T. Dale, Jennifer A. Alison, Zoe McKeough, Renae J. McNamara, Lissa Spencer, Christine Jenkins and Julie Redfern
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Rebecca Raeside: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia
Anna C. Singleton: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia
Allyson Todd: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia
Stephanie R. Partridge: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia
Karice K. Hyun: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia
Helen Kulas: NSW Agency for Clinical Innovation, Sydney, NSW 2065, Australia
Sally L. Wootton: Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, Sydney, NSW 2103, Australia
Marita T. Dale: Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Jennifer A. Alison: Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Zoe McKeough: Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Renae J. McNamara: Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Lissa Spencer: Department of Physiotherapy, Sydney Local Health District, Sydney, NSW 2050, Australia
Christine Jenkins: Institute of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
Julie Redfern: Engagement and Co-Design Research Hub, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia

IJERPH, 2022, vol. 19, issue 24, 1-12

Abstract: Background: COVID-19 pandemic lockdowns led to the closure of most in-person pulmonary rehabilitation programs in Australia. Text message programs are effective for delivering health support to aid the self-management of people with chronic diseases. This study aimed to evaluate the implementation of a six-month pre-post text message support program (Texting for Wellness: Lung Support Service), and the enablers and barriers to its adoption and implementation. Methods: This mixed-methods pre-post study used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the Texting for Wellness: Lung Support Service, which is an automated six-month text message support program that included evidence-based lifestyle, disease-self management and COVID-19-related information. Reach was measured by the proportion of participant enrolments and demographic characteristics. Adoption enablers and barriers were measured using text message response data and a user feedback survey (five-point Likert scale questions and free-text responses). Implementation was evaluated to determine fidelity including text message delivery data, opt-outs, and intervention costs to promote and deliver the program. Results: In total, 707/1940 (36.4%) participants enrolled and provided e-consent, with a mean age (±standard deviation) of 67.9 (±9.2) years old (range: 23–87 years). Of participants who provided feedback, (326/707) most ‘agreed’ or ‘strongly agreed’ that the text messages were easy to understand (98.5%), helpful them to feel supported (92.3%) and helped them to manage their health (88.0%). Factors influencing engagement included a feeling of support and reducing loneliness, and its usefulness for health self-management. Messages were delivered as planned (93.7% successfully delivered) with minimal participant dropouts (92.2% retention rate) and low cost ($AUD24.48/participant for six months). A total of 2263 text message replies were received from 496 unique participants. There were no reported adverse events. Conclusion: Texting for Wellness: Lung Support Service was implemented quickly, had a broad reach, with high retention and acceptability among participants. The program was low cost and required minimal staff oversight, which may facilitate future implementation. Further research is needed to evaluate the efficacy of text messaging for the improvement of lung health outcomes and strategies for long-term pulmonary rehabilitation program maintenance.

Keywords: digital health; text messaging; implementation science; public health; pulmonary rehabilitation; chronic respiratory disease; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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