Mobile Text Message Design and Delivery Preferences of Patients with Type 2 Diabetes: A Social Marketing Approach

Mobile text messaging could be more effective for type 2 diabetes management when messages are designed and delivered according to patients’ needs and preferences. Communication-persuasion theories and message design approaches can provide a more useful guide to understanding patients’ message-specific preferences and developing the most relevant messages that could lead to behavior change and its maintenance. Hence, this study aimed to provide insights into patients’ mobile text messaging perspectives and explore their message design and delivery preferences within a patient-oriented framework. A qualitative methodology including semi-structured interviews was employed with adult patients either in-person or online. Participants’ preferences on several message design approaches, such as message framing, tone, tailoring strategies, evidence, and message format, were asked by showing them different message dyads. Their preferred message time, frequency, and format (autonomous or in-person) were also assessed. Thematic analysis was performed for coding, categorizing, and interpreting the qualitative data. Data saturation was achieved at the 12th interview [range 40–71 years old; male (58%), have type 2 diabetes for nearly 3.9 years on average]. Using text messaging for type 2 diabetes self-management was positively perceived and mainly associated with accessibility to reach information. Patients seemed to prefer an individualized delivery schedule and favor gain-framed messages, advanced tailoring strategies, an authoritarian tone, a standard texting format, and statistical evidence in the message content. This qualitative study provides practical implications for improving communication with patients, reducing time and effort to engage with them, and implementing more targeted health interventions/programs via mobile text messaging.