Krames Staywell's Text Connection messaging software

A small pilot study of text message interventions for pregnant women and people with diabetes suggests that people respond positively to receiving text messages from their insurance company.

Regence Blue Cross Blue Shield, an insurer with 2.2 million members in Idaho, Oregon, Washington and Utah, worked with Krames Staywell to offer health text messages to 69 pregnant women and 56 diabetes patients. Of those, 38 pregnant women and 27 people with diabetes completed the assessment survey. Participants received weekly text messages with information, health tips, and reminders.

About 32 percent of pregnancy participants and 67 percent of diabetes participants said the information in the messages helped them to make positive changes in experiencing or managing their condition. Additionally, nearly 60 percent of pregnant women and almost 67 percent of people with diabetes said they knew more about their condition after receiving the text messages. Almost 90 percent of people in the pregnancy program said they found the messages valuable, as did 89 percent of the respondents with diabetes.

Most respondents in both groups approved of receiving messages from their insurer, and said it positively affected their perception of Regence Blue Cross Blue Shield. Ninety percent of pregnant respondents answered either "I like it" (52 percent) or "It's fine" (38 percent) when asked how they felt about getting health information from Regence. For the diabetes program 100 percent approved of getting messages from Regence -- 68 percent liked it and 32 percent said it was fine. In each group, 56 percent said the messages affected their perception of Regence.

When asked to rank how they most wanted to get information from Regence, though, text messaging came in second, after email, for the diabetes group. For the pregnancy group, texting came in third -- behind both email and getting information from a website.

Janna Kimel, a senior user experience researcher on the project, conducted phone interviews with some of the participants, and reported on those findings at last year's Healthcare Experience Design conference in Boston.

"Several people said to me over the phone 'I really feel like Regence cares'," she said at the time. "Do you have any idea how that feels as a person who works for a health insurance company?"

She said that people shared specific actions they took because of the texts as well, such as enrolling in a nutrition plan or filling out a birthing plan. Kimel said the participants in the programs seemed to enjoy the text messages for different reasons.

"With diabetics, the strongest motivation is staying alive," she said. "[They say] 'I don't want to be alone, I don't want to do it alone, and this little text message I get every day makes me feel less alone.' Pregnant women worry much more about physical than emotional things. They like having specific things to do."