A text message program to support college students in COVID-19 isolation
By Jessica Fitts Willoughby, Rebekah King, Paula M. Adams
COVID-19 has drastically affected life at many college campuses, causing the closure of schools or the preemptive move to online teaching. With another semester quickly approaching, universities again only have a handful of options available, with no clear or correct answer in terms of balancing learning and public health efforts.
Some universities have chosen to have a small proportion of in person classes to facilitate learning. However, even with precautions in place, some have seen a rise in COVID-19 cases. As a number of cases of COVID-19 may be asymptomatic, meaning people do not experience symptoms of the illness but can still spread the virus, it is especially important to follow public health guidelines around contact tracing and isolation if a person is known to be infected. However, following isolation protocols for college students can be difficult. Many are away from home, some for the first time, and may be without strong support networks.
For some students who do not experience symptoms, it may be difficult to convey the importance of isolation, which typically means two weeks away from others in an effort to contain the spread of the virus. College students are frequent users of technology, including text messaging. Research has found text message-based interventions to be useful for health promotion. With this in mind, we created a text message-based intervention for college students to offer support, motivation, and distraction during the 14 days of recommended isolation.
The intervention was created based on formative research collected among Washington State University (WSU) students during the summer and fall of 2020. Our efforts were informed by insights from focus groups conducted by campus health services, data collected as part of a return to campus online training, and a survey specifically designed to gather data among WSU students who had been diagnosed with COVID-19 to find out what was helpful following their diagnoses. The intervention was also based on behavior change theory (the Theory of Planned Behavior and Self Determination Theory) and best practices in text message-based interventions. After development, a small group of COVID Champions at the university tested the messages prior to the launch of the intervention. At the moment, we do not have data available on the effectiveness of the intervention. However, we wanted to provide the messages in case they could be of use to other universities who have an infrastructure in place to support such efforts.
Students received messages if they opted in to the system, and had the opportunity to stop receiving messages at any time. WSU was providing support for students diagnosed with COVID-19. Among their offerings, we were able to offer the text messages as something students could sign up for. Once students signed up, they would receive the initial message, and the program included messages that spanned 14 days (see figure for all messages and message distribution timeline).
Recommendations for isolation vary depending on presence of symptoms and/or timing of testing. The text message-based intervention does not provide medical advice, but encouragement, support, and motivation to follow public health guidance. Messages included links to interesting content and relevant content as well as information on local resources.
As COVID-19 continues to spread across the country, until vaccines and additional therapeutics are in place, isolation of those infected with COVID-19 while transmission is possible is one of the few options that can help. While we acknowledge that structural limitations and/or access to resources may greatly limit the ability of some to isolate, this text message intervention may be one way in which universities can help provide students with information about resources, motivation to maintain in isolation for the required duration, and provide support during this difficult time. The messaging is available for use or adaptation to fit the needs of your program. If you do end up using the program, we would very much appreciate knowing about it, and if you could, consider providing a link to our short survey at the end (we can provide it upon request) so we can gather data to see if this tool is seen as useful during this challenging time.
Contacts:
Jessica Willoughby, associate professor, the Edward R. Murrow College of Communication, WSU, Jessica.willoughby@wsu.edu
Rebekah King, community engagement coordinator, Cougar Health Services, WSU, Rebekah.king@wsu.edu
Paula M. Adams, director of health promotion, Cougar Health Services, WSU padams@wsu.edu
