“They Kept Me Steadyã¢â‚¬Â�: A Mixed Method Study of a Texting Interventions for Men Enrolled in a Responsible Fatherhood Program

Background and Purpose: A developing area of study is the use of cell-phone technology for intervention and research. Mobile technology has been used to collect research data, track participants, and has been found to increase engagement in health services. Despite the promise for using mobile technology for engaging hard to reach populations, few studies have explicitly tested the impact of these technologies on engagement and retention and no research was identified that engaged fathers in services using these approaches. In this mixed method study we explore the impact of delivering text messaging to program participants on program engagement, participation, and retention.

Methods: Men who enrolled in a responsible fatherhood program (n=224) were randomly assigned into one of three groups. The texting intervention group received twice weekly text messages aimed for 12 weeks. An increased incentive group received additional monetary incentive for completing program components including two research interviews. Control group participants received program services as usual. A research advisory board consisting of direct service staff, researchers, and past and current fatherhood program participants worked together to develop the text message content and protocols. Program participation, engagement, and retention in the protocol were measured at 6 and 12 weeks. A semi-structured interview as conducted with a sample of 10 fathers assigned to the texting intervention.

Results: ANOVA and chi-square analyses revealed no statistically significant differences between treatment and control groups. Thematic analysis of the qualitative interviews suggests that fathers benefited from the intervention in three important ways: (1) reinforcement of skills learned in the fatherhood curriculum; (2) connection to the program will not in attendance; and (3) mental well-being. Fathers expressed satisfaction and shared positive feedback about the content of the messages they received.

Conclusions and Implications: Texting is a low-cost approach that can be easily implemented in service and research protocols to engage and stay in contact with participants. Participants reported positive experiences receiving the messages although outcomes related to engagement, participation, and retention were null in the quantitative portion of the study. A surprising finding was the participants reported feelings of well-being related to receiving the pre-programmed text messages. Future research and practice should explore the integration of texting into program services especially around mental health and well-being. Further, we found that participants reported high levels of engagement in all groups, thus between differences would be hard to detect and suggesting that measures of engagement for this population may need to be further refined.