As the desire to utilize mobile phones in international health projects has increased in the last few years, organizations continually ask a similar question, “We want to use mobile phones. Now what?” But the decision to introduce or start a mhealth project needs to come after answering many questions before “now what?” especially when dealing with behavior change communication projects. Enter Abt Associates, FrontlineSMS, and Text to Change. Two guides have recently been released to help organizations assess whether or not mobiles are the right tool, and if they are, the process moving forward. One is from Abt Associates and is entitled mBCC Field Guide: A Resource for Developing Mobile Behavior Change Communication Programs. The other one was created in collaboration between FrontlineSMS and Text to Change and is entitled Communications for change: How to use text messaging as an effective behavior change campaigning tool.

mHealth is a sexy term these days but it is not always the best approach to creating behavior change.  Simply using mobile devices will not instantly make your project/program better. But when designed and implemented with the end user in mind, they can be a cheaper and more direct tool to pass information along in order to change behaviors.

Reason for the Guides

Abt and FrontlineSMS/Text to Change saw the need to have a guide that can lead practitioners through the necessary steps in order to see if and how a mobile solution could be used in the field. Each guide clearly shows the need to analyze on how a mobile intervention would fit into a program. They both do a great job pointing out that every situation is different and that a mhealth intervention must fit into the context and infrastructure of the region. But they are structured in very different ways and have noticeably different lengths (50 pages vs 7 pages). The Frontline/Text to Change guide is structured more like a checklist and mostly focused on text message interventions. The mBCC guide is longer and walks the reader thoroughly through the assessment process. But the guides show how to strategically think about behavior change communication projects.

The mBCC Field Guide

Abt Associates broke down the guide into 6 chapters with each chapter focusing on a specific topic. Each chapter lays out the necessary research and design that must be conducted in order to successfully utilize mobiles for behavior change. The chapters are in order of how one should follow the process (even though you can pick and choose chapters if you have already completed a chapter before reading). The chapters include Situation Analysis, Audience Segmentation, Behavior Change Objectives, Message Development, Tools & Technologies, and Monitoring and Evaluation. Each chapter also includes tools in the form of Excel templates that can be utilized to complete the assessment discussed in the chapter. With a high level of detail along with the structured worksheets, this guide is designed for those who are new to mhealth and are seeking a step-by-step walk through from the start.

Frontline/Text to Change

As mentioned before, the FrontlineSMS and Text to Change guide is more of a checklist of things to research and discuss before designing and implementing a mobile-based behavior change project. With a DOs and DON’Ts list, it covers context, content, developing campaigns, and monitoring and evaluation. This skeleton format is a quick read and is probably better suited for an organization that either has worked with mobile devices before or is somewhat knowledgeable about mhealth.

Both are very useful guides for the intended audiences. With mhealth still only mostly being used in pilot projects, we need to find answers to what changes behavior. The greater number of projects that use mobile devices for behavior change communication (when they are deemed most appropriate) means more data and evidence will be produced in order to show the true impact of mobile devices. These guides give the necessary direction to organizations to start leveraging mobile devices in health projects and discover what does and does not work along with why, which is the most important question of all.

As an ending note, the mBCC Field Guide was presented by Gael O’Sullivan, Stephen Rahaim, and Shalu Umapathy from Abt Associates during the latest mHealth Working Group meeting. They explained that the guide needed to be a “living document,” and they requested feedback about it from mhealth practitioners, especially those in the field. Please visit their website (http://www.mbccfieldguide.com/) in order to provide any feedback. To provide feedback to FrontlineSMS and Text to Change, please find used the contact information here and here.