SCALE-UP Counts program shows text messaging can be an effective tool for public health

Reviewed by Megan Craig, M.Sc.Aug 24 2023

An examination of the SCALE-UP Counts program was recently published in the journal Pediatrics. This analysis, led by Yelena Wu, PhD, investigator at Huntsman Cancer Institute and associate professor in the department of dermatology at the University of Utah (the U), and David Wetter, PhD, MS, investigator at Huntsman Cancer Institute and professor in the department of population health sciences at the U, received support from RADx-Underserved Populations (RADx-UP) and funding from the National Institute of Health (NIH).

The SCALE-UP Counts program was designed to promote COVID-19 testing through collaboration with local schools, especially those who serve historically marginalized populations. This was done using two-way texting, meaning that staff, parents, or guardians could respond. Scale Up COUNTS sought to make it easier for schools to have access to COVID-19 testing and provided guidance to families and staff on when to test.

Wu's research is typically focused on cancer prevention in children, teens, and young adults. However, during the pandemic, along with Wetter, Adam Hersh, MD, PhD, Guilherme Del Fiol, MD, PhD, Kim Kaphingst, ScD, Jonathan Chipman, PhD, and Ben Haaland, PhD, she used her expertise to advise local K-12 schools on COVID-19 testing policies and logistics.

Tammy Stump, PhD, visiting instructor at Huntsman Cancer Institute, helped lead a special article, which described initial findings from the Scale Up COUNTS study. Results from the analysis of the SCALE-UP Counts program, and the accompanying piece led by Stump, show that texting can increase participation in public health programs.

Text messaging and health navigation are feasible ways to reach staff in K-12 schools to provide health screening messages. We found that 99% of staff had a valid cell phone number for the program, and fewer than 4% chose to opt out of the program. At the time of these analyses, four months after the program started, 19% of staff had engaged with the SCALE-UP Counts system in some way."

Tammy Stump, PhD, visiting instructor at Huntsman Cancer Institute

These results not only show that the program helped schools and families navigate the pandemic, but can help researchers understand how to increase participation in cancer prevention, screening, and education initiatives in the future.

"We wanted to see if the use of readily available technology increased the participation of the public in health programs," says Wu. "COVID-19 was a unique opportunity to test this while providing what we thought was an important service to our communities in Utah."

Wu's team will continue to evaluate the reach and engagement of the SCALE-UP program, as well as the cost-effectiveness of using texting to communicate health information to large groups of people.

"Text messaging seems to be an effective, and low-resource opportunity to meet people where they are at," says Stump. "This is important when looking into how we can make public health initiatives more accessible."

In addition to funding from ABC Science Collaborative, and RAD-x UP, this study was supported by the NCI including P30 CA042014 and Huntsman Cancer Foundation.