Use of short message service for monitoring Zika-related behaviors in four Latin American countries: lessons learned from the field.

BACKGROUND: Effective response to widespread epidemics relies in part on rapidly changing information from affected communities as individuals react to emergency response efforts. The short message service (SMS) approach was used to monitor knowledge, prevention, and behavior during an outbreak of Zika cases in Honduras, El Salvador, the Dominican Republic, and Guatemala in 2017. SMS methods supported collection of monitoring data at a time of heightened reliance on communication via mobile phones, and when the use of phones for epidemic-related communication was amplified. SMS methods were used to collect monitoring data on knowledge of Zika risk and prevention, and behaviors to prevent Zika infection.
METHODS: Serial SMS surveys were conducted over a seven-month period to capture changing community perceptions of risk and behaviors to prevent Zika during the epidemic. This article discusses the development of the SMS surveys, from planning and designing tools to collecting the data, and the unique experiences encountered during survey implementation.
RESULTS: Special considerations for the effective use of SMS for data collection are described, including market penetration of mobile phones, predominant phone types in use, preparation of communities and the target audience, options for tailoring questionnaires to the available technology, relationships with telecommunication companies, and supporting participants' ability to complete questionnaires. The article discusses issues related to the development of the questionnaires, context-specific challenges before and during implementation of the surveys, and creative strategies to overcome barriers. Lessons learned, and recommendations to increase opportunities for a successful SMS survey, are included.
CONCLUSIONS: Understanding the social and economic context of mobile phone use in the target area and careful crafting of SMS questionnaires can produce useful data that may rival information captured through other approaches, such as Knowledge, Attitudes and Practices (KAP) surveys. Despite the challenges experienced, there is room for more consistent and widespread use of SMS for data collection in Latin America.