BACKGROUND: During the unprecedented time of the COVID-19 pandemic, the need to support mental wellbeing is urgent . In March 2020, Text4Hope was provided as a community health service to Alberta residents . This free service aims to promote psychological resilience and alleviate pandemic-associated stress, anxiety, and depression symptoms .
OBJECTIVE: This study aimed to evaluate the feedback, satisfaction, experience, and perceptions of Text4Hope subscribers, and to examine any differences based on gender after receiving six weeks of daily supportive text messages . Additionally, the study examined anticipated receptivity for technology-based medical services that could be offered during major crises, emergencies, or pandemics, such as COVID-19 .
METHODS: Individuals self-subscribed to Text4Hope to receive daily supportive text messages for three months . Subscribers were invited to complete an online survey at six weeks to collect service satisfaction related information . Overall satisfaction was assessed on a scale from 0 to 10, using a related-measures t-test; and Likert scale satisfaction responses were used to assess various aspects of the Text4Hope program . Gender differences were analyzed using One-Way ANOVA and Chi-Square analysis .
RESULTS: The total number of subscribers who completed baseline and six-week survey were 2032 , 1788 (88.0 %) were female , 219 (10.8 %) were male, and 25 (1.2 %) were other gender . The mean age of study participants was 44.58 (SD=13.45) The mean overall satisfaction score was 8.55/10 (SD=1.78) suggesting that overall, respondents' satisfaction with the Text4Hope program was high . ANOVA analysis, using the Welch test (n=1,716) demonstrated that females had significantly higher mean satisfaction scores, compared to males; 8.65 vs. 8.11, respectively (Mean Difference=0.546 , 95% CI=0.19-0.91, P <.001), but not to``Other"gender (Mean Difference= -0.938 , 95% CI= -0.37-2.25, P>.05). More than 70% of subscribers agreed that Text4Hope helped them to cope with stress and anxiety, feel connected to a support system, manage COVID-19 related issues, and improve mental wellbeing . Similarly, subscribers agreed that messages were positive, affirmative, and succinct . Messages were read by 97.9% of respondents always or often and more than 20% returned to messages always or often . The majority of subscribers (89.3 %) read the messages and either reflected upon them or took a positive action . Subscribers welcomed almost all technology-based services as part of their health care during crisis or emergency situations (70 %). Text4Hope was perceived to be more effective by subscribers identifying as female, who reported higher satisfaction and improved coping after receiving messages for 6 weeks .
CONCLUSIONS: Respondents affirmed the high quality of the messages with their positive feedback . Technology-based services can provide remotely accessible and population-level interventions that align with recommended distancing practices during pandemics . Text4Hope subscriber feedback revealed high satisfaction and acceptance rates after six weeks of receiving daily messages . CLINICALTRIAL: The study protocol was approved by the Research and Ethics Board of the University of Alberta (Pro00086163). INTERNATIONAL REGISTERED REPORT: RR2-10.2196/19292.