Acceptability and Effectiveness of Text Message Reminders to Improve Patient Attendance During the Sociopolitical Crisis in Haiti: Telephone-Based Survey.

Background: The sociopolitical crisis in Haiti affects health care center attendance, creating significant challenges in ensuring patient compliance with medical appointments. Objective: This study aimed to assess the effectiveness of text message reminders on patient attendance in the context of the sociopolitical crisis of Haiti, examining the influence of patient perceptions, behaviors, and socioeconomic factors. Methods: We conducted a cross-sectional study using a telephone survey of 386 randomly selected patients who had an appointment during the third quarter of 2024 at 2 health care centers in the Port-au-Prince metropolitan area. We collected appointment and socioeconomic data, as well as perceptions and behaviors toward text message reminders. We described patients' perceptions and behaviors toward text message reminders, as well as appointment attendance and patient characteristics. We performed bivariate and multivariate logistic regression models to assess whether receiving text message reminders and socioeconomic factors influenced overall appointment attendance. Results: Among 386 patients, 259 attended their appointments on either the appointment day or at a later date for an overall attendance rate of 67.1 % ( 95% CI 62.4%-71.8%). Attendance rates were higher among the 147 patients who confirmed receiving a reminder (77.6%) compared to the 239 who did not (60.7%). SMS text messaging reading behavior varied among patients. Overall, 219/386 (56.7%) patients always, 66/386 (17%) often, 75/386 (19%) sometimes, 21/386 (5%) rarely, and 5/386 (1%) never read their SMS text messaging. All patients liked the initiative of sending reminders and found them helpful. In the multivariate analysis, patients who confirmed receiving a reminder were more likely to attend their appointment compared to those who did not (adjusted odds ratio [AOR] 2.0, 95% CI 1.18-3.39). A patient satisfaction rate of 8 or higher with their physicians was significantly associated with higher attendance rates, compared to 6 or lower, with AORs increasing with satisfaction. Travel time less than 30 minutes (AOR 2.31, 95% CI 1.03-5.19) and 30-60 minutes (AOR 2.78, 95% CI 1.24-6.21), and being with a chronic disease (AOR 0.42, 95% CI 0.23-0.79) were also associated with appointment attendance. Conclusions: Our study highlights the potential of text message reminders to improve appointment attendance in Haiti, despite the sociopolitical crisis. The overall acceptability and positive perceptions of SMS text messaging reminders suggest that they can be a valuable tool in health care settings, especially when adapted to the local context. We recommend that health care centers in Haiti consider integrating SMS text messaging reminder systems into routine patient management to enhance adherence and optimize care delivery.