Impact of text message reminders on attendance at healthy marriage and relationship education workshops

• Published date: 01 October 2023
• Author: Ankita Patnaik,Jonathan E. Gellar,Rebecca Dunn,Brian Goesling
• Date: 01 October 2023
• DOI: http://doi.org/10.1111/fare.12820

RESEARCH

Impact of text message reminders on attendance at

healthy marriage and relationship education

workshops

AnkitaPatnaik| JonathanE.Gellar | RebeccaDunn |

Brian Goesling

Mathematica, Washington, DC

Correspondence

Ankita Patnaik, Mathematica, 1100 First

Street, NE, 12th Floor, Washington, DC

20002-4221, USA.

Email: apatnaik@mathematica-mpr.com

Funding information

U.S. Department of Health and Human

Services, Grant/Award Number:

HHSP233201500095G

[Correction added on Feb 13, 2023, after first

online publication: Reference for (Futris et al.,

2020) has been inserted]

Abstract

Objective: This study examined the impacts of different

types of text message reminders on couples’attendance at

healthy marriage and relationship education (HMRE)

workshops.

Background: Regular attendance is often a challenge for

couples participating in HMRE workshops. Studies sug-

gest that nudges can increase attendance at appointments,

but there has been little research on their application to

family support programs.

Method: We conducted a Bayesian adaptive randomized

controlled trial involving 1,742 couples in Florida. We

assigned couples to either a control group that received no

reminders or one of several treatment groups that received

different types of reminders. We compared attendance

across groups to estimate impacts of the messages on cou-

ples’initial and continued attendance.

Results: Simple reminders that provided only the date and

time of the first session increased couples’initial session

attendance by 12% compared with the control group.

None of the reminders increased continued attendance

among couples who attended the first session.

Conclusion: Simple reminders worked best for increasing

initial attendance compared with messages with enhanced

content, such as motivational messages, graphics, or peer

testimonials. Couples that attended the first session had

similarly high rates of continued session attendance

regardless of the reminders.

Author note: This study was supported by contract HHSP233201500095G from the U.S. Department of Health and Human Services,

Administration for Children and Families. The views expressed herein are those of the authors and do not necessarilyreflect the views of

the U.S. Department of Health and Human Services.

Received: 10 May 2022Revised: 29 September 2022Accepted: 15 November 2022

DOI: 10.1111/fare.12820

© 2022 National Council on Family Relations.

1474 Family Relations. 2023;72:1474–1490.wileyonlinelibrary.com/journal/fare

Implications: Text message reminders show potential as a

tool for boosting initial attendance at voluntary family

support programs.

KEYWORDS

attendance, healthy marriage, nudge, relationship education, reminders,

text messages

A growing body of research suggests that nudges—subtle, modest changes in a person’s

environment—have the power to help people take actions and make decisions that better align

with their goals (DellaVigna & Linos, 2022; Hummel & Maedche 2019). A nudge is a small,

easy, and inexpensive change to an environment or to the way choices are presented. Thaler

and Sunstein (2008) popularized the idea that small changes based on behavioral science can

influence recipients’behavior and decision making. By definition, nudges are “any aspects of

the choice architecture that alters people’s behavior in a predictable way without forbidding

any options or significantly changing their economic incentives”(Thaler & Sunstein, 2008,

p. 6). For example, if the goal is to increase people’s healthy eating habits, then reordering the

way food is presented—such as putting fruit at someone’s eye level—counts as a nudge but ban-

ning junk food does not. Nudges can take many forms, from simple reminders that address

memory failure to targeted content that addresses procrastination or low motivation.

Nudge theory is based in behavioral science, a field that synthesizes findings from psychol-

ogy, economics, sociology, and other disciplines to develop a more nuanced understanding of

how and why people think and behave as they do. Traditional economic theory argues that

humans act rationally, weighing the costs and benefits of their options while using all the infor-

mation available to them, before choosing how to act. For example, traditional economic

theory’s explanation for why participants attend a workshop is that people weigh the costs of

attendance (e.g., transportation, childcare, time) against the benefits of attendance

(e.g., enjoyment, gaining new skills, financial benefits) and will choose to attend if the benefits

outweigh the costs.

However, a growing body of evidence shows that classic economic theory cannot, by itself,

explain all the ways or reasons people act in real-world situations. For example, people’s atten-

tion, memory, self-control, and other cognitive resources are limited and can be overwhelmed.

Further, situations of scarcity, which can include poverty or limited time, might reduce people’s

capacity to process information, plan effectively, solve problems and exercise executive control

(Mullainathan & Shafir, 2013). These factors can influence people’s short-term behavior, such

as attending a workshop, and result in actions that are not aligned with their longer term goals,

such as improving or sustaining the quality of their romantic relationships. Thaler and Sunstein

(2008) suggested that using light-touch behavioral interventions such as nudges can help people

make better decisions and act in a way that aligns with their intentions and long-term goals.

Reminders are a common type of nudge. They have the potential to address several chal-

lenges, including inattention, procrastination, memory failure, and competing demands on time,

which can keep people from completing their intended actions. Reminding people about infor-

mation they already know or reminding them to do something can influence their behavior, for

instance, by addressing their inattention or memory failure and prompting them to act. For

example, well-timed text messages can remind recipients of their intended actions at the right

moment, in turn helping support attendance at medical appointments, school classes, and group

workshops, for example. Reminders might be especially effective for families with low incomes,

because the cognitive and emotional demands of daily financial stressors can pull attention

from intended actions (Gennetian et al., 2016; Haushofer & Fehr, 2014; Mani et al., 2013).

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