A pilot study of 79 older adults in Jordan found that receiving 30 culturally tailored text messages over one month significantly improved their knowledge about preventing chronic diseases by 40.62 points and their attitudes toward healthy living by 24.43 points. However, actual daily behavior changes weren’t yet measurable after just one month. According to Gram Research analysis, text messages appear feasible and acceptable for health education in resource-limited settings, though longer interventions are needed to see if people actually change their habits.
Researchers in Jordan tested whether sending daily text messages could help older adults learn about healthy eating and exercise to prevent diseases like diabetes and heart disease. They sent 79 older adults 30 personalized text messages over one month, with messages tailored to their culture and based on proven behavior-change science. The study found that people significantly improved their knowledge and attitudes about preventing disease, though they didn’t immediately change their daily habits. According to Gram Research analysis, this pilot study shows that text-message health education is practical and acceptable for older adults in low-income countries, paving the way for larger studies.
Key Statistics
A 2026 pilot study of 79 older adults in Jordan found that receiving 30 daily culturally adapted text messages increased disease prevention knowledge by 40.62 points and improved health attitudes by 24.43 points over one month.
According to research reviewed by Gram, women, younger older adults, more educated participants, and those living alone showed the greatest improvement in health knowledge and attitudes from text message interventions in a 2026 Jordan study.
A 2026 pilot study found that while text messages significantly improved knowledge (Cohen’s d = 3.29) and attitudes (Cohen’s d = 1.77) toward disease prevention in older adults, actual behavior change was not yet significant after one month.
The Quick Take
- What they studied: Whether sending culturally customized daily text messages could help older adults in Jordan learn about and adopt healthier habits to prevent chronic diseases like diabetes, heart disease, and stroke.
- Who participated: 79 older adults in Jordan with an average age of 57 years who already had chronic diseases. The group included both men and women with varying education levels.
- Key finding: After receiving 30 daily text messages over one month, participants showed huge improvements in their knowledge about disease prevention (40.62 points higher on a test) and their attitudes toward healthy living (24.43 points higher). However, their actual daily behaviors didn’t change significantly yet.
- What it means for you: Text messages appear to be a practical way to teach older adults about preventing disease, especially in countries with limited healthcare resources. However, knowing about healthy habits and actually doing them are different things: this study shows the first step works, but changing real-world behavior takes more time and support.
The Research Details
This was a pilot study, which means it was a small test run before doing a bigger, more rigorous study. Researchers recruited 79 older adults in Jordan who already had chronic diseases. Everyone received the same intervention: 30 text messages sent daily over one month. Each message was customized to fit Jordanian culture and focused on three areas: eating better, moving more, and preventing disease. The messages were designed using Social Cognitive Theory, a scientific framework that explains how people learn and change behavior.
Before the study started, all participants answered a detailed questionnaire about their knowledge, attitudes, and practices related to disease prevention. They answered the same questions again after receiving all 30 text messages. Researchers compared the before-and-after scores to see if the text messages made a difference. They also looked at which types of people improved the most, for example, did younger people improve more than older people? Did more educated people respond better?
This research approach is important because it tests whether a simple, low-cost tool (text messages) can work in real-world settings where many older adults live. In Jordan and similar countries, healthcare resources are limited, so finding scalable solutions that don’t require expensive clinics or doctors is crucial. A pilot study like this one helps researchers understand if an idea is worth testing on a larger scale. The findings give them the information they need to design a bigger, more rigorous study that can prove whether text messages actually work long-term.
This study has several strengths: it used validated questionnaires (meaning the questions were proven to measure what they’re supposed to measure), it was culturally adapted for Jordan (not just translated from another country), and it used proper statistical methods to analyze results. However, there are important limitations: there was no control group (a group that didn’t receive text messages to compare against), the study only lasted one month (too short to see if people actually change habits), and it was small (79 people). These limitations mean the results are promising but not definitive proof that text messages work. The researchers themselves say this is a pilot study meant to prepare for a larger, more rigorous trial.
What the Results Show
The text messages had a dramatic effect on what people knew about preventing disease. On average, participants’ knowledge scores jumped by 40.62 points: this is a huge improvement measured by something called Cohen’s d of 3.29, which means the effect was very large. Their attitudes toward healthy living also improved significantly, with scores increasing by 24.43 points (Cohen’s d = 1.77, also a large effect).
When researchers combined knowledge and attitudes together, the overall improvement was highly significant (Cohen’s d = 2.15). This means the text messages successfully taught people and changed how they felt about preventing disease.
However, there’s an important catch: the researchers found no significant change in actual practices, meaning people didn’t report doing more exercise or eating better yet. This is a common finding in health research: knowing what to do and actually doing it are two very different things. The text messages worked well for teaching and changing minds, but one month wasn’t long enough to see people actually changing their daily routines.
The study revealed interesting patterns about who benefited most from the text messages. People with higher education improved more than those with less education. Younger participants (within the older adult group) showed greater improvement than the oldest participants. Women improved more than men. People living alone improved more than those living with family. These patterns suggest that text messages might work best for certain groups, and that future programs might need different approaches for less educated older adults or those living with family.
This study fits into a growing body of research showing that mobile health (using phones for health education) can work in low- and middle-income countries. Previous studies have shown text messages can help with various health conditions, but most focused on younger adults or specific diseases. This research adds to the evidence by testing text messages specifically for older adults with multiple chronic diseases in a Middle Eastern setting. The large improvements in knowledge and attitudes match what other mobile health studies have found, but the lack of behavior change in just one month is also consistent with previous research showing that knowledge alone doesn’t automatically lead to action.
This pilot study has several important limitations that readers should understand. First, there was no control group, researchers didn’t compare the text message group to a group that received no messages, so they can’t be completely sure the messages caused the improvements (though it’s likely). Second, the study only lasted one month, which is too short to see if people actually change their long-term habits. Third, the sample size was small (79 people), so results might not apply to all older adults. Fourth, participants knew they were being studied and answered questions about their behavior, which can make people report better behavior than they actually do. Finally, the study only measured actual behavior change through self-reported questionnaires, not through objective measures like fitness tests or food diaries.
The Bottom Line
Based on this pilot study, text messages appear to be a promising, practical tool for teaching older adults about disease prevention in resource-limited settings. However, the evidence is still preliminary: this is not yet strong enough to recommend text messages as a complete solution for preventing disease. The recommendation would be: text messages can be part of a larger program to help older adults learn about and start thinking about healthy habits, but they should be combined with other support (like family involvement, community programs, or follow-up counseling) to help people actually change their daily behaviors. Confidence level: moderate: this is promising but needs larger studies to confirm.
This research is most relevant to older adults in low- and middle-income countries who have chronic diseases and limited access to healthcare education. It’s also important for healthcare workers, public health officials, and program designers in these regions who are looking for affordable ways to educate patients. Older adults in wealthy countries with extensive healthcare systems might benefit less, since they typically have more access to doctors and health education programs. The findings are less relevant to younger adults, as the study specifically tested older people.
Based on this study, you should expect to see improvements in knowledge and understanding within the first month of receiving daily text messages. However, actual changes in daily habits (eating better, exercising more) typically take much longer, usually 3-6 months or more. This is why the researchers are planning a longer study. If you were to use text messages for health education, realistic expectations would be: weeks 1-4 (learning and attitude change), weeks 5-12 (beginning to change habits), and months 4+ (establishing new routines).
Frequently Asked Questions
Do text messages actually help older adults prevent disease?
Text messages successfully teach older adults about disease prevention and improve their attitudes toward healthy living, according to a 2026 Jordan study of 79 participants. However, one month isn’t long enough to see if people actually change their daily habits. Longer studies are needed to confirm real-world behavior change.
How often should older adults receive health text messages?
The 2026 pilot study used one text message daily for one month and found this frequency was acceptable and effective for improving knowledge and attitudes. However, researchers haven’t yet tested whether daily messages are better than weekly messages or whether people can sustain engagement beyond one month.
Who benefits most from health text messages?
A 2026 study found that women, younger older adults (within the older adult age range), more educated individuals, and those living alone showed greater improvements from health text messages. This suggests text messages may need to be adapted differently for less educated older adults or those living with family.
Can text messages replace doctor visits for disease prevention?
No. While text messages effectively teach about disease prevention, they cannot replace medical care. The 2026 Jordan study shows text messages work best as part of a larger health program, combined with professional medical guidance and other support to help people actually change their behaviors.
How long does it take to see behavior changes from health text messages?
The 2026 pilot study only lasted one month and didn’t measure actual behavior change yet. Based on general health research, expect knowledge improvements within weeks 1-4, attitude changes by week 8, and actual habit changes by 3-6 months with ongoing support.
Want to Apply This Research?
- Track daily knowledge gains by logging one health fact learned from messages each day, and rate your confidence in understanding that fact on a 1-10 scale. After one month, review how your confidence scores improved. This directly mirrors what the study measured and shows progress even before behavior changes.
- Set a specific goal based on one message topic per week (for example, ‘Week 1: Learn about heart-healthy foods; Week 2: Plan one meal with these foods; Week 3: Add 10 minutes of walking daily’). Use the app to receive and save the daily messages, then check off which messages you acted on, even in small ways.
- Create a 12-week tracking system in the app: Weeks 1-4 focus on knowledge (how many facts do you remember?), Weeks 5-8 focus on attitudes (how motivated do you feel?), and Weeks 9-12 focus on actual behavior (how many days did you follow through?). This mirrors the study’s findings and gives realistic milestones for change.
This pilot study provides preliminary evidence that text messages can improve health knowledge and attitudes in older adults with chronic diseases. However, this is a small, early-stage study without a control group, and results may not apply to all populations or settings. Text messages should not replace professional medical advice, diagnosis, or treatment. Before making any changes to your health routine or disease management, consult with your healthcare provider. This research is promising but not yet definitive proof of effectiveness, larger studies are needed to confirm long-term benefits and actual behavior change.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.
