Researchers tested whether sending text message reminders could get more people to visit a produce market located at a health center. They found that when patients received bilingual text messages reminding them about the market, about 81 more people visited each month. However, the study also discovered that some groups—including men, people on Medicaid, and uninsured patients—were less likely to return after taking a break. This suggests that while text messages work, health centers may need to try different ways to reach everyone fairly, such as offering home delivery or other options.
The Quick Take
- What they studied: Does sending text message reminders help people remember to visit a farmers market that’s set up at a health center?
- Who participated: Nearly 2,600 patients from a health center that serves low-income communities. The study looked at people who had stopped visiting the market for 3 months or longer.
- Key finding: Text message reminders led to about 81 more people visiting the produce market each month. However, men, people with Medicaid insurance, and uninsured people were less likely to come back after taking a break.
- What it means for you: If you have trouble remembering to visit a farmers market at your health center, text reminders might help. But if you’re in a group that’s less likely to return, you might benefit more from other options like home delivery or phone calls instead of just texts.
The Research Details
Researchers looked at attendance records from a health center’s produce market over three years (March 2021 to March 2024). They compared how many people visited before and after the health center started sending bilingual text message reminders in April 2024. This type of study is called a ‘quasi-experimental’ design because researchers watched what happened when they introduced the text messages, rather than randomly assigning people to receive them or not.
The researchers tracked monthly attendance numbers and looked at which patients came back after being away for 3 months or longer. They used statistical methods to account for other factors that might affect attendance, like how long someone had been a patient at the health center.
This research design is useful because it shows what happens in real-world situations at actual health centers, not just in controlled laboratory settings. By looking at actual attendance data over time, researchers could see if the text messages had a lasting effect or if people just came once and then stopped.
The study used real attendance data from an actual health center, which makes the findings relevant to real life. However, because researchers didn’t randomly assign some people to get texts and others not to, we can’t be 100% certain that the texts alone caused the increase in attendance—other things happening at the same time might have played a role. The study also looked at a specific health center, so results might be different in other communities.
What the Results Show
After the health center started sending bilingual text message reminders in April 2024, attendance at the produce market increased by about 81 people per month on average. This increase stayed steady over time, suggesting the text messages had a lasting effect, not just a one-time boost.
However, the study revealed important differences in who came back after taking a break. Men were about 26% less likely to return compared to women. People enrolled in Medicaid were about 33% less likely to return. Most significantly, uninsured people were about 47% less likely to return compared to people with insurance.
These findings suggest that while text messages work as a general strategy, they don’t work equally well for everyone. Some groups of people need different kinds of help to stay engaged with the produce market.
The study found that insurance status was the strongest predictor of whether someone would come back to the market. This is important because it suggests that people facing financial hardship might have other barriers beyond just forgetting about the market—they might have transportation issues, work schedules that conflict, or other challenges that text messages alone can’t solve.
Previous research has shown that food insecurity (not having reliable access to healthy food) is a major health problem, especially for low-income and minority communities. This study builds on that knowledge by testing a simple, low-cost solution. While other studies have shown that farmers markets at health centers can help, this is one of the first to test whether text reminders can increase attendance. The findings align with other research showing that simple reminders can help people remember to do healthy behaviors.
The study only looked at one health center, so results might be different in other places. The researchers couldn’t randomly assign people to get text messages or not, so they can’t be completely certain the texts caused the increase—something else happening at the same time might have contributed. The study also didn’t track whether people actually bought food or improved their health, just whether they showed up. Finally, the study didn’t explore why certain groups were less likely to return, so we don’t know if it’s because they didn’t get the texts, didn’t see them, or had other reasons for not coming back.
The Bottom Line
If you run a health center with a produce market, sending bilingual text message reminders appears to be an effective way to increase attendance (moderate confidence). However, this should be combined with other strategies to reach people who are less likely to respond to texts alone, such as men, uninsured people, and people on Medicaid. Consider offering home delivery, phone calls, or in-person outreach to these groups (moderate confidence).
Health center administrators and public health officials should care about this research because it offers a practical, affordable way to help more people access fresh food. Patients who struggle to remember appointments or who might benefit from fresh produce should know that their health center may send them reminders. Community organizations working on food access should consider this approach. However, people should understand that text reminders alone may not solve food access problems for everyone.
The study showed that attendance increased within the first month of starting text messages and stayed higher for the rest of the study period. However, this doesn’t mean individual people will see health benefits immediately. It typically takes weeks to months of eating more fresh produce to notice improvements in energy, digestion, or other health markers.
Want to Apply This Research?
- Track weekly visits to your health center’s produce market or local farmers market. Record the date, what you bought, and how much you spent. This helps you see patterns in your shopping habits and reminds you to go regularly.
- Set up push notifications in your health center’s app (or ask them to send you text reminders) about produce market days and times. Mark these dates on your phone calendar and set a reminder for the day before. Try to visit at least once every two weeks.
- Keep a simple log of your farmers market visits for 3 months. Note how many times you went, what produce you bought, and whether reminders helped you remember. Share this with your doctor to discuss how increasing fresh produce intake is affecting your health.
This research shows that text message reminders can help increase attendance at health center produce markets, but it does not provide medical advice. Results may vary depending on your location, health center, and personal circumstances. If you have questions about food access programs or how to improve your diet, please speak with your doctor or a registered dietitian. This study focused on attendance rates, not health outcomes, so we cannot say whether visiting the produce market will directly improve your health without additional research. Some groups (men, uninsured people, and Medicaid enrollees) were less likely to benefit from text reminders alone, so you may need additional support or different types of outreach.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.