{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:12:27Z","timestamp":1790928747922,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015753","name":"Mental Health Foundation","doi-asserted-by":"publisher","award":["00"],"award-info":[{"award-number":["00"]}],"id":[{"id":"10.13039\/100015753","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012381","name":"Royal Alexandra Hospital Foundation","doi-asserted-by":"publisher","award":["00"],"award-info":[{"award-number":["00"]}],"id":[{"id":"10.13039\/100012381","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Edmonton and Calgary Community Foundations","award":["00"],"award-info":[{"award-number":["00"]}]},{"name":"Edmonton Civic Employee\u2019s Foundation","award":["00"],"award-info":[{"award-number":["00"]}]},{"name":"Calgary Health Trust","award":["00"],"award-info":[{"award-number":["00"]}]},{"DOI":"10.13039\/501100018911","name":"University Hospital Foundation","doi-asserted-by":"publisher","award":["00"],"award-info":[{"award-number":["00"]}],"id":[{"id":"10.13039\/501100018911","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Alberta Children\u2019s Hospital Foundation","award":["00"],"award-info":[{"award-number":["00"]}]},{"DOI":"10.13039\/501100000001","name":"Alberta Cancer Foundation","doi-asserted-by":"publisher","award":["00"],"award-info":[{"award-number":["00"]}],"id":[{"id":"10.13039\/501100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: In March 2020, Alberta Health Services launched Text4Hope, a free mental health text-message service. The service aimed to alleviate pandemic-associated stress, generalized anxiety disorder (GAD), major depressive disorder (MDD), and suicidal propensity. The effectiveness of Text4Hope was evaluated by comparing psychiatric parameters between two subscriber groups. Methods: A comparative cross-sectional study with two arms: Text4Hope subscribers who received daily texts for six weeks, the intervention group (IG); and new Text4Hope subscribers who were yet to receive messages, the control group (CG). Logistic regression models were used in the analysis. Results: Participants in the IG had lower prevalence rates for moderate\/high stress (78.8% vs. 88.0%), likely GAD (31.4% vs. 46.5%), and likely MDD (36.8% vs. 52.1%), respectively, compared to respondents in the CG. After controlling for demographic variables, the IG remained less likely to self-report symptoms of moderate\/high stress (OR = 0.56; 95% CI = 0.41\u20130.75), likely GAD (OR = 0.55; 95% CI = 0.44\u20130.68), and likely MDD (OR = 0.50; 95% CI = 0.47\u20130.73). The mean Composite Mental Health score, the sum of mean scores on the PSS, GAD-7, and PHQ-9 was 20.9% higher in the CG. Conclusions: Text4Hope is an effective population-level intervention that helps reduce stress, anxiety, depression, and suicidal thoughts during the COVID-19 pandemic. Similar texting services should be implemented during global crises.<\/jats:p>","DOI":"10.3390\/ijerph18042157","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T12:40:16Z","timestamp":1614084016000},"page":"2157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Mental Health Outreach via Supportive Text Messages during the COVID-19 Pandemic: Improved Mental Health and Reduced Suicidal Ideation after Six Weeks in Subscribers of Text4Hope Compared to a Control Population"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2743-0372","authenticated-orcid":false,"given":"Vincent I. O.","family":"Agyapong","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-6398","authenticated-orcid":false,"given":"Reham","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Hrabok","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-4804","authenticated-orcid":false,"given":"Wesley","family":"Vuong","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5979-136X","authenticated-orcid":false,"given":"Jasmine M.","family":"Noble","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Institute of Health Economics, 1200 10405 Jasper Avenue Edmonton, AB T5J 3N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Gusnowski","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Mrklas","sequence":"additional","affiliation":[{"name":"Strategic Clinical NetworksTM, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB T2P 2M5, Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Snaterse","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen","family":"Surood","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health, Alberta Health Services, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Min","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-934X","authenticated-orcid":false,"given":"Russell","family":"Greiner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Alberta Machine Intelligence Institute, Edmonton, AB T6G 2B7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9097-900X","authenticated-orcid":false,"given":"Andrew J.","family":"Greenshaw","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada"},{"name":"Asia-Pacific Economic Cooperation (APEC) Digital Hub for Mental Health, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020, September 29). 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