Case Managers, HIV-Positive Youth, and a Text Messaging Intervention: “That care just didn’t happen before.”

Objective: Scant research addresses how technology use impacts job satisfaction for medical case managers. The E-VOLUTION program is a novel client-to-medical case manager direct text messaging intervention to improve health outcomes for youths with HIV. This study examines how E-VOLUTION affected medical case managers’ job satisfaction and the care they provided to clients. Method: We recruited medical case managers and their clients (ages 18–29) from three clinics in St. Louis, MO, for in-depth, semistructured interviews. We interviewed eight medical case managers and 19 clients and used directed content analysis to analyze interview transcripts and the 17,286 text messages sent between clients and their case managers. Results: Direct texting improved medical case managers’ job satisfaction and feelings of efficiency by streamlining rote responsibilities and allowing them to provide better client care. Medical case managers reported that direct texting enabled clients to achieve better health and well-being. Conclusion: Use of text messaging programs in medical case management may reduce worker turnover and improve quality of care, and ultimately health outcomes, for young people with HIV.