SMS feasibility
In total, 44 patients were supposed to receive 25 messages over 6 months, but due to a staff communication error, texts were only sent for 3 months or 12 messages or 528 total texts. We had 3 participants who left prior to their intervention and therefore were not enrolled in the SMS text system; therefore, we would expect 492 texts attempted. Our system demonstrated a total of 258 texts (52% of expected) were attempted by the end of the 3-month follow-up period. This difference highlighted the need for more close weekly monitoring of our SMS system. No further understanding of this process was found during the feasibility trial but informed our processes for the full trial. Seventy-four percent of attempted texts were registered as sent through the messaging system. This send rate was found to be equal across each intervention arm. Of the text messages that failed delivery, most were not delivered because the participant traveled outside of cellular coverage or had their phone off, prohibiting delivery. Our only protocol deviation was termination of SMS text messages at 3 months post-intervention rather than 6 months post-intervention due to limited communication.