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We investigated how short messages communicating health information would best be distributed to people with vision difficulties using mobile phones. Twelve visually-impaired persons who were unable to read short message service (SMS) messages directly compared three methods of presenting text messages as speech: (1) ordinary SMS messages were sent to the users and converted into speech by the mobile phone; (2) multimedia messages were sent to the users with prerecorded speech-synthesized information; and (3) mobile phone calls were placed to the users and prerecorded speech-synthesized messages were streamed to them. The latter two approaches used server-generated sound files. Over a three-month trial period, we sent a total of 88 SMS messages to the subjects, 111 multimedia messaging service (MMS) messages and 104 telephone calls. All of the SMS messages, 88% of the MMS messages and 69% of the telephone calls were received. In subsequent interviews, we asked the users which presentation method they preferred. SMS scored significantly better than both MMS (P = 0.033) and telephones (P = 0.006). All three methods had serious drawbacks. However, the study suggests that it might be possible to develop suitable technology for communicating with people with vision difficulties by mobile phone.
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