A strength of the current research is the use of objective and validated measures. This is important to ensure that the behavioral outcomes of SMS-delivered interventions are accurately assessed, and this should be maintained in future research. A major evaluation problem in the current literature is the lack of assessment of intervention effects on targeted behaviors. Most clinical care studies failed to measure the behaviors targeted in the intervention, even though these outcomes are more proximal to intervention exposure than health outcomes. This has serious consequences as it prevents assessment of the intervention effects on the targeted behaviors that are hypothesized to cause subsequent health benefits.