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week (OR 1.08, 95% CI 1.04-1.13; P less then .001). CONCLUSIONS Multimedia message delivery for PTSD treatment showed symptom-reduction rates similar to traditional forms of treatment delivery, suggesting further study of messaging as a treatment medium. Most patients completed an 8-week course, reflecting the acceptability of messaging interventions. Delivering treatment via two-way messaging offers increased opportunities for widespread access to mental health care. ©Matteo Malgaroli, Thomas Derrick Hull, Shannon Wiltsey Stirman, Patric