scholarly journals Evaluation of the Healthy Living after Cancer text message-delivered, extended contact intervention using the RE-AIM framework

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jennifer R. Job ◽  
Elizabeth G. Eakin ◽  
Marina M. Reeves ◽  
Brianna S. Fjeldsoe
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Text Message ◽  
Text Messages ◽  
Trial Registration ◽  
Healthy Living ◽  
Intervention Cost ◽  
Extended Contact ◽  
After Cancer ◽  
Text Message Intervention

Abstract Background Text message-delivered interventions have potential to prevent weight regain and maintain diet and physical activity behaviours through extending contact with participants following initial weight loss, lifestyle interventions. Using the RE-AIM Framework, this study evaluated the adoption, reach, implementation, effectiveness, and maintenance of an extended contact text-message intervention following the Healthy Living after Cancer (HLaC) program. HLaC was a 6-month, telephone-delivered intervention targeting healthy diet, physical activity and weight loss for adult cancer survivors, offered by Cancer Councils (CCs) in Australia. Methods HLaC completers (n = 182) were offered extended contact via text messages for 6-months (HLaC+Txt). Text message content/frequency was individually tailored to participant’s preferences, ascertained through two telephone-tailoring interviews with CC staff. Adoption (HLaC+Txt uptake among eligible CCs), reach (uptake by HLaC completers) and implementation (intervention cost/length; text dose) were assessed. The effectiveness of extended contact relative to historic controls was quantified by pre-to-post HLaC+Txt changes in self-reported: weight, moderate-vigorous physical activity (MVPA), fruit and vegetable intake, fat and fibre behaviour. Maintenance, following 6-months of noncontact for the intervention cohort, was assessed for these same variables. Semi-structured interviews with CC staff and participants contextualised outcomes. Results HLaC+Txt was adopted by all four CCs who had delivered HLaC. In total, 115 participants commenced HLaC+Txt, with reach ranging across CCs from 47 to 80% of eligible participants. The mean number of weeks participants received the text message intervention ranged across CCs from 18.5–22.2 weeks. Participants received (median, 25th,75th percentile) 83 (48, 119) texts, ranging across CCs from 40 to 112. The total cost of HLaC+Txt delivery was on average $AUD85.00/participant. No meaningful (p < 0.05) differences in self-reported outcomes were seen between HLaC+Txt and control cohorts. After 6-months no contact the intervention cohort had maintained weight, fruit intake, fat and fibre index scores relative to end of HLaC+Txt outcomes. Participants/CC staff perceived an important intervention component was maintaining accountability. Conclusions While feasible to implement, HLaC+Txt was not effective in the short term. However, intervention effects during the non-contact period suggest the program supports longer term maintenance of weight and diet behaviour. Intervention delivery in this real-world context highlighted key considerations for future implementation. Trial registration Australian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015).

scholarly journals Evaluation of the Healthy Living after Cancer Text Message-Delivered, Extended Contact Intervention using the RE-AIM Framework

2021 ◽  
Author(s):  
Jennifer R. Job ◽  
Elizabeth G. Eakin ◽  
Marina M. Reeves ◽  
Brianna S Fjeldsoe
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Text Message ◽  
Text Messages ◽  
Healthy Living ◽  
Intervention Cost ◽  
Adult Cancer Survivors ◽  
Extended Contact ◽  
After Cancer ◽  
Text Message Intervention

Abstract Background: Text message-delivered interventions have potential to prevent weight regain and maintain diet and physical activity behaviours through extending contact with participants following initial weight loss, lifestyle interventions. This study evaluated the adoption, reach, implementation, effectiveness and maintenance of an extended contact text-message intervention following the Healthy Living after Cancer (HLaC) program. HLaC was a 6-month, telephone-delivered intervention targeting healthy diet, physical activity and weight loss for adult cancer survivors, offered by Cancer Councils (CCs) in Australia. Methods: HLaC completers (n=182) were offered extended contact via text messages for 6-months (HLaC+Txt). Text message content/frequency was individually tailored to participant’s preferences, ascertained through two telephone-tailoring interviews with CC staff. Adoption (HLaC+Txt uptake among eligible CCs), reach (uptake by HLaC completers) and implementation (intervention cost/length; text dose) were assessed. The effectiveness of extended contact relative to historic controls was quantified by pre-to-post HLaC+Txt changes in self-reported: weight, moderate-vigorous physical activity (MVPA), fruit and vegetable intake, fat and fibre behaviour. Maintenance, following 6-months of noncontact for the intervention cohort, was assessed for these same variables. Semi-structured interviews with CC staff and participants contextualised outcomes. Results: HLaC+Txt was adopted by all four CCs who had delivered HLaC. In total, 115 participants commenced HLaC+Txt, with reach ranging across CCs from 47–80% of eligible participants. The mean number of weeks participants received the text message intervention ranged across CCs from 18.5 – 22.2 weeks. Participants received (median, 25th,75th percentile) 83 (48, 119) texts, ranging across CCs from 40 to 112. The total cost of HLaC+Txt delivery was on average $AUD85.00/participant. No meaningful (p<0.05) differences in self-reported outcomes were seen between HLaC+Txt and control cohorts. After 6-months no contact the intervention cohort had maintained weight, fruit intake, fat and fibre index scores relative to end of HLaC+Txt outcomes. Participants and CC staff perceived an important intervention component was maintaining accountability. Conclusions: While feasible to implement, HLaC+Txt was not effective in the short term. However, intervention effects during the first 6-months of non-contact suggest the program supports longer term maintenance of weight and diet behaviour. Intervention delivery in this real-world context highlighted key considerations for future implementation.Trial Registration: Australian and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12615000882527 (registered on 24/08/2015)

Implementation of a text message intervention to promote behavioural change and weight loss among overweight and obese Brazilian primary care patients

2018 ◽  
Vol 25 (8) ◽  
pp. 476-483 ◽  
Author(s):  
Lorenn L Gusmão ◽  
Antonio L Ribeiro ◽  
Maíra Viana Rego Souza-Silva ◽  
Paulo R Gomes ◽  
Alline M Beleigoli ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Pilot Study ◽  
Behavioural Change ◽  
Text Message ◽  
Text Messages ◽  
Wilcoxon Test ◽  
Message Delivery ◽  
Belo Horizonte ◽  
Text Message Intervention

Introduction Mobile-technology-based interventions are promising strategies for promoting behavioural change in obese patients. The aims of this study were to evaluate the feasibility of implementing a text message intervention, and to assess the effects of the intervention on body mass index (BMI) and self-reported behavioural change. Methods TELEFIT was a three-phase feasibility study comprising the following stages: (a) the development of text messages; (b) testing; and (c) a quasi-experimental pilot study in which patients who were engaged in obesity/overweight educational groups in public primary care centres in Belo Horizonte, Brazil, were recruited. A bank of text messages was drafted and reviewed by an expert panel, text message delivery software was developed and tested, and a pilot study assessed patients before and after receiving the intervention using validated questionnaires and body measures. The data were analysed using the Wilcoxon test. Results A total of 46 patients completed the follow-up; 93.5% were women and the median age was 42 years (interquartile range (IQR) 34–52 years). At four months, participants had a significant reduction in BMI (median 31.3 (IQR 28.2–34.6) vs. 29.9 (IQR 27.2–34.6) kg/m2, p < 0.001), systolic (median 125 (IQR 120–132) vs. 120 (IQR 110–130) mmHg, p = 0.013) and diastolic blood pressure (median 80 (IQR 70–100) vs. 80 (IQR 70–80) mmHg, p = 0.006), when compared to baseline. All patients reported to be satisfied and willing to continue receiving the intervention, and 93.3% felt that the intervention helped them change their behaviours. Discussion This study has shown that a text message intervention to promote behavioural change and weight loss was feasible and effective in a short-term period. Participants were satisfied and willing to continue receiving the SMS messages.

Abstract P386: Design of a Tailored Text-message Intervention for Weight Loss

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Julia Kolodziejczyk ◽  
Anglica Barrera ◽  
Kevin Patrick ◽  
Lindsay Dillon ◽  
Simon Marshall ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Weight Management ◽  
Large Scale ◽  
Controlled Trial ◽  
Self Regulation ◽  
Text Message ◽  
User Preferences ◽  
Text Messages ◽  
Text Message Intervention

Introduction: Tailoring information is a commonly used health communication technique to individualize behavior change programs. However, few studies have applied individualized tailoring to a text-message intervention. Using tailoring with text-messages may be a powerful behavior change tool as this technology is inexpensive, asynchronous, and is ubiquitous across socio-economic segments. We developed a tailored, “push/pull,” text-message intervention for overweight/obese English and Spanish-speaking participants that targets weight management behaviors. The development of the theory-driven logic rules for individualized text-messages is described. Methods: A robust web-based participant intake system was developed to gather and store the data needed to individualize the messages by personalization, feedback, and content matching. Feedback and content matching was based on both a baseline weight management behavior survey and continual text message-based assessments related to individual behaviors and perceived barriers. The system is designed so that participants who show rapid and sustained progress can advance through the content, while those having difficulties can receive additional tips and suggestions. Participants will be scheduled to receive 3-4 interactive messages per day from our library of over 6,000 text messages. We categorized the messages into five groups: 1) Subject matter: Content related to nutrition and physical activity behaviors; 2) Behavioral core strategies based on Self-Regulation Theory (e.g. self-monitoring, goal setting); 3) Message type (e.g. reminder, feedback); 4) Personalization (e.g. favorite restaurants, friends’ names); and 5) Location related messages. We also developed a “like/ don’t like” feature so that the system can continuously learn user preferences for message types and adjust the type of future messages sent accordingly. Conclusion: A large-scale randomized controlled trial is underway to evaluate the efficacy of this text-message intervention. While this intervention is aimed at weight loss, our tailoring technique will likely apply to other health behaviors as well.

scholarly journals Dose and engagement during an extended contact physical activity and dietary behavior change intervention delivered via tailored text messaging: exploring relationships with behavioral outcomes

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Brianna S Fjeldsoe ◽  
Ana D Goode ◽  
Jennifer Job ◽  
Elizabeth G Eakin ◽  
Kate L Spilsbury ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Behavior Change ◽  
Text Messaging ◽  
Text Message ◽  
Text Messages ◽  
Dietary Behaviors ◽  
Fixed Dose ◽  
Participant Engagement ◽  
Extended Contact

Abstract Background Extended contact interventions delivered via text messaging are a low-cost option for promoting the long-term continuation of behavior change. This secondary analysis of a text message–delivered extended contact intervention (‘Get Healthy, Stay Healthy’ (GHSH)) explores the extent to which changes in physical activity, dietary behaviors and body weight were associated with the frequency of text messages (dose) and contact between the health coach and participant (engagement). Methods Following a telephone coaching program, participants were randomised to receive extended contact via tailored text messages (GHSH, n = 114) or no additional contact (n = 114) over a 6-month period. Message dose, timing, and content were based on participant preferences, ascertained during two tailoring telephone calls. All incoming and outgoing messages were recorded. At baseline and 6 months, participants self-reported body weight and dietary behaviors (fruit and vegetable servings/day). Moderate-vigorous physical activity (MVPA) was assessed via accelerometry. Results Median dose (25th, 75th percentile) was 53 (33, 72) text messages in total across six months. Mean fortnightly dose in weeks 1–2 was 5.5 (95 % CI: 4.3, 6.6) text messages, and remained stable (with the exception of planned decreases in weeks involving additional intervention contacts). Offset against the average fortnightly dose of goal checks (1.6, 95 % CI: 1.3, 2.0 and 1.5, 95 % CI: 1.2, 1.8, for physical activity and diet respectively), mean replies to goal checks were highest in weeks 1–2 (1.4, 95 % CI: 1.4, 1.5 and 1.3, 95 % CI: 1.2, 1.4, respectively) and tended to become lower in most weeks thereafter. Greater weight loss was positively associated with text message dose (P = 0.022), with a difference of 1.9 kg between participants receiving the most and fewest texts. There was no association between engagement and changes in outcome measures. Conclusions A fixed dose of texts does not seem suitable to meet participants’ individual preferences. Higher self-selected text doses predicted better weight outcomes. However, greater participant engagement through text replies does not predict more favourable outcomes, despite being a suggested facilitator of successful behavior change maintenance. Trial registration Australian New Zealand Clinical Trials Registry number: ACTRN12613000949785. Date registered: 27 August 2013. Retrospectively registered. http://www.anzctr.org.au/.

scholarly journals Steps Ahead: optimising physical activity in adults with cystic fibrosis: Study Protocol for a pilot randomised trial using wearable technology

2020 ◽  
Vol 3 ◽  
pp. 21
Author(s):  
Maire Curran ◽  
Audrey C. Tierney ◽  
Louise Collins ◽  
Lauren Kennedy ◽  
Ciara McDonnell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystic Fibrosis ◽  
Remote Monitoring ◽  
Randomised Trial ◽  
Text Message ◽  
Wearable Technology ◽  
Structured Interview ◽  
Text Messages ◽  
University Hospital ◽  
Active Comparator

Background: Physical activity (PA) and exercise are widely documented as key components in the management of cystic fibrosis (CF). In recent years there have been significant improvements in telehealth, in particular; wearable technology,  smartphone use and remote monitoring, all of which may have potential to impact on PA in adults  with CF. The objective of this pilot randomised trial is to explore the effect of wearable technology, which is remotely monitored, combined with personalised text message feedback and goal setting, on PA in adults with CF. Secondary endpoints include lung function, aerobic capacity, quality of life, body composition, wellbeing and sleep. Methods: This is a pilot randomised trial which will be conducted at the University Hospital Limerick, Ireland. Participants will be randomised to the intervention or active comparator after their baseline assessment. The 12-week intervention will consist of wearable technology (Fitbit Charge 2) which is linked to an online monitoring system (Fitabase) that enables the physiotherapist to remotely monitor participant data. The CF physiotherapist will set individualised PA goals with each participant at baseline and will send text message feedback each week. The text messages will be personalised, one-way texts with positive reinforcement on step count attained by the participant. The active comparator group will receive this wearable technology which is also linked to Fitabase; however, no feedback will be provided to participants in this group. Both groups will be re-assessed at 12 weeks. After this point, both groups will continue with the Fitbit alone for a further 12 weeks. Both groups will be re-assessed at 24 weeks. A semi structured interview will assess satisfaction and acceptability of the intervention. Discussion: This is a novel concept which utilises modern technology, remote monitoring and personalised feedback to investigate the effect on PA  in adults with CF.  Trial registration: ClinicalTrials.gov NCT03672058 (14/09/2018)

A Newsletter/Text Message Intervention Promoting Beverage-Related Parenting Practices: Pilot Test Results

2018 ◽  
Vol 20 (6) ◽  
pp. 897-904 ◽  
Author(s):  
Arwa Zahid ◽  
Marla Reicks
Keyword(s):  
Rural Areas ◽  
Parenting Practices ◽  
Text Message ◽  
Text Messages ◽  
Potential Health ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverages ◽  
Reduce Sugar ◽  
Text Message Intervention ◽  
Home Availability

Positive beverage parenting practices may reduce sugar-sweetened beverage consumption by children and prevent potential health problems. An online newsletter/text message intervention was conducted with parents of children 6 to 12 years to improve beverage parenting practices. Newsletters and text messages were sent weekly over a 4-week period providing gain-framed messages encouraging parenting practices including role modeling and controlling home beverage availability. Pre–post surveys included measures of home availability of beverages and parent beverage intake as an indication of parenting practices. Parents were primarily White, well-educated, and female. About one third lived in rural areas. Results from 100 parents with pre–post data from baseline to 4 weeks showed decreased reported home availability of regular soda pop (p = .008), decreased parent intake of sweetened beverages (p = .004), and decreased parent-reported child intake of regular soft drinks (p = .001), and sweetened juice drink beverages (p < .0001). Most parents (82%) reported reading all three newsletters and indicated that the information provided was relevant (93%). A brief newsletter/text message intervention may be a positive and convenient approach to promote positive beverage parenting practices.

An Adaptive, Algorithm-based Text Message Intervention to Promote Health Behavior Adherence in Type 2 Diabetes: Treatment Development and Proof-of-Concept Trial

2021 ◽  
pp. 193229682110650
Author(s):  
Christopher M. Celano ◽  
Christina Massey ◽  
Jessica Long ◽  
Sonia Kim ◽  
Olivia Velasquez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Adaptive Algorithm ◽  
Controlled Trial ◽  
Text Message ◽  
Self Care ◽  
Well Being ◽  
Psychological Outcomes ◽  
Text Messages

Background: Most individuals with type 2 diabetes (T2D) struggle to adhere to one or more health behaviors. Text message interventions (TMIs) have the potential to improve adherence but have had mixed effects on diet and activity in T2D. We developed an eight-week, adaptive, algorithm-driven TMI to promote physical activity, diet, self-care, and well-being. Then, in a single-arm trial, we assessed its feasibility, acceptability, and preliminary efficacy in 15 individuals with T2D and suboptimal adherence. Methods: Participants received daily text messages and were asked to rate the utility of each message (0=not helpful, 10=very helpful). These ratings were used by an algorithm to select subsequent messages based on each participant’s prior ratings. We assessed intervention feasibility by rates of message transmission/response and acceptability through ratings of message utility and burden. Finally, we examined pre-post changes in diabetes self-care, diet, physical activity, and psychological outcomes and calculated effect sizes (Cohen’s d). Results: All text messages were delivered, and participants provided ratings for 79% of messages, above our a priori thresholds for feasibility. Participants rated the individual messages and overall TMI as subjectively useful (utility: 8.1 [SD=2.1] and 7.8 [SD=2.0], respectively) and not burdensome (burden: 0.8 [SD=1.8]). The intervention led to significant, medium- to large-sized improvements in self-care ( d=0.77), diet ( d=0.99), and activity ( d=0.61) but minimal change in psychological outcomes. Conclusions: The TMI was feasible and well-accepted, and it led to promising improvements in adherence-related outcomes. These findings should be confirmed in a larger randomized controlled trial.

Abstract P196: Personalized Dynamical System Models Of Individual Text Message Effects On Changes In Physical Activity

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sarah Hojjatinia ◽  
Constantino M Lagoa ◽  
Ashley B West ◽  
Sahar Hojjatinia ◽  
Taylor Turrisi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Emerging Adults ◽  
Systems Engineering ◽  
Computational Models ◽  
Cardiovascular Health ◽  
Decision Rules ◽  
Text Message ◽  
Text Messages ◽  
Dynamical Models ◽  
Step Counts

Introduction: Text-message interventions with universal decision rules (treatment algorithms) demonstrate modest and inconsistent effects on physical activity. Efforts to increase effect sizes by targeting, tailoring or generically customizing content have largely been unsuccessful. In this study, system identification methods from control systems engineering were applied to develop person-specific dynamical models of individual responses to motivational text messages. Methods: Emerging adults not meeting aerobic physical activity guidelines (verified by accelerometer during a 1-week run-in period) received 0-6 messages/day while wearing a Fitbit Versa watch for 3 months. Experimental messages targeted cognitive or affective determinants of physical activity (move more) or sedentary behavior (sit less); comparator messages were inspirational quotes. For each participant, two dynamical models were estimated using difference equations: one to model the effects of move more and sit less messages and the other to model the effects of affectively- and cognitively-targeted messages. Both models included comparator messages. Effects represent the expected change in behavior immediately after message receipt (vs expected behavior without a message). Model order was determined individually to balance uncertainty and overfitting (range = 2-9). Results: The sample (n = 20) was mostly female (60%), White (65%), and not Hispanic or Latino (95%) with a mean age of 24.4 years (SD = 3.3; range = 19-29). Idiographic patterns of behavior change were readily observed from the personalized dynamical models. Most participants’ step counts increased after messages to move more (60% of participants’ responses exceeded the 95% error interval [responders], M = 94.3 steps; 83% of responders increased steps) and sit less (50% responders, M = 114.6 steps; 90% of responders increased steps), as well as control messages (75% responders, M = 59.5 steps; 60% of responders increased steps). Step counts also increased after messages targeting cognitive determinants (80% responders, M = 97.1 steps; 75% of responders increased steps) and affective determinants (75% responders, M = 52.9 steps, 67% of responders increased steps), as well as control messages (75% responders, M = 57.8 steps; 60% of responders increased steps). Conclusions: Motivational text messages can alter physical activity dynamics, and responses to different message types are highly personalized. Among responders, most message types increased expected step counts but some messages were iatrogenic and decreased expected step counts. Computational models of those dynamics provide a foundation for personalizing decision rules to select the type and time the delivery of messages to promote physical activity and improve cardiovascular health.

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