scholarly journals Understanding acceptability in the context of text messages to encourage medication adherence in people with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Y. Kiera Bartlett ◽  
Cassandra Kenning ◽  
Jack Crosland ◽  
Nikki Newhouse ◽  
Lisa M. Miles ◽  
...  
Keyword(s):  
Online Survey ◽  
Text Message ◽  
Text Messages ◽  
Health Interventions ◽  
Mixed Methods Study ◽  
Proof Of Concept ◽  
Affective Attitude ◽  
Potential Tool ◽  
Surprising Finding

Abstract Background Acceptability is recognised as a key concept in the development of health interventions, but there has been a lack of consensus about how acceptability should be conceptualised. The theoretical framework of acceptability (TFA) provides a potential tool for understanding acceptability. It has been proposed that acceptability measured before use of an intervention (anticipated acceptability) may differ from measures taken during and after use (experienced acceptability), but thus far this distinction has not been tested for a specific intervention. This paper 1) directly compares ratings of anticipated and experienced acceptability of a text message-based intervention, 2) explores the applicability of the TFA in a technology-based intervention, and 3) uses these findings to inform suggestions for measuring acceptability over the lifespan of technology-based health interventions. Methods Data were obtained from a quantitative online survey assessing anticipated acceptability of the proposed text messages (n = 59) and a 12-week proof-of-concept mixed methods study assessing experienced acceptability while receiving the text messages (n = 48). Both quantitative ratings by return text message, and qualitative data from participant interviews were collected during the proof-of-concept study. Results The quantitative analysis showed anticipated and experienced acceptability were significantly positively correlated (rs > .4). The qualitative analysis identified four of the seven constructs of the TFA as themes (burden, intervention coherence, affective attitude and perceived effectiveness). An additional two themes were identified as having an important impact on the TFA constructs (perceptions of appropriateness and participants’ role). Three suggestions are given related to the importance of appropriateness, what may affect ratings of acceptability and what to consider when measuring acceptability. Conclusions The high correlation between anticipated and experienced acceptability was a surprising finding and could indicate that, in some cases, acceptability of an intervention can be gauged adequately from an anticipated acceptability study, prior to an expensive pilot or feasibility study. Directly exploring perceptions of appropriateness and understanding whether the acceptability described by participants is related to the intervention or the research - and is for themselves or others - is important in interpreting the results and using them to further develop interventions and predict future use.

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.

scholarly journals Intervention development of a brief messaging intervention for a randomised controlled trial to improve diabetes treatment adherence in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalie Leon ◽  
Hazel Namadingo ◽  
Kirsty Bobrow ◽  
Sara Cooper ◽  
Amelia Crampin ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Controlled Trial ◽  
Text Message ◽  
Intervention Development ◽  
Text Messages ◽  
Sub Saharan Africa ◽  
Diabetes Treatment ◽  
Sub Saharan ◽  
Randomised Controlled

Abstract Background Brief messaging interventions, including Short Message Service (SMS) text-messages, delivered via mobile device platforms, show promise to support and improve treatment adherence. To understand how these interventions work, and to facilitate transparency, we need clear descriptions of the intervention development process. Method We describe and reflect on the process of designing and pretesting an evidence- and theory-informed brief messaging intervention, to improve diabetes treatment adherence in sub-Saharan Africa. We followed the stepwise approach recommended by the Medical Research Council, United Kingdom (MRC UK) Framework for Development and Evaluation of Complex Health Interventions and guidance for mobile health intervention development. Results We used a four-phase, iterative approach that first generated primary and secondary evidence on the lived experience of diabetes, diabetes treatment services and mobile-phone use. Second, we designed a type 2 diabetes-specific, brief text-message library, building on our previous hypertension text-message library, as well as drawing on the primary and secondary data from phase one, and on expert opinion. We then mapped the brief text-messages onto behaviour change (COM-B) theoretical constructs. Third, we refined and finalised the newly developed brief text-message library through stakeholder consultation and translated it into three local languages. Finally, we piloted the intervention by pre-testing the automated delivery of the brief text-messages in the trial sites in Malawi and South Africa. The final SMS text Adherence suppoRt for people with type 2 diabetes (StAR2D) intervention was tested in a randomised controlled trial in Malawi and South Africa (trial registration: ISRCTN70768808). Conclusion The complexity of public health interventions requires that we give more attention to intervention development work. Our documentation and reflection on the StAR2D intervention development process promotes transparency, replicability, assessment of intervention quality, and comparison with other studies.

scholarly journals COVID-19 Pandemic: Gender difference in satisfaction with a daily supportive text message program (Text4Hope) and preference for technology-based health supports during emergencies (Preprint)

2020 ◽  
Author(s):  
Vincent Agyapong ◽  
Reham Shalaby ◽  
Wesley Vuong ◽  
Marianne Hrabok ◽  
April Gusnowski ◽  
...  
Keyword(s):  
Online Survey ◽  
Text Message ◽  
Population Level ◽  
Text Messages ◽  
Mental Wellbeing ◽  
Service Satisfaction ◽  
Depression Symptoms ◽  
Psychological Resilience ◽  
Emergency Situations ◽  
Chi Square Analysis

BACKGROUND During the unprecedented time of the COVID-19 pandemic, the need to support mental wellbeing is urgent. In March 2020, Text4Hope was provided as a community health service to Alberta residents. This free service aims to promote psychological resilience and alleviate pandemic-associated stress, anxiety, and depression symptoms. OBJECTIVE This study aimed to evaluate Text4Hope subscribers’ experience, satisfaction, and perspectives related to technology-based support during crisis or emergency situations, such as the COVID-19 pandemic, by gender. METHODS Individuals self-subscribe to Text4Hope to receive daily supportive text messages for three months. Subscribers were invited to complete an online survey at six weeks to collect service satisfaction related information. Overall satisfaction was assessed on a scale from 0 to 10 using the one sample t-test and Likert scale satisfaction responses were used to assess various aspects of the Text4Hope program. Gender differences were measured by using One-Way ANOVA test and Chi-Square analysis. RESULTS Overall service satisfaction was high (8.55/10 (SD=1.78) and more than 70% of subscribers agreed that Text4Hope helped them to cope with stress and anxiety, feel connected to a support system, manage COVID-19 related issues, and improve mental wellbeing. Similarly, subscribers agreed that messages were positive, affirmative, and succinct. Messages were read by 97.9% of respondents always or often and more than 20% returned to messages always or often. The majority of subscribers (89.3%) read the messages and either reflected upon them or took a positive action. Subscribers welcomed almost all technology-based services as part of their health care during crisis or emergency situations (70%). Text4Hope was more effective among females, who reported higher satisfaction rates and improved coping after receiving text messages. CONCLUSIONS Text4Hope successfully captured subscribers’ satisfaction and acceptance, during COVID-19 pandemic. Respondents affirmed the high quality of the messages with their positive feedback. Technology-based services can provide remotely accessible, cost-effective, and population-level interventions that align with recommended distancing practices during pandemics. Text4Hope subscriber feedback revealed high satisfaction and acceptance rates after six weeks of receiving daily messages. CLINICALTRIAL The study protocol was approved by the Research and Ethics Board of the University of Alberta (Pro00086163). INTERNATIONAL REGISTERED REPORT RR2-10.2196/19292

scholarly journals Mobile Phone Text Message Intervention on Diabetes Self-Care Activities, Cardiovascular Disease Risk Awareness, and Food Choices among Type 2 Diabetes Patients

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1314 ◽  
Author(s):  
Martha J. Nepper ◽  
Jennifer R. McAtee ◽  
Lorey Wheeler ◽  
Weiwen Chai
Keyword(s):  
Type 2 Diabetes ◽  
Intervention Group ◽  
Text Message ◽  
Self Care ◽  
Food Choices ◽  
Text Messages ◽  
Control Group ◽  
Risk Awareness ◽  
Cvd Risk

This study examines the effects of educational text messages on diabetes self-care activities, cardiovascular disease (CVD) risk awareness, and home food availabilities related to food choices among patients with type 2 diabetes. Quasi-experimental design was used with 40 patients (58.0 ± 10.6 years) in the intervention group and 39 (55.7 ± 12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks. Pre- and post-intervention measures were collected for both groups. Ninety-four percent of the participants receiving text messages indicated the usefulness of this program. The intervention group either maintained the same level or demonstrated small improvements in diabetes self-care activities after the intervention. Significant increases in scores of CVD risk awareness (57% increase; p = 0.04) and availabilities of fresh fruits (320% increase; p = 0.01) and fresh vegetables (250% increase; p = 0.02) in the home and weekly total (16% increase; p = 0.02) and moderate/vigorous (80% increase; p = 0.006) physical activity levels were observed for the intervention group relative to the control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education. The study is registered with Clinical Trials.gov (NCT03039569).

scholarly journals A remotely-delivered community action project to promote a diabetes lifestyle intervention programme in northwest London: basis, process and outcomes

2021 ◽  
Vol 11 (2) ◽  
pp. 250-255
Author(s):  
Sharan J Kapadia ◽  
Yu Gao ◽  
Ewa Cumming
Keyword(s):  
Diabetes Mellitus ◽  
Online Survey ◽  
Community Action ◽  
Text Messages ◽  
Teaching Evaluation ◽  
Information Leaflet ◽  
Intervention Programme ◽  
Phone Calls ◽  
Action Project

Background: The prevalence of type 2 diabetes mellitus (T2DM) in London is rising, obesity being a major driver. As part of a primary care placement, the authors (two medical students and a lead general practitioner) directly promoted the Reducing Weight with Intensive Dietary Support (REWIND) programme to patients in Northwest London and collected feedback on the promotion. Methods: The team developed and delivered three remote interventions: a redesigned patient-facing information leaflet, phone calls and text messages, and a live, interactive webinar, to directly engage patients and raise awareness about REWIND. Feedback was collected pre and post-webinar using an anonymised, online survey (essentially functioning as a ‘teaching’ evaluation). Results: Mean interest in REWIND had increased from 2.7 (pre-promotion) to 4.7 (post-promotion), knowledge about REWIND had increased from 2.1 to 4, and self-reported likelihood of enrolling had increased from 2.6 to 4.2 (P<0.01 in all cases). The reported usefulness of the leaflet and webinar was scored 3.7 and 4.4 respectively. Within two weeks of the webinar, two of these patients had joined REWIND. Conclusion: Feedback from the patients and GP revealed that the project successfully raised awareness, improved knowledge, and increased the likelihood of enrolment in REWIND. Diabetes programmes and organisations are encouraged to adapt the methods of this project to their own contexts, especially in light of COVID-19 where remote interventions will remain essential.

scholarly journals Preferences for the format of text messages containing results of online screening for sexually transmitted infections: a service evaluation

2018 ◽  
Vol 29 (10) ◽  
pp. 1014-1016
Author(s):  
Tom Nadarzynski ◽  
Clare Scholfield ◽  
Ynez Symonds ◽  
Cynthia Graham ◽  
Sally Kidsley
Keyword(s):  
Positive Result ◽  
Sexually Transmitted Infections ◽  
Online Survey ◽  
Text Message ◽  
Service Evaluation ◽  
Text Messages ◽  
Sexually Transmitted ◽  
Multiple Texts ◽  
To Receive ◽  
Additional Sample

We conducted an online survey to examine the preferences for receiving a text message with results of a test for sexually transmitted infections (STIs) as part of online self-sampling service at Solent NHS Trust. Findings showed that if all tests were negative, participants would prefer to receive one text message. However, in the event of a positive result, a large majority (86%) would prefer to receive a separate text with the name of the STI for which the test was positive. Similarly, three-quarters (74%) of participants would prefer to receive multiple texts indicating which test was inconclusive and required an additional sample. The results of this survey support a change of practice to sending multiple text messages with the results of online self-sampling that include the names of STIs.

A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Mobile Telephone ◽  
Future Research ◽  
Quick Method ◽  
Suicide Attempters ◽  
To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

Text Messaging as a Mental Health Treatment Intervention: A Corpus-Based Study

2019 ◽  
Author(s):  
Megan Partch ◽  
Cass Dykeman
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Text Messaging ◽  
Low Cost ◽  
Statistical Significance ◽  
Text Message ◽  
Treatment Session ◽  
Text Messages ◽  
Health Treatment ◽  
Emotional Tone

Mental health treatment providers seek high-impact and low-cost means of engaging clients in care. As such, text messaging is becoming more frequently utilized as a means of communication between provider and client. Research demonstrates that text message interventions increase treatment session attendance, decrease symptomology, and improve overall functioning. However, research is lacking related to the linguistic make up of provider communications. Text messages were collected from previously published articles related to the treatment of mental health disorders. A corpus of 39 mental health treatment text message interventions was composed totaling 286 words. Using Linguistic Inquiry and Word Count (LIWC) software, messages were analyzed for prevalence of terminology thought to enhance client engagement. Clout, demonstrating the writer’s confidence and expertise, and positive Emotional Tone were found to be at a high level within the corpus. Results demonstrated statistical significance for five linguistic variables. When compared with national blog norms derived from Twitter, Clout, Emotional Tone, and use of Biological terminology were found to be at higher rates than expected. Authenticity and Informal terminology were found at significantly lesser rates.

Efficacy and Impact of an mHealth Intervention to promote Mental Wellness for American Indian and Alaska Native Teens and Young Adults: A Randomized Controlled Trial of the BRAVE Study (Preprint)

2020 ◽  
Author(s):  
Stephanie Craig Rushing ◽  
Allyson Kelley ◽  
Sheana Bull ◽  
David Stephens ◽  
Julia Wrobel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Young Adults ◽  
Alaska Native ◽  
Help Seeking ◽  
Culturally Relevant ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
Mental Wellness

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.

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