Development and Pilot Testing of Text Messages to Reduce Sugar-Sweetened Beverage Intake in Rural Caregivers and Adolescents: A Mixed-Methods Study (Preprint)

BACKGROUND High consumption of sugar-sweetened beverages (SSB) poses significant health concerns, particularly for rural adults and adolescents. Developing innovative strategies that target caregivers as the agents of change could be a promising way to improve both caregiver and adolescent health. Sending text messages through mobile phones has been cited as an effective way to improve behavioral outcomes, although little research has been conducted in rural areas, particularly focusing on SSB intake. OBJECTIVE Targeting rural caregivers, the objectives of this two phase study were to: 1) understand caregivers’ perceptions and language preferences for SSB-related text messages to inform and refine message development and delivery, and 2) evaluate the acceptability of text messages for SSB behavior change, and examine short-term effects on SSB behaviors. METHODS A convergent mixed-methods design was used to systematically develop and pilot test text messages with caregivers in Southwest Virginia. In phase one, five focus groups that included a card-sorting activity were conducted to explore advantages/disadvantages, language preferences (i.e., tone of voice, audience, phrase preferences), and perceived use of text messages. In phase two, caregivers participated in a 5-week text message pilot trial that included weekly educational and personalized strategy messages and SSB assessments at baseline and follow-up. Before the focus groups and after completing the pilot trial, caregivers also completed a pre-post survey that assessed SSB intake, SSB home availability, and caregiver SSB-related practices. Caregivers also completed individual follow-up telephone interviews following the pilot trial. RESULTS In phase one, caregivers (n=33) reported that text messages were convenient, accessible, and easy to read. Additionally, caregivers preferred messages with empathetic and authoritative tones of voice that provided useful strategies and stayed away from using absolute words (e.g., always, never). In the phase two pilot trial (n=30), 87% of caregivers completed baseline and 77% completed follow-up assessment suggesting a high utilization rate. Other ways caregivers reported benefiting from the text messages included sharing messages with family members, friends, and coworkers (80%), making mental notes (57%), and looking back at messages as reminders (50%). Caregivers reported significant improvements in home environment, parenting practices, and rulemaking around SSB (all P <0.05). Also, the frequency of SSB intake among caregivers and adolescents significantly decreased (P <0.01). CONCLUSIONS Spending time in the formative phases of text message development helped to understand the unique perspectives and language preferences of the target population. This study also found that delivering an intervention through text messages has the potential to improve caregiver behaviors and reduce SSB intake in rural caregivers and adolescents. Findings from this study were used to develop a larger bank of text messages, which will be used in a future study testing the effectiveness of a text message intervention targeting SSB-related caregiver behaviors.

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Development and Pilot Testing of Text Messages to Help Reduce Sugar-Sweetened Beverage Intake Among Rural Caregivers and Adolescents: Mixed Methods Study

JMIR mhealth and uhealth ◽

10.2196/14785 ◽

2019 ◽

Vol 7 (7) ◽

pp. e14785

Author(s):

Maryam Yuhas ◽

Kathleen J Porter ◽

Donna-Jean P Brock ◽

Annie Loyd ◽

Brittany A McCormick ◽

...

Keyword(s):

Mixed Methods ◽

Focus Groups ◽

Phase 1 ◽

Pilot Trial ◽

Text Message ◽

Text Messages ◽

Phase 2 ◽

Rural Caregivers ◽

Caregiver Behaviors

Background A high consumption of sugar-sweetened beverages (SSBs) poses significant health concerns, particularly for rural adults and adolescents. A manner in which the health of both caregivers and adolescents can be improved is by developing innovative strategies that target caregivers as the agents of change. Sending text messages through mobile phones has been cited as an effective way to improve behavioral outcomes, although little research has been conducted in rural areas, particularly focusing on SSB intake. Objective By targeting rural caregivers, this 2-phase study aimed to (1) understand caregivers’ perceptions and language preferences for SSB-related text messages to inform and refine message development and delivery and (2) evaluate the acceptability of text messages for SSB intake behavior change and examine short-term effects on SSB intake behavior. Methods A convergent mixed methods design was used to systematically develop and pilot-test text messages with caregivers in Southwest Virginia. In phase 1, 5 focus groups that included a card-sorting activity were conducted to explore advantages/disadvantages, language preferences (ie, tone of voice, audience, and phrase preferences), and perceived use of text messages. In phase 2, caregivers participated in a 5-week text message pilot trial that included weekly educational and personalized strategy messages and SSB intake assessments at baseline and follow-up. Before the focus groups and after completing the pilot trial, caregivers also completed a pre-post survey that assessed SSB intake, SSB home availability, and caregivers’ SSB-related practices. Caregivers also completed individual follow-up telephone interviews following the pilot trial. Results In phase 1, caregivers (N=33) reported that text messages were convenient, accessible, and easy to read. In addition, they preferred messages with empathetic and authoritative tones that provided useful strategies and stayed away from using absolute words (eg, always and never). In the phase 2 pilot trial (N=30), 87% of caregivers completed baseline and 77% completed follow-up assessment, suggesting a high utilization rate. Other ways in which caregivers reported benefiting from the text messages included sharing messages with family members and friends (80%), making mental notes (57%), and looking back at messages as reminders (50%). Caregivers reported significant improvements in home environment, parenting practices, and rulemaking around SSB (P=.003, P=.02, and P=.04, respectively). In addition, the frequency of SSB intake among caregivers and adolescents significantly decreased (P=.003 and P=.005, respectively). Conclusions Spending time in the formative phases of text message development helped understand the unique perspectives and language preferences of the target population. Furthermore, delivering an intervention through text messages has the potential to improve caregiver behaviors and reduce SSB intake among rural caregivers and adolescents. Findings from this study were used to develop a larger bank of text messages, which would be used in a future study, testing the effectiveness of a text message intervention targeting SSB intake–related caregiver behaviors.

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Usability and Acceptability of a Text Message-Based Developmental Screening Tool for Young Children: Pilot Study (Preprint)

10.2196/preprints.10814 ◽

2018 ◽

Author(s):

Pamela Ryden Johnson ◽

Jessica Bushar ◽

Margaret Dunkle ◽

Sharon Leyden ◽

Elizabeth T Jordan

Keyword(s):

Focus Groups ◽

Low Income ◽

Screening Tool ◽

Text Message ◽

Text Messages ◽

Developmental Screening ◽

Screening Questions ◽

Low Income Mothers ◽

Developmental Screening Tool

BACKGROUND Only 30% of parents of children aged 9-35 months report that their child received a developmental screening in the previous year. Screening rates are even lower in low-income households, where the rates of developmental delays are typically higher than those in high-income households. Seeking to evaluate ways to increase developmental screening, Text4baby, a national perinatal texting program, created an interactive text message-based version of a validated developmental screening tool for parents. OBJECTIVE This study aimed to assess whether a text message-based developmental screening tool is usable and acceptable by low-income mothers. METHODS Low-income mothers of infants aged 8-10 months were recruited from the Women, Infants and Children Program clinics in Prince George’s County, MD. Once enrolled, participants used text messages to receive and respond to six developmental screening questions from the Parents’ Evaluation of Developmental Status: Developmental Milestones. After confirming their responses, participants received the results and feedback. Project staff conducted a follow-up phone survey and invited a subset of survey respondents to attend focus groups. A representative of the County’s Infants and Toddlers Program met with or called participants whose results indicated that their infants “may be behind.” RESULTS Eighty-one low-income mothers enrolled in the study, 93% of whom reported that their infants received Medicaid (75/81). In addition, 49% of the mothers were Hispanic/Latina (40/81) and 42% were African American (34/81). A total of 80% participated in follow-up surveys (65/81), and 14 mothers attended focus groups. All participants initiated the screening and responded to all six screening questions. Of the total, 79% immediately confirmed their responses (64/81), and 21% made one or more changes (17/81). Based on the final responses, 63% of participants received a text that the baby was “doing well” in all six developmental domains (51/81); furthermore, 37% received texts listing domains where their baby was “doing well” and one or more domains where their baby “may be behind” (30/81). All participants received a text with resources for follow-up. In a follow-up survey reaching 65 participants, all respondents said that they would like to answer screening questions again when their baby was older. All but one participant would recommend the tool to a friend and rated the experience of answering questions and receiving feedback by text as “very good” or “good.” CONCLUSIONS A mobile text version of a validated developmental screening tool was both usable and acceptable by low-income mothers, including those whose infants “may be behind.” Our results may inform further research on the use of the tool at older ages and options for a scalable, text-based developmental screening tool such as that in Text4baby.

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A text-message intervention for adolescents with depression and their parent/caregiver to overcome cognitive barriers to mental health treatment initiation: Focus groups and a pilot trial (Preprint)

10.2196/preprints.30580 ◽

2021 ◽

Author(s):

Brian Suffoletto ◽

Tina Goldstein ◽

David Brent

Keyword(s):

Mental Health ◽

Focus Groups ◽

Mental Health Treatment ◽

Phase 1 ◽

Pilot Trial ◽

Text Message ◽

Phase 2 ◽

Test Engagement ◽

Text Message Intervention

BACKGROUND Many adolescents with depression do not pursue mental health (MH) treatment following referral by a heathcare provider. We developed a theory-based automated text message intervention (Text to Connect, T2C) that attempts to reduce cognitive barriers to initiation of MH care. OBJECTIVE In this 2-phase study, we sought to first understand potential for T2C and then test engagement, usability, and potential efficacy of T2C among adolescents with depression and their parent/caregiver. METHODS In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parent/caregiver (n=9) separately and transcripts were examined for themes. In phase 2, we conducted an open trial of T2C with adolescents with depression referred to MH care (n=43) and their parent/caregiver (n=28). We assessed usability by examining program engagement, usability ratings and qualitative feedback at 4-weeks follow-up. We assessed potential effectiveness by examining change in perceived barriers to treatment and MH care initiation from baseline to 4-weeks. RESULTS In phase 1, we found that themes supported the T2C approach. In phase 2, we found high engagement with daily negative affect check-ins, high usability ratings, and self-reported decreases in barriers to MH treatment over time among adolescents. At 4-weeks follow-up, most adolescents reported either having initiated MH care (52%) or pending scheduling (15%), leaving only 15% of adolescents still not interested in MH care. CONCLUSIONS Findings from this study suggest that T2C is acceptable to adolescents with depression and most parent/caregivers, is used at high rates, and may be helpful to reduce cognitive barriers to MH care initiation. CLINICALTRIAL NCT04560075

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MyDiaText™: Feasibililty and Functionality of a Text Messaging System for Youth With Type 1 Diabetes

The Diabetes Educator ◽

10.1177/0145721719837895 ◽

2019 ◽

Vol 45 (3) ◽

pp. 253-259 ◽

Cited By ~ 3

Author(s):

Tara Kaushal ◽

Kathleen A. Montgomery ◽

Reid Simon ◽

Kelly Lord ◽

Jennifer Dougherty ◽

...

Keyword(s):

Type 1 Diabetes ◽

User Satisfaction ◽

Text Messaging ◽

Pilot Trial ◽

Text Message ◽

Text Messages ◽

Support Tool ◽

Reading Text

Purpose The purpose of this study was to determine the feasibility and functionality of MyDiaText™, a website and text messaging platform created to support behavior change in adolescents with type 1 diabetes (T1DM) and to evaluate user satisfaction of the application. Methods This study was a nonrandomized, prospective, pilot trial to test the feasibility and user interface with MyDiaText, a text message system for 10- to 17-year-old youths with newly diagnosed T1DM. Feasibility was evaluated by assessing for the user’s ability to create a profile on the website. Functionality was defined by assessing whether a subject responded to at least 2 text messages per week and by their accumulating points on the website. User satisfaction of the text messaging system was assessed using an electronic survey. The 4 phases of this study were community engagement—advisory sessions, screening and enrollment, intervention, and follow-up. Results Twenty subjects (14 male, 6 female) were enrolled. All subjects were able to create a profile, and of these, 86% responded to at least 2 text messages per week. A survey administered during follow-up showed that users enjoyed reading text messages, found them useful, and thought the frequency of messages was appropriate. Conclusion MyDiaText is a feasible, functional behavioral support tool for youth with T1DM. Users of the application reported high satisfaction with text messages and the reward system.

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

Crisis ◽

10.1027/0227-5910/a000017 ◽

2010 ◽

Vol 31 (2) ◽

pp. 109-112 ◽

Cited By ~ 35

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.

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Recovery Following Peer and Text Messaging Support after Discharge from Acute Psychiatric Care: A Randomized Controlled Pilot Trial (Preprint)

10.2196/preprints.27137 ◽

2021 ◽

Author(s):

Reham Shalaby ◽

Marianne Hrabok ◽

Pamela Spurvey ◽

Rabab M. Abou El-Magd ◽

Michelle Knox ◽

...

Keyword(s):

Peer Support ◽

Text Messaging ◽

Psychiatric Care ◽

Text Message ◽

Text Messages ◽

Treatment As Usual ◽

Usual Condition ◽

Randomized Controlled ◽

Acute Psychiatric Care

BACKGROUND Peer support (PS) is emotional, social, and practical help that is provided by non-professionals to assist others in sustaining health behaviours. PS is valued in recovery-oriented models of mental health and is becoming implemented increasingly at the organizational level. Text messaging is a relatively low cost, high impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users. OBJECTIVE This study aims to evaluate the effect of an innovative peer support system plus supportive text messaging program on the recovery of discharged patients from acute psychiatric care. METHODS This is a prospective, rater-blinded, pilot randomized controlled trial, including 180 patients discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages, peer-support only, or peer-support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale; RAS) was completed at baseline, six weeks, three months, and six months. Descriptive analysis, One-Way ANOVA, and repeated measures MANCOVA were deployed to examine the changes in RAS among the study groups and over the follow-up time points. RESULTS Sixty-five patients completed assessments at each time-point. For the overall sample, higher scores were found for the peer-support plus text message condition compared to the text message only and treatment as usual condition on several scales (i.e., Willingness to ask for help and Personal Confidence and Hope) and total score on the RAS. CONCLUSIONS Peer support plus supportive text messaging results in improved recovery compared to other interventions. It is advisable to incorporate the two interventions as a part of routine practice for patients with psychiatric disorders upon their hospital discharge. CLINICALTRIAL The study received ethical approval from the Health Ethics Research Board of the University of Alberta (Ref # Pro00078427) and operational approval from the Alberta Health Services regional health authority. All patients provided written informed consent. The study was registered with clinicaltrials.gov (Trial registration number NCT03404882).

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How Acceptable Is A Wireless Pill Bottle That Monitors and Texts In Response To Missed Doses: Focus Groups With Young African American MSM Living With HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1060 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S422-S422 ◽

Cited By ~ 3

Author(s):

Mark Dworkin ◽

Palak Panchal ◽

Antonio Jimenez ◽

Robert Garofalo ◽

Jessica E Haberer ◽

...

Keyword(s):

African American ◽

Focus Groups ◽

Technology Acceptance ◽

Text Message ◽

Social Contact ◽

Case Manager ◽

Text Messages ◽

Pill Bottle ◽

African American Msm ◽

Living With Hiv

Abstract Background African American MSM (AAMSM) living with HIV are less likely to have viral suppression than other racial groups. Wisepill, a wireless pill bottle, transmits a cellular signal to a server when opened and is designed to measure antiretroviral therapy (ART) adherence. The objective of this study was to explore the acceptability of a proposed intervention in these young AAMSM using the Wisepill device opening data to trigger a real-time text alert that ART may not have been taken during a planned time to either the user, a trusted social contact, or a healthcare worker, depending on the duration of consecutively missed doses (1 dose, 3 doses, 7 doses, respectively). Methods From December 2016 – May 2017, AAMSM living with HIV age 18–34 years (N = 25) participated in a study that included five focus groups (n = 23) and one on one interviews (n = 2). We performed theory-based discussion grounded in the Technology Acceptance Model. Specifically, we explored usefulness, convenience, concerns, and intention to use. Results Fifty-two percent missed at least one dose in the 4 days prior to the focus group meeting. Almost all participants (94%) favored the idea of a wireless pill bottle monitor and linked text message notification that ART may have been missed. The device was considered convenient for use at home or in a backpack, but too large for a pocket. Stigma and privacy were common concerns. For example, participants did not want to carry the device with them if the pills would “sound like a walking pharmacy” and did not want a text message that said, “You missed your HIV meds.” They preferred text message notifications that ranged from emoji icons to cryptic short texts and wanted to receive an email as a backup plan. Most believed that the device appearance would not gain unwanted attention. Thirty percent of the participants identified a partner as a social contact to whom the 3-day missed dose reminders would be sent whereas others designated their mother, aunt, brother, friend, pastor, and case-manager. Conclusion An adherence intervention using a wireless pill bottle monitoring device linked to text notifications was acceptable to most of the young AAMSM in this study. Acceptability may be enhanced by personalization of the responsive text messages and a backup email option. Disclosures J. E. Haberer, Merck: Consultant, Consulting fee; Natera: Shareholder, Stock ownership

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Feasibility and Acceptability of a Physical Activity Tracker and Text Messages to Promote Physical Activity During Chemotherapy for Colorectal Cancer: Pilot Randomized Controlled Trial (Smart Pace II)

JMIR Cancer ◽

10.2196/31576 ◽

2022 ◽

Vol 8 (1) ◽

pp. e31576

Author(s):

Erin L Van Blarigan ◽

Anand Dhruva ◽

Chloe E Atreya ◽

Stacey A Kenfield ◽

June M Chan ◽

...

Keyword(s):

Physical Activity ◽

Digital Health ◽

Controlled Trial ◽

Text Message ◽

Text Messages ◽

Walk Test ◽

Randomized Controlled ◽

6 Minute Walk Test ◽

Minute Walk

Background We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate-to-vigorous physical activity in patients with colorectal cancer (CRC) during chemotherapy. Objective This study aimed to determine whether a digital health physical activity intervention is feasible and acceptable during chemotherapy for CRC. Methods Potentially eligible patients with CRC expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco, and on the web through advertising. Eligible patients were randomized 1:1 to a 12-week intervention (Fitbit Flex, automated SMS text messages) versus usual care. At 0 and 12 weeks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-minute walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-minute walk test outcomes were masked. The primary outcomes were adherence (eg, Fitbit wear and text response rate) and self-assessed acceptability of the intervention. The intervention would be considered feasible if we observed at least 80% complete follow-up and 70% adherence and satisfaction, a priori. Results From 2018 to 2020, we screened 240 patients; 53.3% (128/240) of patients were ineligible and 26.7% (64/240) declined to participate. A total of 44 patients (44/240, 18%) were randomized to the intervention (n=22) or control (n=22) groups. Of these, 57% (25/44) were women; 68% (30/44) identified as White and 25% (11/44) identified as Asian American or Pacific Islander; and 77% (34/44) had a 4-year college degree. The median age at enrollment was 54 years (IQR 45-62 years). Follow-up at 12 weeks was 91% (40/44) complete. In the intervention arm, patients wore Fitbit devices on a median of 67 out of 84 (80%) study days and responded to a median of 17 out of 27 (63%) questions sent via SMS text message. Among 19 out of 22 (86%) intervention patients who completed the feedback survey, 89% (17/19) were satisfied with the Fitbit device; 63% (12/19) were satisfied with the SMS text messages; 68% (13/19) said the SMS text messages motivated them to exercise; 74% (14/19) said the frequency of SMS text messages (1-3 days) was ideal; and 79% (15/19) said that receiving SMS text messages in the morning and evening was ideal. Conclusions This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored SMS text message content. Studies with more socioeconomically diverse patients with CRC are required. Trial Registration ClinicalTrials.gov NCT03524716; https://clinicaltrials.gov/ct2/show/NCT03524716

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Translatability of a Wearable Technology Intervention to Increase Adolescent Physical Activity: Mixed Methods Implementation Evaluation

Journal of Medical Internet Research ◽

10.2196/13573 ◽

2020 ◽

Vol 22 (8) ◽

pp. e13573

Author(s):

Harriet Koorts ◽

Jo Salmon ◽

Anna Timperio ◽

Kylie Ball ◽

Susie Macfarlane ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Behavior Change ◽

Focus Groups ◽

Wearable Technology ◽

Text Messages ◽

System Level ◽

Socioeconomically Disadvantaged ◽

Web Based ◽

Perceived Impact

Background Wearable technology interventions combined with digital behavior change resources provide opportunities to increase physical activity in adolescents. The implementation of such interventions in real-world settings is unknown. The Raising Awareness of Physical Activity (RAW-PA) study was a 12-week cluster randomized controlled trial targeting inactive adolescents attending schools in socioeconomically disadvantaged areas of Melbourne, Australia. The aim was to increase moderate- to vigorous-intensity physical activity using (1) a wrist-worn Fitbit Flex and app, (2) weekly challenges, (3) digital behavior change resources, and (4) email or text message alerts. Objective This paper presents adolescents’ and teachers’ perceptions of RAW-PA in relation to program acceptability, feasibility and perceived impact, adolescent engagement and adherence, and the potential for future scale-up. Methods A mixed methods evaluation of the RAW-PA study assessed acceptability, engagement, feasibility, adherence, and perceived impact. A total of 9 intervention schools and 144 intervention adolescents were recruited. Only adolescents and teachers (n=17) in the intervention group were included in the analysis. Adolescents completed web-based surveys at baseline and surveys and focus groups postintervention. Teachers participated in interviews postintervention. Facebook data tracked engagement with web-based resources. Descriptive statistics were reported by sex. Qualitative data were analyzed thematically. Results Survey data were collected from 142 adolescents at baseline (mean age 13.7 years, SD 0.4 years; 51% males) and 132 adolescents postintervention. A total of 15 focus groups (n=124) and 9 interviews (n=17) were conducted. RAW-PA had good acceptability among adolescents and teachers. Adolescents perceived the intervention content as easy to understand (100/120, 83.3%) and the Fitbit easy to use (112/120; 93.3%). Half of the adolescents perceived the text messages to be useful (61/120; 50.8%), whereas 47.5% (57/120) liked the weekly challenges and 38.3% (46/120) liked the Facebook videos. Facebook engagement declined over time; only 18.6% (22/118) of adolescents self-reported wearing the Fitbit Flex daily postintervention. Adolescents perceived the Fitbit Flex to increase their physical activity motivation (85/120, 70.8%) and awareness (93/119, 78.2%). The web-based delivery facilitated implementation of the intervention, although school-level policies restricting phone use were perceived as potential inhibitors to program roll-out. Conclusions RAW-PA showed good acceptability among adolescents attending schools in socioeconomically disadvantaged areas and their teachers. Low levels of teacher burden enhanced their perceptions concerning the feasibility of intervention delivery. Although adolescents perceived that RAW-PA had short-term positive effects on their motivation to be physically active, adolescent adherence and engagement were low. Future research exploring the feasibility of different strategies to engage adolescents with wearable technology interventions and ways of maximizing system-level embeddedness of interventions in practice would greatly advance the field.

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Pre-notification and personalisation of text-messages to retain participants in a smoking cessation pregnancy RCT: an embedded randomised factorial trial

F1000Research ◽

10.12688/f1000research.51964.1 ◽

2021 ◽

Vol 10 ◽

pp. 637

Author(s):

Elizabeth Coleman ◽

Rachel Whitemore ◽

Laura Clark ◽

Karen Daykin ◽

Miranda Clark

Keyword(s):

Smoking Cessation ◽

Text Message ◽

Text Messages ◽

Completion Rate ◽

Factorial Trial ◽

Study Within A Trial ◽

Early Text ◽

Secondary Outcomes ◽

Randomised Controlled

Background: Low response rates in randomised controlled trials can compromise the reliability of the results, so ways to boost retention are often implemented. Although there is evidence to suggest that sending a text message to participants increases retention, there is little evidence around the timing or personalisation of these messages. Methods: A two-by-two factorial SWAT (study within a trial) was embedded within the MiQuit-3 trial, looking at smoking cessation within pregnant smokers. Participants who reached their 36-week gestational follow-up were randomised to receive a personalised or non-personalised text message, either one week or one day prior to the telephone follow-up. Primary outcomes were completion rate of questionnaire via telephone. Secondary outcomes included: completion rate via any method, time to completion, and number of reminders required. Results In total 194 participants were randomised into the SWAT; 50 to personalised early text, 47 to personalised late text, 50 to non-personalised early text, and 47 to non-personalised late text. There was no evidence that timing of the text message (early: one week before; or late: one day before) had an effect on any of the outcomes. There was evidence that a personalised text would result in fewer completions via telephone compared with a non-personalised text (adjusted OR 0.44, 95% CI 0.22–0.87, p=0.02). However, there was no evidence to show that personalisation or not was better for any of the secondary outcomes. Conclusion Timing of the text message does not appear to influence the retention of participants. Personalisation of a text message may be detrimental to retention; however, more SWATs should be undertaken in this field.

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