Image-Based Dietary Assessment and Tailored Feedback Using Mobile Technology: Mediating Behavior Change in Young Adults

Assessing the implementation of nutrition interventions is important to identify characteristics and dietary patterns of individuals who benefit most. The aim was to report on young adults’ experiences of receiving dietary feedback text messaging intervention. Diet was captured using an image-based 4-day mobile food recordTM application (mFRTM) and assessed to formulate two tailored feedback text messages on fruit and vegetables and energy-dense nutrient-poor (EDNP) foods and beverages. At 6-months 143 participants completed a second mFRTM and a questionnaire evaluating the dietary feedback. Participants who agreed the text messages made them think about how much vegetables they ate were more likely to increase their intake by at least half a serve than those who disagreed [odds ratio (OR) = 4.28, 95% Confidence Interval (CI): 1.76 to 10.39]. Those who agreed the text messages made them think about how much EDNP foods they ate, were twice as likely to decrease their intake by over half a serve (OR = 2.39, 95%CI: 1.12 to 5.25) than those who disagreed. Undertaking detailed dietary assessment ensured the tailored feedback was constructive and relevant. Personal contemplation about vegetable and EDNP food intake appears to be a mediator of dietary change in young adults.

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Promoting Antenatal Care Attendance Through a Text Messaging Intervention in Samoa: Quasi-Experimental Study

JMIR mhealth and uhealth ◽

10.2196/15890 ◽

2020 ◽

Vol 8 (6) ◽

pp. e15890

Author(s):

Jessica L Watterson ◽

Diego Castaneda ◽

Caricia Catalani

Keyword(s):

Data Analysis ◽

Maternal Health ◽

Antenatal Care ◽

Pregnant Women ◽

Text Messaging ◽

Individual Characteristics ◽

Text Messages ◽

Quasi Experimental ◽

Text Messaging Intervention ◽

Sms Text Messaging

Background Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. Objective This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. Methods This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. Results The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (P=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. Conclusions These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.

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Exploring Potential Factors in Sticker Use Among Japanese Young Adults

International Journal of Virtual Communities and Social Networking ◽

10.4018/ijvcsn.2018040101 ◽

2018 ◽

Vol 10 (2) ◽

pp. 1-23

Author(s):

Shogo Kato ◽

Yuuki Kato ◽

Yasuyuki Ozawa

Keyword(s):

College Students ◽

Young Adults ◽

Text Messaging ◽

Text Messages ◽

Perceived Usefulness ◽

Nonverbal Cues ◽

Potential Factors

In text-based communication, people can now use not only emoticons and emoji, but also graphical symbols called stickers. This study focused on the use of stickers in text-based communication. A questionnaire asking subjects to individually rate the perceived usefulness of 25 features of stickers was prepared and used in a survey targeting 211 Japanese college students. The authors then explored potential factors in the roles of stickers. The study revealed three potential roles of stickers: “easy transmission of subtle nuances and nonverbal cues,” “abundant and versatile expressions that can be substituted for text messages,” and “changing the topic, flow, or rationale of the interaction.” The authors examined the effects of gender and text messaging dependency on these roles. Results showed significant effects of dependency in all roles, but effects of gender were seen in only “abundant and versatile expressions that can be substituted for text messages.”

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A Culturally Adapted SMS Text Messaging Intervention to Promote Antiretroviral Therapy Adherence Among African Americans: Protocol for a Single-Arm Trial

JMIR Research Protocols ◽

10.2196/21592 ◽

2020 ◽

Vol 9 (12) ◽

pp. e21592

Author(s):

Maulika Kohli ◽

Elizabeth C Pasipanodya ◽

Jessica L Montoya ◽

Maria Marquine ◽

Martin Hoenigl ◽

...

Keyword(s):

African American ◽

African Americans ◽

Text Messaging ◽

Text Messages ◽

Hiv Care ◽

Virologic Suppression ◽

Art Adherence ◽

Culturally Tailored ◽

Text Messaging Intervention ◽

Sms Text Messaging

Background African Americans are disproportionally affected by HIV and have poorer rates of antiretroviral therapy (ART) adherence compared to other racial or ethnic groups in the United States. Factors associated with poor HIV disease outcomes are commonly associated with sociostructural barriers that prevent engagement with and retention in HIV care. SMS text messaging interventions to promote ART adherence among predominantly non-Hispanic White persons with HIV (PWH) have been shown to be efficacious; however, limited research has been devoted to culturally tailoring interventions for underrepresented racial/ethnic groups. Considering African Americans show poorer engagement along the HIV care continuum, we developed an individualized and culturally tailored two-way SMS text messaging intervention to improve ART adherence and associated virologic suppression among African American PWH. Objective In this paper we describe the protocol of a culturally tailored individualized Texting for Adherence Building (iTAB) intervention in a 24- to 48-week, single-arm study. Methods We developed a culturally tailored iTAB intervention, which we are implementing in a 24- to 48-week, single-arm study. Participants were recruited from the Family Health Centers of San Diego (FHCSD), a federally qualified health center. Patient inclusion criteria were (1) receiving care at the FHCSD, (2) living with HIV, (3) self-identification as Black, African American, or of African ancestry, (4) English speaking, (5) age 18 or older, (6) currently on ART, and (7) able to provide informed consent. Study enrollment began in November 2017 and closed in July 2019. A total of 90 participants from the FHCSD enrolled in the iTAB intervention, and we anticipate completing data collection in July 2020. Participants were assisted in individualizing and customizing their SMS text message preferences at the baseline study visit. Self-assessment measures are collected at baseline, interim, and final study visits. Problems related to sending/receiving SMS text messages and barriers to ART adherence are assessed at each interim study visit. The FHCSD staff monitors and tracks participants’ daily SMS text message responses to ART adherence reminders using a clinical dashboard. Results We hypothesize that the proportion of individuals achieving HIV virologic suppression (viral load <40 copies/mL) will be greater at the end of the intervention period compared to the proportion prior to study implementation. Additionally, we anticipate that rates of virologic suppression at the end of the intervention among participants receiving iTAB will be comparable to those among the general FHCSD non-African American population who did not receive iTAB. Finally, we anticipate a high response rate to iTAB SMS text messages as well as positive participant feedback at the end of the intervention with regard to the acceptability of, satisfaction with, and perceived efficacy of iTAB. Conclusions The iTAB intervention is a novel individualized two-way SMS text messaging intervention that has been culturally tailored for use among African Americans with HIV. We anticipate that iTAB will demonstrate efficacy in future randomized control trials and will be supportive of medication adherence among other populations facing health disparities. International Registered Report Identifier (IRRID) DERR1-10.2196/21592

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Testing the feasibility and acceptability of a religiously-tailored text messaging intervention to reduce smoking among Somali Muslim men during Ramadan

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa260 ◽

2020 ◽

Author(s):

Rebekah Pratt ◽

Olamide Ojo-Fati ◽

Diana DuBois ◽

Kolawole Okuyemi ◽

Amanda L Graham ◽

...

Keyword(s):

Text Messaging ◽

Intervention Strategy ◽

Smoking Behavior ◽

Text Message ◽

Text Messages ◽

Smoking Reduction ◽

Muslim Men ◽

Quitting Smoking ◽

Text Message Intervention ◽

Text Messaging Intervention

Abstract Introduction The prevalence of smoking among Somali Muslim male immigrants residing in Minnesota is estimated at 44%, however smoking reduction is common during the month of Ramadan. This study evaluated the feasibility and impact of a religiously-tailored text message intervention delivered during Ramadan to encourage smoking reduction among Somali Muslim men who smoke. Methods 50 Somali men were recruited. Participants received two text messages per day starting one week prior to and throughout the month of Ramadan. Approximately half were religiously-tailored and half were about the risks of smoking and benefits of quitting. Smoking behavior was assessed at baseline, and at weeks 4 (end of Ramadan), 8, and 16. Outcomes included feasibility, acceptability, and preliminary impact of the text message intervention on smoking reduction and bio-verified abstinence. Results The average age was 41 years. Average time to first cigarette was 1.8 hours at baseline, and 46% of participants smoked menthol cigarettes. Eighteen of 50 participants selected English and 32 selected Somali text messages. Subjects significantly reduced self-reported cigarettes per day (CPD) from 12.4 CPD at baseline to 5.8 CPD at Week 16 (p<0.001). Seven subjects reported quitting at week 16, five completed CO testing, confirming self-reported abstinence. The majority of participants found the cultural and religious references encouraging at the end of the week 16 survey. Conclusions Religiously-tailored text messages to decrease smoking are feasible and acceptable to Somali Muslim men who smoke during Ramadan. This intervention for addressing smoking disparities is worthy of further study. Implications Recruitment of Somali Muslim men who smoke is feasible and supports the idea that further studies targeting smoking during Ramadan are practical. Ramadan presents a window of opportunity upon which to build smoking cessation interventions for smokers who identify as Muslim. These preliminary findings suggest that text messaging is a feasible and acceptable intervention strategy, and that religious tailoring was well received. Such an approach may offer potential for addressing smoking disparities among Somali Muslim male smokers.

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Feasibility and acceptability of a pilot tailored text messaging intervention for adolescents and young adults completing cancer treatment

Psycho-Oncology ◽

10.1002/pon.5287 ◽

2019 ◽

Vol 29 (1) ◽

pp. 164-172 ◽

Cited By ~ 2

Author(s):

Lisa A. Schwartz ◽

Lauren C. Daniel ◽

Dare Henry‐Moss ◽

Christopher P. Bonafide ◽

Yimei Li ◽

...

Keyword(s):

Young Adults ◽

Cancer Treatment ◽

Text Messaging ◽

Adolescents And Young Adults ◽

Text Messaging Intervention

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Using graphic text-messaging to promote smoking cessation among first-generation Chinese and Korean male immigrants

Health Education Research ◽

10.1093/her/cyz006 ◽

2019 ◽

Vol 34 (3) ◽

pp. 332-344

Author(s):

Xiaoquan Zhao ◽

Emily B Peterson ◽

Kyeung Mi Oh ◽

Xiaomei Cai

Keyword(s):

Smoking Cessation ◽

Text Messaging ◽

First Generation ◽

The United States ◽

Text Messages ◽

Washington Dc ◽

Promote Smoking Cessation ◽

Text Messaging Intervention ◽

Expired Air

Abstract First-generation Chinese and Korean male immigrants in the United States are at high risk for tobacco use. This study pilot-tested a graphic, native-language text-messaging intervention to promote smoking cessation among these groups. First-generation Chinese and Korean male immigrant smokers (N = 71) were recruited from the Washington DC area. Participants were randomly assigned to one of four conditions based on a between-subjects 2 (graphic plus text or text-only messages) ï¿½ 2 (quitline information or quitting tips) design. The text-messaging intervention included 30 text messages in total and lasted one month. Participants completed an expired air carbon monoxide (CO) assessment and self-reported measures at both baseline and follow-up. Results show that, from baseline to follow-up, participants’ expired air CO levels decreased significantly (P = 0.001). Attitude toward quitting also became more positive (P = 0.028). Compared with text-only messages, graphic text messages produced greater positive changes in quitting attitudes (P = 0.039) and elicited greater fear response (P = 0.005). Compared with quitting tip messages, quitline information resulted in greater regret (P = 0.016) and fear (P = 0.051). These findings suggest that graphic text-messaging can be an effective method to promote smoking cessation among first-generation Chinese and Korean male immigrants.

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Maternal Obesity Management Using Mobile Technology: A Feasibility Study to Evaluate a Text Messaging Based Complex Intervention during Pregnancy

Journal of Obesity ◽

10.1155/2015/814830 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 30

Author(s):

Hora Soltani ◽

Alexandra M. S. Duxbury ◽

Madelynne A. Arden ◽

Andy Dearden ◽

Penny J. Furness ◽

...

Keyword(s):

Mobile Technology ◽

Complex Intervention ◽

Text Messaging ◽

Maternal Obesity ◽

Comparison Group ◽

Healthy Lifestyle ◽

Negative Impact ◽

Text Messages ◽

Obese Women ◽

Obesity Management

Background. Maternal obesity and excessive gestational weight gain (GWG) are on the rise with negative impact on pregnancy and birth outcomes. Research into managing GWG using accessible technology is limited. The maternal obesity management using mobile technology (MOMTech) study aimed at evaluating the feasibility of text messaging based complex intervention designed to support obese women (BMI ≥ 30) with healthier lifestyles and limit GWG.Methods. Participants received two daily text messages, supported by four appointments with healthy lifestyle midwife, diet and activity goal setting, and self-monitoring diaries. The comparison group were obese mothers who declined to participate but consented for their routinely collected data to be used for comparison. Postnatal interviews and focus groups with participants and the comparison group explored the intervention’s acceptability and suggested improvements.Results. Fourteen women completed the study which did not allow statistical analyses. However, participants had lower mean GWG than the comparison group (6.65 kg versus 9.74 kg) and few (28% versus 50%) exceeded the Institute of Medicine’s upper limit of 9 kg GWG for obese women.Conclusions. MOMTech was feasible within clinical setting and acceptable intervention to support women to limit GWG. Before further trials, slight modifications are planned to recruitment, text messages, and the logistics of consultation visits.

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A Mentor-Led Text-Messaging Intervention Increases Intake of Fruits and Vegetables and Goal Setting for Healthier Dietary Consumption among Rural Adolescents in Kentucky and North Carolina, 2017

Nutrients ◽

10.3390/nu11030593 ◽

2019 ◽

Vol 11 (3) ◽

pp. 593 ◽

Cited By ~ 2

Author(s):

Alison Gustafson ◽

Stephanie Jilcott Pitts ◽

Kristen McQuerry ◽

Oyinlola Babtunde ◽

Janet Mullins

Keyword(s):

North Carolina ◽

Goal Setting ◽

Text Messaging ◽

Vegetable Intake ◽

Text Messages ◽

Fruit And Vegetable Intake ◽

Rural Adolescents ◽

Fruit And Vegetable ◽

Intervention Effect ◽

Text Messaging Intervention

Introduction—Text-messaging interventions hold promise for successful weight loss interventions. However, there is limited research on text-messaging interventions to improve dietary intake among rural adolescents, who are at greater risk for obesity and related risk factors. The goal of this study was to test an eight-week, mentor-led text-messaging intervention among 14–16-year-old rural adolescents: the “Go Big and Bring It Home” Project to improve fruit and vegetable and healthy beverage intake. Methods and Materials—Eight rural high schools in eastern Kentucky and eastern North Carolina participated (n = 4 were randomized as intervention schools and n = 4 were randomized as control schools). Adolescents were recruited to participate in the eight-week text-messaging intervention. The text messages were primarily affective messages, and included a weekly challenge related to consuming fruits, vegetables, or healthy/low-calorie beverages. Undergraduate nutrition students sent text messages on Tuesday and Saturday every week over the eight-week period via the “Group Me” mobile application. Delayed controls received no information or text messages during the eight-week intervention. Fruit and vegetable intake was measured with the National Cancer Institute Fruit and Vegetable screener and beverage intake was assessed using the Beverage Questionnaire-10 (BEVQ-10). Intention-to-treat analyses were conducted among all those that completed the baseline and post-intervention survey (n = 277 intervention students and n = 134 delayed control students). All linear regression models were adjusted for race and were clustered on school to control for intraclass correlation. Results—In adjusted analyses, there was a statistically significant positive intervention effect on the primary outcome of fruit and vegetable servings/day with a mean difference between intervention and control participants of 1.28 servings/day (95% Confidence Interval 1.11, 1.48). There was no intervention effect on beverage intake. There was a statistically significant increase in the odds of goal setting for healthier dietary behaviors among intervention participants relative to controls. Conclusion—An eight-week text-messaging intervention led to increases in self-reported fruit and vegetable intake and improvements in goal setting for healthier dietary behaviors. Due to the use of undergraduate students to deliver the messages, and use of an existing web application, this text-messaging intervention can be sustained in underserved, rural environments. Thus there is potential for significant reach and public health impact to improve dietary patterns.

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Text message reminders as an adjunct to a substance use intervention for adolescents and young adults: Pilot feasibility and acceptability findings

Digital Health ◽

10.1177/2055207620965052 ◽

2020 ◽

Vol 6 ◽

pp. 205520762096505

Author(s):

Frank J Schwebel ◽

Mary E Larimer

Keyword(s):

Substance Use ◽

Young Adults ◽

Drug Use ◽

Text Messaging ◽

Text Message ◽

Text Messages ◽

Adolescents And Young Adults ◽

Message Content ◽

Acceptable Method ◽

Pilot Intervention

Objective Text messaging has been proposed as a method for increasing the reach of interventions for harmful alcohol and other drug use. This paper describes the design of an automated text messaging adjunct to a substance use intervention intended to support adolescents and young adults attempting to change their alcohol and other drug use behavior. Feasibility and acceptability testing was conducted as part of this pilot study. Method Five focus groups were conducted to refine text message content and finalize pilot intervention design. Automated, daily, substance use-related reminder text messages were sent to pilot intervention participants ( n = 39), who were recruited from outpatient treatment. Results Of those who were invited, 63% enrolled in the study and 89.7% remained enrolled in the study as measured by completing at least one assessment after baseline. Participants reported a positive experience with the messages, particularly supportive/empowering messages and commitment reminder messages. Conclusions These findings suggest that text messaging is a feasible and acceptable method for delivery of substance use-related reminder content as an adjunct to substance use intervention.

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