An overwhelming majority of surveyed people who enrolled in the customized texting service txt4health, piloted last year in Detroit and Cincinnati, said the free mobile education program made them more aware of their diabetes risk and more likely to make diet-related behavior changes and lose weight, according to two studies.
The service also was launched in New Orleans, but those participants were not included in the studies, which were conducted by researchers with the University of Michigan.
While the program seemed to work well for those who completed it, only 39% stuck through all 14 weeks, the researchers reported in a pair of studies published Dec. 19 on the website of the Journal of Medical Internet Research.
We found that this method of health intervention had potential to significantly influence peoples health habits and have great reach, Lorraine R. Buis, PhD, lead author of the studies and an assistant professor in the Department of Family Medicine at the U-M Medical School, said in a news release. However, sustained participant engagement across the 14 weeks was lower than desired.
Its clear that a text message program may not be appropriate for everyone. However, for a large subset of people, this may be a feasible, acceptable and useful strategy to motivate positive behavior changes.
Of 160 participants surveyed for the study, most reported that after completing the program, they were more likely to replace sugary drinks with water (78%), have a piece of fresh fruit instead of dessert (74%), substitute a small salad for chips or fries when dining out (76%), buy healthier foods when grocery shopping (80%) and eat more grilled, baked or broiled foods instead of fried (76%).
Most survey respondents also reported that text messages were easy to understand (100%), that the program made them knowledgeable of their risk of developing type 2 diabetes (88%) and more aware of their dietary and physical activity habits (89%). Also, 88% said they enjoyed participating in the program.
The txt4health initiative is a large, public health focused text message-based program that aims to raise type 2 diabetes risk awareness, as well as facilitate weekly weight and physical activity self-monitoring to lower diabetes risk. Both pilots were supported by the Office of the National Coordinator for Health Information Technology.
The program was led in Detroit by the Southeast Michigan Beacon Community and in Cincinnati by the Greater Cincinnati Beacon Collaborative. The groups launched txt4health as part of each citys campaign to educate the public about diabetes and prevention.
The researchers enrolled 1,838 participants in the program and asked them background questions to get personalized health tips and recommendations over 14 weeks. Overall, roughly 74% of participants completed the diabetes risk assessment, 89% tracked their weight and 55% reported their physical activity at least once during the program.
Text message programs may be a useful tool when used as a component in a broad-based public health campaign, Buis said. However, sole reliance on this strategy may be cautioned when targeting a general population because the level of individual engagement widely varies.
We need to further explore ways to improve retention rates among participants.
Studies: http://www.jmir.org/2013/12/e281/; http://www.jmir.org/2013/12/e282