scholarly journals Development and Preliminary Feasibility of iByte4Health: A Mobile Health (mHealth) Pediatric Obesity Prevention Intervention to Engage Parents with Low-Income of Children 2–9 Years

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4240
Author(s):  
Gina L. Tripicchio ◽  
Melissa Kay ◽  
Sharon Herring ◽  
Travis Cos ◽  
Carolyn Bresnahan ◽  
...  

This research describes the development and preliminary feasibility of iByte4Health, a mobile health (mHealth) obesity prevention intervention designed for parents with a low-income of children 2–9 years of age. Study 1 (n = 36) presents findings from formative work used to develop the program. Study 2 (n = 23) presents a 2-week proof-of-concept feasibility testing of iByte4Health, including participant acceptability, utilization, and engagement. Based on Study 1, iByte4Health was designed as a text-messaging program, targeting barriers and challenges identified by parents of young children for six key obesity prevention behaviors: (1) snacking; (2) physical activity; (3) sleep; (4) sugary drinks; (5) fruit and vegetable intake; and (6) healthy cooking at home. In Study 2, participants demonstrated high program retention (95.7% at follow-up) and acceptability (90.9% reported liking or loving the program). Users were engaged with the program; 87.0% responded to at least one self-monitoring text message; 90.9% found the videos and linked content to be helpful or extremely helpful; 86.4% found text messages helpful or extremely helpful. iByte4Health is a community-informed, evidenced-based program that holds promise for obesity prevention efforts, especially for those families at the increased risk of obesity and related disparities. Future work is warranted to test the efficacy of the program.

2020 ◽  
Vol 48 (5) ◽  
pp. 373-380
Author(s):  
Kasia Kulinski ◽  
Natalie A Smith

Many patients spend months waiting for elective procedures, and many have significant modifiable risk factors that could contribute to an increased risk of perioperative morbidity and mortality. The minimal direct contact that usually occurs with healthcare professionals during this period represents a missed opportunity to improve patient health and surgical outcomes. Patients with obesity comprise a large proportion of the surgical workload but are under-represented in prehabilitation studies. Our study piloted a mobile phone based, multidisciplinary, prehabilitation programme for patients with obesity awaiting elective surgery. A total of 22 participants were recruited via the Wollongong Hospital pre-admissions clinic in New South Wales, Australia, and 18 completed the study. All received the study intervention of four text messages per week for six months. Questionnaires addressing the self-reported outcome measures were performed at the start and completion of the study. Forty percent of participants lost weight and 40% of smokers decreased their cigarette intake over the study. Sixty percent reported an overall improved health score. Over 80% of patients found the programme effective for themselves, and all recommended that it be made available to other patients. The cost was A$1.20 per patient per month. Our study showed improvement in some of the risk factors for perioperative morbidity and mortality. With improved methods to increase enrolment, our overall impression is that text message–based mobile health prehabilitation may be a feasible, cost-effective and worthwhile intervention for patients with obesity.


Author(s):  
Nishal Anthony ◽  
Jennifer Molokwu ◽  
Ogechika Alozie ◽  
Diego Magallanes

Introduction: Attendance to clinic appointments and compliance with treatment plans are essential components of HIV/AIDS care. Compliance is especially important in young and minority individuals living with HIV/AIDS. We assessed the effectiveness of a text-based reminder system compared with usual care in improving the attendance to clinic and social work appointments at a Ryan White-funded clinic based in an academic institution. Methods: Convenience sample looking at 2 periods, 6 months before initiation of text messages and 6 months after initiation of text messages. Results: Following a 6-month postintervention period, we found a statistically significant reduction in our no-show rates (individuals failing to keep scheduled appointments) of 24.8% versus 17.7%, P value .05. Conclusion: Using an inexpensive online text messaging system, we were able to significantly decrease no-show rates in a primarily younger, low-income, and uninsured population.


10.2196/18583 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18583
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz

Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.


2020 ◽  
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz

BACKGROUND Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. OBJECTIVE In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. METHODS For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. RESULTS Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (<i>P</i>=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. CONCLUSIONS In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.


10.2196/12675 ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. e12675 ◽  
Author(s):  
LaHoma Smith Romocki ◽  
Andrea Des Marais ◽  
Leslie Cofie ◽  
Chelsea Anderson ◽  
Theresa Curington ◽  
...  

Background An estimated one in eight cervical cancer cases are due to a lack of follow-up care for abnormal Pap test results. Low rates of completion of follow-up care particularly affect low-income minority women. The burden of cervical cancer could be reduced through interventions that improve timely colposcopy follow-up and treatment of abnormal screening results. Mobile communications via text messaging present a low-cost opportunity to increase rates of clinic return among women referred to follow-up after obtaining abnormal screening results. Objective Our aims were to determine the acceptability and feasibility of using text messaging to increase completion of follow-up care following abnormal cervical cancer screening (Pap test) results and to examine factors that may affect the acceptability and use of text messaging to increase communications between health care providers (HCP) and low-income minority women. Methods The study participants were 15 low-income women who had undergone a Pap test within the preceding 12 months. Semistructured interviews, including open- and closed-ended questions from a validated questionnaire, were conducted by phone or in person. Responses to closed-ended survey items were tabulated, and descriptive statistics were generated using Microsoft Excel. Responses to the open-ended questions were coded and analyzed using NVivo 11 qualitative analysis software. Results Nearly all participants (14/15, 93%) were comfortable receiving a text message from an HCP stating that their Pap test results were available (<40 years: 100%; ≥40 years: 86%). Over half (8/15; 53%) of the participants were comfortable receiving a text message stating that their Pap test results were abnormal, although many preferred to receive such information via a phone call (6/15; 40%). Most participants (9/15; 60%) believed that receiving a text reminder would make them more likely to attend their appointment. The preferred method for receiving a reminder appeared to vary by age, with older women preferring telephone reminders over text messaging reminders. Analysis of open-ended questions suggested that text messaging appeals to some women due to its wide use and convenience for communicating with HCPs. However, women cited concerns about the confidentiality of messages and barriers to understanding the messages, including the physical capacity to read and accurately interpret the content of the messaging. Conclusions Most participants indicated a willingness to receive text messages from their HCPs about cervical cancer screening results and believed that text messages were the best way to remind them of appointments for follow-up care. Potential concerns could be addressed by excluding explicit references to the nature of the appointment in the text message in order to avoid disclosure of sensitive health information to unauthorized individuals. Although text messaging seems promising to improve adherence to timely follow-up, personal preferences should be considered by allowing patients to opt-out of text communications.


2015 ◽  
Vol 2 (1) ◽  
pp. e4 ◽  
Author(s):  
Matthew A Broom ◽  
Amy S Ladley ◽  
Elizabeth A Rhyne ◽  
Donna R Halloran

Background Postpartum depression (PPD) is the most common medical problem among new mothers that can have a negative impact on infant health. Traditional treatments are often difficult for low-income mothers to complete, particularly given the numerous barriers families face. Objective Among low-income, primarily racial, and ethnic minority mothers with postpartum depression, our aim was to evaluate (1) the feasibility of sending supportive text messages, and (2) the perception of receiving private, supportive text messages for postpartum depression. Methods Mothers found to be at risk for postpartum depression received supportive text messages four times weekly for 6 months in addition to receiving access to traditional counseling services based within an academic pediatric office. Feasibility was evaluated along with cellular and text messaging use, access, and perception of the message protocol. Perception of the message protocol was evaluated at study completion via a Likert scale questionnaire and open-ended qualitative survey. Results In total, 4158/4790 (86.81%) text messages were successfully delivered to 54 mothers over a 6-month period at a low cost (US $777.60). Among the 96 scripted messages, 37 unique messages (38.54%) allowed for a response. Of all sent messages that allowed for responses, 7.30% (118/1616) were responded to, and 66.1% of those responses requested a call back; 46% (25/54) of mothers responded at least once to a text message. Mothers felt that messages were easily received and read (25/28, 89%) and relevant to them personally (23/28, 82%). Most shared texts with others (21/28, 75%). Conclusions Text messaging is feasible, well-accepted, and may serve as a simple, inexpensive adjunct therapy well-suited to cross socioeconomic boundaries and provide private support for at-risk mothers suffering from postpartum depression.


2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Leonard M. Lopoo ◽  
Colleen Heflin ◽  
Joseph Boskovski

We report results from a series of randomized controlled trials (RCTs) run between January 2019 and February 2020 testing behavioral interventions designed to increase the likelihood that SNAP recipients recertify on-time in Hennepin County, the most populous county in Minnesota. Given the different levels of governance and the abundance of qualifying rules and processes that low-income households must negotiate to obtain and retain SNAP food assistance benefits, many households may fail to recertify for SNAP. Administrative burden includes the difficulties created by having to learn deadlines and which forms constitute the proper paperwork necessary to recertify. In our main intervention, we test a three-armed study (n=23,756), comparing the efficacy of the Hennepin County SNAP recertification auto-dialer communication, a behaviorally-informed text message, and a third arm with both the Hennepin county autodialer and our text message, against a control group that did not receive any reminder at the beginning of the recertification month but did receive other standard written communications. Results from this trial show that the autodialer is not an effective reminder. However, the interventions with text messages are effective in improving recertification rates around five percent (p<0.01) over no additional message and around two percentage points (p<0.05) over the Hennepin County autodialer message currently being used. Text messaging appears to be particularly effective for SNAP recipients under the age of 60 with low to moderate levels of education.


2019 ◽  
Vol 13 (4) ◽  
pp. 709-712 ◽  
Author(s):  
Krzysztof Goniewicz ◽  
Frederick M. Burkle

ABSTRACTObjectiveThe increased risk of mass accidents or major catastrophes taking place necessitates the organization of remedial measures to help protect against these unusual events and adequate preparation in order to minimize their effects. One such initiative is the early notification of residents within a specific area about the risk of a particular calamity. Nowadays, the prevalence of mobile devices enables the installation of various mobile applications allowing for the communication and receiving of information about potential dangers. In many countries there are variously developed systems of notification in place based specifically on text messages.MethodsCurrently, new laws introduced in Poland establish that it is the obligation of operators of mobile networks to send text messages to all customers of these networks who are within the area where there is a serious risk of a catastrophe. Such messages are in the form of a short alert, to be sent only in extraordinary situations when there is an immediate threat to health or life. The alert is intended to help in the avoidance of danger or to mitigate its impact.ResultsThis article presents the potential implementation of the early warning system based on text message alerts in Poland, and in particular focuses on decreasing the risks associated with natural disasters.ConclusionsWhile early text messaging is essential to disaster communications and mitigation, the article further states that means must be found to ensure equal access to the most vulnerable populations and all those, vulnerable and not, who do not have immediate access to text messaging systems. (Disaster Med Public Health Preparedness. 2019;13:709–712)


2019 ◽  
Author(s):  
Megan Partch ◽  
Cass Dykeman

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.


Author(s):  
Andrea A. Joyce ◽  
Grace M. Styklunas ◽  
Nancy A. Rigotti ◽  
Jordan M. Neil ◽  
Elyse R. Park ◽  
...  

The impact of the COVID-19 pandemic on US adults’ smoking and quitting behaviors is unclear. We explored the impact of COVID-19 on smoking behaviors, risk perceptions, and reactions to text messages during a statewide stay-at-home advisory among primary care patients who were trying to quit. From May–June 2020, we interviewed smokers enrolled in a 12-week, pilot cessation trial providing text messaging and mailed nicotine replacement medication (NCT04020718). Twenty-two individuals (82% white, mean age 55 years), representing 88% of trial participants during the stay-at-home advisory, completed exit interviews; four (18%) of them reported abstinence. Interviews were thematically analyzed by two coders. COVID-19-induced environmental changes had mixed effects, facilitating quitting for some and impeding quitting for others. While stress increased for many, those who quit found ways to cope with stress. Generally, participants felt at risk for COVID-19 complications but not at increased risk of becoming infected. Reactions to COVID-19 and quitting behaviors differed across age groups, older participants reported difficulties coping with isolation (e.g., feeling disappointed when a text message came from the study and not a live person). Findings suggest that cessation interventions addressing stress and boredom are needed during COVID-19, while smokers experiencing isolation may benefit from live-person supports.


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