Development of a Theoretically Driven mHealth Text Messaging Application for Sustaining Recent Weight Loss.

Abstract

Background

Mobile phone short message service (SMS) text messaging, has the potential to serve as an intervention medium to promote sustainability of weight loss that can be easily and affordably used by clinicians and consumers.

Objective

To develop theoretically driven weight loss sustaining text messages and pilot an mHealth SMS text messaging intervention to promote sustaining recent weight loss in order to understand optimal frequency and timing of message delivery, and for feasibility and usability testing. Results from the pilot study were used to design and construct a patient privacy compliant automated SMS application to deliver weight loss sustaining messages.

Methods

We first conducted a pilot study in which participants (N=16) received a daily SMS text message for one month following a structured weight loss program. Messages were developed from diet and exercise guidelines. Following the intervention, interviews were conducted and self-reported weight was collected via SMS text messaging.

Results

All participants (N=16) were capable of sending and receiving SMS text messages. During the phone interview at 1 month post-baseline and at 3 months post-baseline, 13/14 (93%) of participants who completed the study reported their weight via SMS. At 3 months post-baseline, 79% (11/14) participants sustained or continued to lose weight. Participants (13/14, 93%) were favorable toward the messages and the majority (10/14, 71%) felt they were useful in helping them sustain weight loss. All 14 participants who completed the interview thought SMS was a favorable communication medium and was useful to receive short relevant messages promptly and directly. All participants read the messages when they knew they arrived and most (11/14, 79%) read the messages at the time of delivery. All participants felt that at least one daily message is needed to sustain weight loss behaviors and that they should be delivered in the morning. Results were then used to develop the SMS text messaging application.

Conclusions

Study results demonstrated the feasibility of developing weight loss SMS text messages, and the development of an mHealth SMS text messaging application. SMS text messaging was perceived as an appropriate and accepted tool to deliver health promotion content.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.2196/mhealth.2343

Publication Info

Shaw, Ryan J, Hayden B Bosworth, Jeffrey C Hess, Susan G Silva, Isaac M Lipkus, Linda L Davis and Constance M Johnson (2013). Development of a Theoretically Driven mHealth Text Messaging Application for Sustaining Recent Weight Loss. JMIR mHealth and uHealth, 1(1). p. e5. 10.2196/mhealth.2343 Retrieved from https://hdl.handle.net/10161/30038.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Shaw

Ryan Shaw

Associate Professor in the School of Nursing

I lead teams that are shaping the future of healthcare through digital transformation. By applying a digital equity lens, we discover how to translate emerging technologies into innovative patient care models. My work has been funded by the US National Institutes of Health (NIH) and the National Science Foundation (NSF), among others.

In addition to research, I teach classes in health informatics and research methods, and mentor students and trainees to become the next generation of health scientists and clinicians.

Bosworth

Hayden Barry Bosworth

Professor in Population Health Sciences

Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)  at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities. 

Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.

Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy

Susan Gray Silva

Associate Research Professor in the School of Nursing

Dr. Silva is an Associate Research Professor in the Duke University School of Nursing and School of Medicine, with specialty training in neurobehavioral assessment, cognitive neuropsychology, and biostatistics. Within the PhD Program in the School of Nursing, Dr. Silva mentors students and teaches courses in General Linear Models, Generalized Linear Mixed Models, Mediator and Moderator Analyses, and Longitudinal Data Analysis. She also teaches a course in Quantitative Methods for Evaluating Health Care Practices course in the Doctor of Nursing Practices program and guides students in the design and analysis of quality improvement projects and implementation science studies.

Prior to joining the faculty in the School of Nursing in August 2009, Dr. Silva was a faculty statistician in the Clinical Trials Statistics Group and a mental health researcher in the Division of Neurosciences at Duke Clinical Research Institute (DCRI) and the Division of Medical Psychology in the Department of Psychiatry and Behavioral Sciences at Duke. While at DCRI, her focus was on the design and analysis of multi-center neuropsychiatric clinical trials.

Before coming to Duke in 1999, Dr. Silva was the Director of the Neurobehavioral Assessment Core and Associate Director of the Data Management & Biostatistics Core for the National Institute of Mental Health-funded Neuroscience Clinical Research Center at the University of North Carolina-Chapel Hill.

Dr. Silva served as the Statistical PI for the NIMH’s Treatment for Adolescents with Depression Study (TADS), NIMH’s Substance Use Outcomes Following Treatment for Adolescent Depression (SOFTAD) study, NIMH’s Child and Adolescent Psychiatry Trials Network (CAPTN). She was a statistical co-investigator for NIDA’s National Drug Abuse Treatment Clinical Trials Network (CTN), NICHD’s Reproductive Medicine Network (RMN), and SAMHSA’s National Center for Child Traumatic Stress. Dr. Silva has been a member of the NIMH's Data and Safety Board for Child and Adolescent Interventions and Health Services since 2002.

As a researcher and statistician, Dr. Silva's focus has been on the application of (1) multi-level mixed-effects trajectory models for longitudinal data, (2) ecological momentary assessment; (3) moderator and mediator analyses, and (4) structural equation modeling for complex moderated mediation analyses.
Lipkus

Isaac Marcelo Lipkus

Professor in the School of Nursing

Research Interests
Dr. Lipkus is interested in how risk perceptions, attitudinal, and dispositional variable (e.g., belief in a world) are related to modifying lifestyle behaviors such the prevention and detection of cancer, tobacco use, and physical activity.

Davis

Linda Lindsey Davis

Ann Henshaw Gardiner Distinguished Professor Emerita of Nursing

My research interests are grounded in my early experiences as an adult nurse practitioner and are around elder care,family stress, coping and adaptation, and methods and measures for clinical research around those issues.

Johnson

Constance Margaret Johnson

Associate Professor Emerita in the School of Nursing

Dr. Johnson is an Associate Professor with tenure and a health informatician with interdisciplinary training in nursing and health informatics, and is the Faculty Coordinator of the Systems Programs at the Duke University School of Nursing. She has a secondary appointment in the Department of Community and Family Medicine in the Duke University School of Medicine and is an adjunct associate professor at the University of Texas at Houston Health Science Center, School of Biomedical Informatics. She earned her BSN from the University of Connecticut and her MS and PhD from the School of Biomedical Informatics at the University of Texas at Houston. She has over 25 years of experience in research and informatics in the area of health promotion and disease prevention.

Dr. Johnson’s current research interests in health informatics include human-computer interaction, and how the representation and visualization of information impacts health care decisions in the area of disease prevention and health promotion. As a Primary Investigator, she has received research funding from the National Cancer Institute, National Library of Medicine, National Heart, Lung and Blood Institute, AHRQ, and RENCI. She is also a Co-Investigator and Co-PI on various other grants in the area of Health Informatics. Dr. Johnson also mentors Master’s, DNP, and PhD students.


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