Feasibility and Effectiveness of an Automated Bilingual Text Message Intervention for Weight Loss: Pilot Study

Abstract

BackgroundLittle is known about the feasibility and acceptability of tailored text message based weight loss programs for English and Spanish-language speakers.ObjectiveThis pilot study evaluated the feasibility, acceptability, and estimated impact of a tailored text message based weight loss program for English and Spanish-language speakers. The purpose of this pilot study was to inform the development of a full-scale randomized trial.MethodsThere were 20 overweight or obese participants (mean age 40.10, SD 8.05; 8/20, 40% male; 9/20, 45% Spanish-speakers) that were recruited in San Diego, California, from March to May 2011 and evaluated in a one-group pre/post clinical trial. For 8 weeks, participants received and responded to 3-5 text messages daily sent from a fully automated text messaging system. They also received printed weight loss materials and brief 10-15 minute weekly counseling calls. To estimate the impact of the program, the primary outcome was weight (kg) measured during face-to-face measurement visits by trained research staff. Pre and post differences in weight were analyzed with a one-way repeated measures analysis of variance. Differences by language preference at both time points were analyzed with t tests. Body mass index and weight management behaviors also were examined. Feasibility and acceptability were determined by recruitment success, adherence (ie, percentage of replies to interactive text messages and attrition), and participant satisfaction.ResultsParticipants who completed the final assessment (N=18) decreased body weight by 1.85 kg (F 1,17=10.80, P=.004, CI∆ 0.66-3.03, η2=0.39). At both time points, there were no differences in weight by language preference. Participants responded to 88.04% (986/1120) of interactive text messages, attrition rate was 10% (2/20), and 94% (19/20) of participants reported satisfaction with the program.ConclusionsThis fully automated text message based weight program was feasible with English and Spanish-speakers and may have promoted modest weight loss over an 8-week period.Trial RegistrationClinicaltrials.gov NCT01171586; http://clinicaltrials.gov/ct2/show/NCT01171586 (Archived by WebCite at http://www.webcitation.org/6Ksr6dl7n).

Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial

“…In addition to chronic disease management, text message support has been used in the public health arena for smoking cessation programs (17), sex education, STD/HIV prevention (18), and adherence to sunscreen usage (19). Success with regard to weight loss has been shown in a domestic pilot study as well as in several studies in other countries (12,14,(19)(20)(21)(22)(23)(24)(25)(26). A recent study showed efficacy of text messaging in cardiac risk factor reduction in participants with cardiovascular disease (27).…”

Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

“…However, specific preferences for these technologies varied between participants. Male representation is highest in behavioral weight loss interventions involving minimal face-to-face contact such as mail, phone, tailored text message, e-mail, and the Internet; yet only 4% of interventions are delivered in this format (Kolodziejczyk et al, 2013; Morgan et al, 2011; Pagoto et al, 2012; Sabinsky, Toft, Raben, & Holm, 2007). While there is a concern that participation in mHealth programs may be limited due to financial constraints, 100% of the study sample owned cell phones and over three quarters used it to access the Internet and send text messages.…”

Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos

“…40 Our participants chose to receive messages in English or Spanish, similar to other bilingual interventions. 26,27 The few messages that were not already available in Spanish were translated by a native Spanish-speaking team member and reviewed by three other bilingual team members. Frequency and timing.…”

“…23 Given the novelty of the mobile messaging component of this intervention, we undertook a process evaluation. Prior research suggests that mobile messaging is acceptable among AA 15,22,24 and Latino populations, including monolingual Spanish speakers, [25][26][27] as well as older adults. 22,28 To our knowledge, this is the first multi-level, church-based intervention to use mobile messaging with both AA and Latino congregations, which presented the challenge of communicating in multiple languages and across cultural contexts.…”