Personalized Coaching via Texting for Behavior Change to Understand a Healthy Lifestyle Intervention in a Naturalistic Setting: Mixed Methods Study (Preprint)

Abstract

BACKGROUND Digital health interventions (DHI) are considered affordable and scalable methods to support healthy lifestyle changes. OBJECTIVE This study explored the effectiveness of personalized SMS coaching for behavior change according to the COM-B model on a sample of physically inactive adults in a fitness organization in Sweden. METHODS The study used a mixed-methods design where the clients acted as their own controls. The participants were clients (n = 28) and fitness consultants (n = 12). Three types of data were collected: i) quantitative data at baseline and after the SMS intervention and the waitlist from the clients; ii) qualitative data from semi-structured interviews with the fitness consultants; and iii) pseudonymized SMS conversations between the fitness consultants and clients. RESULTS The overall results showed that personalized SMS were effective in supporting the clients’ behavior changes. The quantitative analysis showed how the clients’ capabilities (d = 0.50), opportunities (d = 0.43), and relationship to the fitness consultants (d = 0.51) improved during the SMS intervention in comparison to baseline. Further, the qualitative analysis revealed how personalized SMS added value to existing work methods (e.g., increasing continuity and flexibility), and how the relationship between the clients and fitness consultants changed during the intervention, which helped motivate the clients. CONCLUSIONS A conclusion from this study is that personalized SMS is an effective method to support healthy behavior changes. The human connection that emerged in the study, needs to be further explored in order to fully understand the effectiveness of DHI.