Use of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part I): assessment of participant reach and adoption.
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Date
2013-12-20
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Abstract
BACKGROUND There are an estimated 25 8 million American children and adults equivalent to 8 3 of the US population living with diabetes Diabetes is particularly burdensome on minority populations The use of mobile technologies for reaching broad populations is a promising approach given its wide footprint and ability to deliver inexpensive personalized messages to increase awareness of type 2 diabetes and promote behavior changes targeting risk factors associated with type 2 diabetes As a part of the Beacon Community Cooperative Agreement Program txt4health a public facing mobile health information service was launched in 3 Beacon Communities the Southeast Michigan Beacon Community in Detroit MI the Greater Cincinnati Beacon Community in Cincinnati OH and the Crescent City Beacon Community in New Orleans LA Txt4health is a mobile health information service designed to help people understand their risk for type 2 diabetes and become more informed about the steps they can take to lead healthy lives OBJECTIVE The purpose of this investigation was to use the RE AIM framework to document txt4health reach and adoption by focusing on enrollment and participant engagement in program pilots in Southeast Michigan and Greater Cincinnati METHODS We conducted a retrospective records analysis of individual level txt4health system data from participants in Southeast Michigan and Greater Cincinnati to determine participant usage of txt4health and engagement with the program RESULTS Results from the retrospective records analysis revealed that 5570 participants initiated the 2 step enrollment process via 1 of 3 enrollment strategies text message website or directly with Beacon staff who signed participants up via the website In total 33 00 1838 5570 of participants completed the 2 step enrollment process and were fully enrolled in the program All participants 100 00 1620 1620 who enrolled via text message completed the entire 2 step enrollment process versus 5 52 218 3950 of participants who enrolled via website or a Beacon staff member Of those who fully enrolled 71 00 1305 1838 completed the diabetes risk assessment and 74 27 1365 1838 set an initial weight loss goal Overall 39 06 718 1838 of participants completed all 14 weeks of the program and 56 26 1034 1838 dropped out before completing all 14 weeks with the bulk of dropouts occurring in the first 4 weeks Length of participation varied greatly ranging from 0 48 7 weeks median 8 6 mean 15 8 SD 15 8 Wide variability of participant engagement in regards to weekly weight and physical activity was documented CONCLUSIONS Although broadly focused public health text message interventions may have the potential to reach large populations and show high levels of engagement among some users the level of individual engagement among participants varies widely suggesting that this type of approach may not be appropriate for all
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Keywords
Adult, At risk for a particular disease or infection, Client, Access to information or data, Alignment with local norms, Addressing individual beliefs and practices, Pilot, Efficacy, Individual based, Diabetes, Preventive, Mass messaging campaigns, Health education or promotion, SMS, Text