Use of text messaging to motivate exercise in latinos with one or more atherosclerotic risk factors: two pilot studies
Collins, Tracie C.
Rogers, Nicole L.
Ahlers-Schmidt, Carolyn R.
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Collins, Tracie C.; Dong, Fandong; Ablah, Elizabeth; Parra-Medina, Deborah; Cupertino, Paula; Rogers, Nicole L.; Ahlers-Schmidt, Carolyn R. 2014. Use of text messaging to motivate exercise in latinos with one or more atherosclerotic risk factors: two pilot studies. Journal of General Internal Medicine, vol. 29:no. 1:Supplement, April 2014:pp S245-S246
BACKGROUND: Text messaging offers an innovative approach to motivate behavior change and improve control of atherosclerotic risk factors in adult Latinos. We conducted two pilot studies: 1) to determine cell phone and text message usage among Latinos with one or more atherosclerotic risk factors (e.g. age 50–69 years with diabetes mellitus or a history of smoking; hypertension, or hyperlipidemia) and 2) to determine the efficacy of a motivational counseling script, delivered via text messaging, to improve the use of exercise among Latinos with one or more atherosclerotic risk factors. METHODS: We administered a 15-item survey to Latino adults with one or more atherosclerotic risk factors. For an additional sample of Latino adults with one or more JGIM ABSTRACTS S245atherosclerotic risk factors, we conducted a six-week, pre- and post-trial intervention. As part of the six-week trial, we ascertained stage of readiness to engage in exercise, which is a component of the original motivational script -Patient-centered Assessment and Counseling for Exercise (PACE) protocol - and exercise behavior scores (Exercise Behavior Questionnaire). Stage of readiness to exercise is based on the Transtheoretical Model and participants receive a score of one for precontemplation, a score of two to four for contemplation, and a score of five to eight for action/maintenance. Based on a participant’s stage of readiness to exercise score, he/she received text messages. Text messages were sent once per day, 5 days per week for 6 weeks. RESULTS: Among the 82 persons who completed the survey, (mean age 49.2, SD 12.0 years), 96.3 % owned a cellphone, 91.3 % had texting capacity on their cellphones, and 82.1 % had unlimited text messaging. More than 90 % received and sent text messages daily. Further, of those with text messaging capability, 89.2 % received at least one text message daily, and 52.7 % received five or more text messages daily, For the six-week trial, the mean age of the 13 participants was 49.2 years (SD 11.9). All 13 participants received their text messages. At baseline, the mean PACE score was 2.64 (0.67) out of a maximum score of 8 and this increased to 5.36 (0.81) at 6 weeks (P<0.001). At baseline, the mean exercise behavior score was 55.91 (55.76) minutes of exercise per week and this increased to 201.82 (61.61) minutes of exercise per week at 6 weeks (P<0.0003) CONCLUSIONS: Use of cell phones and text messaging is common among Latinos with one or more atherosclerotic risk factors. Further, delivering a behavioral change intervention via text messaging is feasible and potentially efficacious to improve stage of readiness to engage in exercise as well as exercise behaviors among Latinos with one or more atherosclerotic risk factors.
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