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
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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DOI：
10.2196/jmir.2928
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发表时间：
2013-12-01
影响因子：
7.4
通讯作者：
Bondurant, Patricia
中科院分区：
文献类型：
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作者：
Buis, Lorraine R.;Hirzel, Lindsey;Bondurant, Patricia
据估计，美国有2580万儿童和成人患有糖尿病，相当于美国人口的8.3%。糖尿病对少数民族人口的负担尤其沉重。使用移动的技术覆盖广大人群是一种很有前途的方法，因为它具有广泛的足迹和提供廉价个性化信息的能力，可以提高对2型糖尿病的认识，并促进针对与2型糖尿病相关的风险因素的行为改变。作为Beacon社区合作协议计划的一部分，面向公众的移动的健康信息服务txt 4 health在3个Beacon社区推出：密歇根州底特律市的东南密歇根州Beacon社区，俄亥俄州辛辛那提市的大辛辛那提Beacon社区和路易斯安那州新奥尔良市的新月市Beacon社区。Txt 4 health是一种移动的健康信息服务，旨在帮助人们了解他们患2型糖尿病的风险，并更了解他们可以采取的健康生活步骤。目的：本调查的目的是使用RE-AIM框架，通过关注密歇根州东南部和大辛辛那提地区项目试点的注册和参与者参与情况，记录Txt 4 health的覆盖范围和采用情况。我们对密歇根州东南部和大辛辛那提参与者的个人层面的txt 4健康系统数据进行了回顾性记录分析，以确定参与者对txt 4健康的使用情况和参与该计划的情况。结果如下：回顾性记录分析的结果显示，5570名参与者通过以下3种入组策略之一启动了2步入组流程：短信、网站或直接与通过网站注册参与者的Beacon工作人员联系。总共有33.00%（1838/5570）的参与者完成了两步入组过程，并完全入组了该计划。所有通过短信注册的参与者（100.00%，1620/1620）完成了整个两步注册流程，而通过网站或Beacon工作人员注册的参与者中有5.52%（218/3950）完成了整个两步注册流程。在完全入组的患者中，71.00%（1305/1838）完成了糖尿病风险评估，74.27%（1365/1838）设定了初始减肥目标。总体而言，39.06%（718/1838）的参与者完成了所有14周的计划，56.26%（1034/1838）在完成所有14周之前退出，大部分退出发生在前4周。参与时间长短差异很大，范围为0-48.7周（中位数8.6，平均值15.8，SD 15.8）。广泛的变化参与者的参与方面每周的体重和体力activitywere documented.Conclusions：虽然广泛集中的公共卫生短信干预措施可能有潜力达到大量的人群，并显示高水平的参与在一些用户之间，参与者之间的个人参与程度差异很大，这表明这种类型的方法可能不适合所有人。
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.