Designing Patient-Centered Text Messaging Interventions for Increasing Physical Activity Among Participants With Type 2 Diabetes: Qualitative Results From the Text to Move Intervention.
Designing Patient-Centered Text Messaging Interventions for Increasing Physical Activity Among Participants With Type 2 Diabetes: Qualitative Results From the Text to Move Intervention.
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DOI：
10.2196/mhealth.6666
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发表时间：
2017-04-24
影响因子：
5
通讯作者：
Lopez, Lenny
中科院分区：
文献类型：
--
作者：
Horner, Gabrielle N;Agboola, Stephen;Lopez, Lenny
背景技术背景：2型糖尿病（T2 DM）是一种影响美国约2910万人的疾病，另有8600万成年人患有前驱糖尿病。糖尿病自我管理教育是一种由7种行为组成的综合健康干预，可有效改善自我护理行为和血糖控制。研究已经采用短信进行教育，提醒和激励消息，可以作为“行动的线索”，旨在改善血糖监测，自我护理行为，预约出勤率和药物adherence. Adjectives：移动的文本（TTM）研究是一项为期6个月的2个平行组随机对照试验的个人与T2 DM，以增加体力活动，通过计步器测量。干预手臂收到短信每天两次，为6个月，是针对参与者的行为变化的阶段定义的transtheorical model of behaviorchanges.METHODS：我们评估了参与者的态度，他们的经验与短信，专注于感知障碍和促进者，通过两个焦点小组和电话采访。所有的采访录音，逐字转录，编码，并使用扎根理论approaches.RESULTS分析：响应率为67%（31/46参与者）。平均年龄为51.4岁，61%（19/31名参与者）为男性。大多数人会说英语，已婚，至少完成了12年级，大约一半的参与者有全职工作。总体而言，参与者对TTM计划感到满意，并回忆起短信作为教育，信息和激励。项目参与增加了他们与医疗保健中心的联系感。佩戴计步器和每日步数信息作为激励提醒，并通过哨兵效应创造了责任感。然而，文本信息程序的自动化令人沮丧，包括文本发送时间的重复性和可预测性，以及文本信息内容缺乏定制和互动性。参与者建议个性化的短信频率，以及更多的接触时间与人员更强的支持感，包括更大的监督和反馈的基础上，自己的结果和与其他参与者的比较。一种理论的参与者基于短信的干预确定了项目有效性的关键促进因素和障碍，应将其纳入未来的短信干预，以优化参与者满意度，试验登记：Clinicaltrials.gov NCT 01569243; http://clinicaltrials.gov/ct2/show/NCT01569243（由Webcite存档，网址为http：//www.webcitation.org/6pfH6yXag）。
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease affecting approximately 29.1 million people in the United States, and an additional 86 million adults have prediabetes. Diabetes self-management education, a complex health intervention composed of 7 behaviors, is effective at improving self-care behaviors and glycemic control. Studies have employed text messages for education, reminders, and motivational messaging that can serve as "cues to action," aiming to improve glucose monitoring, self-care behaviors, appointment attendance, and medication adherence.OBJECTIVES: The Text to Move (TTM) study was a 6-month 2-parallel group randomized controlled trial of individuals with T2DM to increase physical activity, measured by a pedometer. The intervention arm received text messages twice daily for 6 months that were tailored to the participant's stage of behavior change as defined by the transtheoretical model of behavior change.METHODS: We assessed participants' attitudes regarding their experience with text messaging, focusing on perceived barriers and facilitators, through two focus groups and telephone interviews. All interviews were audiorecorded, transcribed verbatim, coded, and analyzed using a grounded theory approach.RESULTS: The response rate was 67% (31/46 participants). The average age was 51.4 years and 61% (19/31 participants) were male. The majority of individuals were English speakers and married, had completed at least 12th grade and approximately half of the participants were employed full-time. Overall, participants were satisfied with the TTM program and recalled the text messages as educational, informational, and motivational. Program involvement increased the sense of connection with their health care center. The wearing of pedometers and daily step count information served as motivational reminders and created a sense of accountability through the sentinel effect. However, there was frustration concerning the automation of the text message program, including the repetitiveness, predictability of text time delivery, and lack of customization and interactivity of text message content. Participants recommended personalization of texting frequency as well as more contact time with personnel for a stronger sense of support, including greater surveillance and feedback based on their own results and comparison to other participants.CONCLUSIONS: Participants in a theory-based text messaging intervention identified key facilitators and barriers to program efficacy that should be incorporated into future texting interventions to optimize participant satisfaction and outcomes.TRIAL REGISTRATION: Clinicaltrials.gov NCT01569243; http://clinicaltrials.gov/ct2/show/NCT01569243 (Archived by Webcite at http://www.webcitation.org/6pfH6yXag).