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Title: Texting to increase physical activity among teenagers (TXT Me!): Rationale, design, and methods proposal

Author
item Thompson, Deborah - Debbe
item Cantu, Dora - Children'S Nutrition Research Center (CNRC)
item Bhatt, Riddhi - Baylor College Of Medicine
item Baranowski, Tom - Children'S Nutrition Research Center (CNRC)
item Rodgers, Wendy - University Of Alberta
item Jago, Russell - University Of Bristol
item Anderson, Barbara - Baylor College Of Medicine
item Liu, Yan - Children'S Nutrition Research Center (CNRC)
item Mendoza, Jason - University Of Washington
item Tapia, Ramsey - Archimage, Inc
item Buday, Richard - Archimage, Inc

Submitted to: Journal of Medical Internet Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/4/2014
Publication Date: 3/12/2014
Citation: Thompson, D.J., Cantu, D., Bhatt, R., Baranowski, T., Rodgers, W., Jago, R., Anderson, B., Liu, Y., Mendoza, J.A., Tapia, R., Buday, R. 2014. Texting to increase physical activity among teenagers (TXT Me!): Rationale, design, and methods proposal. Journal of Medical Internet Research. 3(1):e14.

Interpretive Summary: Teenagers are not meeting national recommendations for physical activity. This increases their risk of developing obesity and related diseases. Effective methods to increase their daily physical activity in an effective, sustainable manner are needed. This paper reports the rationale, design, and methods for a text-message based intervention to increase the number of steps teenagers take each day. If proven effective, this would be a low-cost, sustainable method for helping teenagers become more physically active in a potentially sustainable manner using an appealing and convenient communication method.

Technical Abstract: Physical activity decreases from childhood through adulthood. Among youth, teenagers (teens) achieve the lowest levels of physical activity, and high school age youth are particularly at risk of inactivity. Effective methods are needed to increase youth physical activity in a way that can be maintained through adulthood. Because teens text a great deal, text messages promoting walking, a low cost physical activity, may be an effective method for promoting sustainable physical activity. The objective of our study was to determine the effect of pedometers, self selected step goals, and texts grounded in the self-determination theory (SDT) on physical activity among the teens. "TXT Me!" was a 12 week intervention that texted 14-17 year olds to increase their daily physical activity by increasing the number of steps they take each day. The intervention was grounded in the SDT. Formative research with the teens helped construct the intervention and develop the texts. A total of 84 texts were developed (12 to set a step goal, and 72 promoting autonomy, competence, and relatedness). The pilot evaluation used a four group, randomized design (n=160). After baseline data collection, the participants were randomized to one of four conditions (no treatment control, pedometer only, pedometer + weekly prompts, pedometer + weekly prompts + SDT grounded texts). Data were collected at baseline and immediately upon completion of the study. The primary outcome was physical activity, measured by 7 days of accelerometry. Basic psychological needs, physical activity motivation, process evaluation, and program satisfaction data were also collected. To our knowledge, this is one of the first studies to explore the use of stand alone, SDT grounded texts, supported by pedometers and prompts to set a self selected step goal, as a method for increasing physical activity among teens. This pilot study will contribute valuable information regarding whether theoretically grounded text messages show promise as an effective method to increase physical activity among teens.