Process evaluation of TXT2BFiT: a multi-component mHealth randomised controlled trial to prevent weight gain in young adults

Abstract

BackgroundTXT2BFiT was one of the first few innovative mHealth programs designed for young adults (18–35 years) with demonstrated efficacy in weight management. However, research is lacking to understand intervention effectiveness, especially in complex, multi-component mHealth programs. This paper investigates participant perceptions of and engagement with the mHealth program components in the TXT2BFiT to understand program effects.MethodsProcess evaluation data were collected continuously for the study duration. The TXT2BFiT program was a multi-component lifestyle program delivered intensively for 3-month followed by a 6-month maintenance phase. Program components included personalised coaching calls, text messages, emails, smartphone apps and website access. Process evaluation measures included frequency of use of components and frequency for number of components used (online survey data); dose delivered and engagement with program components (researcher logs and web platform reports); frequency, timing and difficulties experienced with program components (online survey data) and overall perceptions of program components (online survey data and semi-structured telephone interviews). Qualitative data analysis was performed using NVivo10.ResultsOver 80 % of participants completed post-intervention (3-months, intervention, n = 110, control n = 104) and follow-up surveys (9-months, intervention, n = 96, control n = 104). Thirty intervention participants completed semi-structured telephone interviews. Participants reported high use of coaching calls, text messages and emails and no issues in content delivery from these components. These components were described as helping them to achieve their goals. Website and app use and engagement was low for the duration of the program. Participants would prefer incorporation of the self-monitoring apps and website resources into one smartphone application that can be individualised by entry of their personal data.ConclusionsOur process evaluation has allowed a comprehensive understanding of use and preference for different program components. The high value placed on the coaching calls is consistent with a desire for personalisation of the mHealth program and even further tailoring of text messages and emails. The findings of this study will be used to revise TXT2BFiT for future users.Trial registrationThe trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000924853).

Fit4YAMs: Structuring a Lifestyle Intervention for Rural Overweight and Obese Young Adult Males Using Participatory Design

“…This metaanalysis included a wide range of studies targeting different health behavior activities and did not include YAMs. A recent Australian study of a text messaging nutrition intervention in urban adults aged 18e35 years [33] reported participant acceptance of eight text messages per week. The majority of participants in that study were young adult females from socioeconomically advantaged areas [33].…”

Women’s Perceptions of Participation in an Extended Contact Text Message–Based Weight Loss Intervention: An Explorative Study

“…Many do not access emails as frequently, and emails may be more associated with work and may not be as readily accessible if away from a computer or on holidays [21]. Some of the women preferred the support from telephone calls received in the initial intervention phase, as this enabled an easier two-way conversation.…”

Feasibility and impact study of a reward-based mobile application to improve adolescents’ snacking habits

“…Following previous process evaluations of mHealth interventions in adolescents and young adults, the process evaluation focused on reach and dose received (exposure and satisfaction) (65)(66)(67) . According to Saunders et al, 'reach' refers to degree to which the intended priority audience participates in the intervention; 'exposure' refers to the extent to which the participants use the intervention; and 'satisfaction' refers to the satisfaction of the participants with the programme (45,47) .…”