Process of developing text messages on healthy eating and physical activity for Chilean mothers with overweight or obese preschool children to be delivered via WhatsApp

Parra, Solange; Ortega, Alejandra; Kanter, Rebecca; Kain, Juliana

doi:10.1080/23311886.2018.1521057

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…This paper describes in detail the process for designing and validating the content of an mHealth intervention that utilizes an adaptive learning algorithm to deliver optimized and tailored motivational text messages that promote physical activity. Previous studies have utilized similar methods to inform health text messaging development, such as message drafting based on behavior change theory [16,23] and public health guidelines [18], survey responses of participants' preferences [23], focus groups and expert evaluation [18], and end user ratings of content understanding and appeal [16]. However, the process described herein is unique in that it integrates various design methods previously reported in literature and incorporates crowdsourcing via MTurk as an alternative content pretesting method.…”

Section: Future Directionsmentioning

confidence: 99%

“…Among the published health text messaging studies that describe their content design processes, there is great variability in the methods utilized. Researchers have reported the development of messaging based on public health guidelines [18][19][20][21], health education curricula [14,22], theoretical models [16,18,20,21,23], findings from quantitative surveys or focus groups [16,18,19,21,23,24], evaluation by members of the research team or outside experts [16,18,20,22], and pilot testing within a subset of the target population [19,20,25]. Thus, this study aims to integrate various methods such as participant feedback, pilot testing, crowdsourcing, and expert knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Developing Messaging Content for a Physical Activity Smartphone App Tailored to Low-Income Patients: User-Centered Design and Crowdsourcing Approach

Pathak¹,

Aguilera²,

Williams³

et al. 2021

JMIR Mhealth Uhealth

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Background Text messaging interventions can be an effective and efficient way to improve health behavioral changes. However, most texting interventions are neither tested nor designed with diverse end users, which could reduce their impact, and there is limited evidence regarding the optimal design methodology of health text messages tailored to low-income, low–health literacy populations and non-English speakers. Objective This study aims to combine participant feedback, crowdsourced data, and researcher expertise to develop motivational text messages in English and Spanish that will be used in a smartphone app–based texting intervention that seeks to encourage physical activity in low-income minority patients with diabetes diagnoses and depression symptoms. Methods The design process consisted of 5 phases and was iterative in nature, given that the findings from each step informed the subsequent steps. First, we designed messages to increase physical activity based on the behavior change theory and knowledge from the available evidence. Second, using user-centered design methods, we refined these messages after a card sorting task and semistructured interviews (N=10) and evaluated their likeability during a usability testing phase of the app prototype (N=8). Third, the messages were tested by English- and Spanish-speaking participants on the Amazon Mechanical Turk (MTurk) crowdsourcing platform (N=134). Participants on MTurk were asked to categorize the messages into overarching theoretical categories based on the capability, opportunity, motivation, and behavior framework. Finally, each coauthor rated the messages for their overall quality from 1 to 5. All messages were written at a sixth-grade or lower reading level and culturally adapted and translated into neutral Spanish by bilingual research staff. Results A total of 200 messages were iteratively refined according to the feedback from target users gathered through user-centered design methods, crowdsourced results of a categorization test, and an expert review. User feedback was leveraged to discard unappealing messages and edit the thematic aspects of messages that did not resonate well with the target users. Overall, 54 messages were sorted into the correct theoretical categories at least 50% of the time in the MTurk categorization tasks and were rated 3.5 or higher by the research team members. These were included in the final text message bank, resulting in 18 messages per motivational category. Conclusions By using an iterative process of expert opinion, feedback from participants that were reflective of our target study population, crowdsourcing, and feedback from the research team, we were able to acquire valuable inputs for the design of motivational text messages developed in English and Spanish with a low literacy level to increase physical activity. We describe the design considerations and lessons learned for the text messaging development process and provide a novel, integrative framework for future developers of health text messaging interventions.

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Section: Future Directionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developing Messaging Content for a Physical Activity Smartphone App Tailored to Low-Income Patients: User-Centered Design and Crowdsourcing Approach

Pathak¹,

Aguilera²,

Williams³

et al. 2021

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…(a) Preferred message dissemination approaches. Seven studies discussed parents’ preferred PA message dissemination approaches which included: multi-platform dissemination approaches [ 34 , 50 , 52 ] including both digital (i.e., social media, apps, websites) and traditional (i.e., brochures, magazines, television, or radio) forms of dissemination [ 34 , 53 ], text messaging [ 54 , 55 ], and unique forms dissemination (e.g., storybooks, community “parent nights”) [ 50 , 51 ]. Regardless of dissemination method, parents prefer to receive messages from credible sources such as community centres, public health institutions, schools, doctors, or government agencies [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review

Larocca

Arbour-Nicitopoulos

Tomasone

et al. 2021

IJERPH

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Background: Physical activity (PA) messages have demonstrated success in targeting parent support for PA. However, little research exists to inform the development and dissemination of optimally effective PA messages targeting parents. A synthesis of existing literature is necessary to inform message development and dissemination strategies. Unique considerations for parents of children with disabilities (CWD) should be identified given a need for inclusive PA messaging that consider the needs of CWD and their families. Methods: Systematic scoping methodologies included a peer-reviewed literature search and expert consultation to identify literature regarding PA messages targeting parents, and considerations for parents of CWD. Results: Thirty-four articles that met eligibility criteria were included for examination. Twenty-eight studies were identified regarding the PA messages targeting parents; six themes and 12 subthemes emerged from these articles. Six studies were identified regarding unique considerations for parents of CWD; three themes and four subthemes emerged from these articles. Conclusions: Through knowledge synthesis, this research can contribute to a knowledge translation process to inform practice guidelines for the development and dissemination of PA messages targeting parents, while also providing unique considerations for PA messages targeting parents of CWD.

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“…The South African DPP (SA-DPP) intervention strategy attempts to overcome the issue of scalability by employing a low-intensity group-based lifestyle modification program supported by the delivery of a short messaging service (SMS) to prevent diabetes in South Africa. Although text messaging to encourage behavior change is becoming more popular, Willoubhy et al (2015) [14], Abroms et al (2015) [15], and Para et al (2018) [16] have noted that the development and pretesting of these text messages have been unclear. These authors highlight the underreporting and underdevelopment of these text messages, i.e., the scarcity of publications documenting the process as well as the lack of rigor in the development process of those published [14].…”

Section: Introductionmentioning

confidence: 99%

“…Also, research investigating text messaging in low-income countries is specifically scarce [13]. This study was thus informed by recommendations from authors who recognized the gap in the reporting of the development and pretesting of text messages for health behavior change [13][14][15][16]. The authors' recommendations included conducting formative research, message development, pretesting, and validation as well as piloting.…”

Section: Introductionmentioning

confidence: 99%

The Development of Text Messages to Support People at Risk of Diabetes in Low-Resourced Communities: The South African Diabetes Prevention Programme

Hill,

Faber,

George

et al. 2023

Nutrients

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Emerging evidence suggests that the addition of text messages to standard healthy lifestyle interventions may improve the outcomes of diabetes prevention programs (DPP). This paper describes the process of developing text messages targeting behavior change in people at risk of developing diabetes in low-resourced communities as part of the South African DPP (SA-DPP). The development comprised multiple steps led by nutrition and physical activity experts. The steps included the following: (1) text message development based on the existing SA-DPP curriculum and its formative research; (2) text message evaluation for readability/understandability in terms of content, language, and quality, with 75 participants from two low-resourced areas in Cape Town; (3) text message refinement by the expert panel; (4) evaluation of the refined text messages by participants from Step 2; and (5) text bank finalization. Based on the readability survey, 37 of the 67 formulated text messages [24 of the 44 encouraged healthy eating, and 13 of the 23 promoted physical activity] were refined. Based on focused discussions with participants, seven more messages were refined to consider alternative terminology. The final text bank includes a total of 67 messages comprising topics related to fruit and vegetable consumption as well as the importance of having variety in the diet (n = 15), limiting fat intake (n = 10), avoiding sugar (n = 11), avoiding salt (n = 5), promoting fiber-rich foods (n = 1), messages promoting physical activity (n = 21), and general check-in messages (n = 4). Most of the text messages were acceptable, understandable, and largely feasible to all participants, with some of the nutrition-related messages being less feasible for participants due to their socioeconomic position. The next step is to assess the text messages in the SA-DPP intervention trial.

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Process of developing text messages on healthy eating and physical activity for Chilean mothers with overweight or obese preschool children to be delivered via WhatsApp

Cited by 5 publications

References 19 publications

Developing Messaging Content for a Physical Activity Smartphone App Tailored to Low-Income Patients: User-Centered Design and Crowdsourcing Approach

Developing Messaging Content for a Physical Activity Smartphone App Tailored to Low-Income Patients: User-Centered Design and Crowdsourcing Approach

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review

The Development of Text Messages to Support People at Risk of Diabetes in Low-Resourced Communities: The South African Diabetes Prevention Programme

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