Use of Text Messaging and Facebook Groups to Support the Healthy Children, Strong Families 2 Healthy Lifestyle Intervention for American Indian Families

Abstract

Background Few obesity interventions have been developed for American Indian (AI) families despite the disproportionate risk for obesity experienced within AI communities. The emergence of mobile technologies to enhance intervention delivery may particularly benefit AI communities, many of which are hard-to-reach and underserved. Objective This study aimed to assess the use and perceptions of text messaging and Facebook to support delivery of the Healthy Children, Strong Families 2 (HCSF2) mailed healthy lifestyle/obesity prevention intervention and discuss lessons learned regarding intervention support via these platforms among AI participants. Methods From among AI families with young children (2–5 years old), 450 adult/child dyads were recruited from five rural and urban communities for a year-long intervention. Intervention content was delivered by mail and supported by text messaging and optional Facebook groups. Participants provided feedback on text message and Facebook components post-intervention, and Facebook analytic data were tracked. Results Self-report feedback indicated high satisfaction with both text messaging and Facebook, with tangible content (e.g., recipes, physical activity ideas) cited as most useful. Overall, participants reported higher satisfaction with and perceived efficacy of Facebook content compared to text messaging. Analytic data indicate the optional HCSF2 Facebook groups were joined by 67.8% of adult participants. Among those who joined, 78.4% viewed, 50.8% “liked”, and 22.6% commented on one or more post. Engagement levels differed by urban-rural status, with more urban participants “liking” (P = 0.01) and commenting on posts (P = 0.01). Of note, nearly 1/3 of participants reported changing phone nubsmbers during the intervention. Conclusions This paper demonstrates high satisfaction regarding mobile delivery of HCSF2 intervention support components. Best practices and challenges in utilizing different mobile technologies to promote wellness among AI families are discussed, with particular focus on urban-rural differences. Future mobile-based interventions should consider the context of unstable technology maintenance, especially in low-resource communities. Clinicaltrials.gov ID: NCT01776255

The range of outcomes and outcome measurement instruments collected in multisectoral community‐based obesity prevention interventions in children: A systematic review

“…After full‐text screening, an additional 37 studies were identified. These included 20 studies 5,70–88 reporting 12 additional interventions and 17 studies 89–105 reporting outcomes from the interventions included in the review by Karacabeyli et al but those published after July 2017. The search of the clinical trial registries, the gray literature, and reference lists of included studies identified an additional 32 studies for inclusion in our review (Figure 1).…”

Text Messaging Intervention for Mental Wellness in American Indian and Alaska Native Teens and Young Adults (BRAVE Study): Analysis of User Engagement Patterns

“…Individual and community-level factors that likely influence engagement include phone ownership, network access, cost of devices, network infrastructure, and location [ 34 ]. One SMS intervention to support healthy lifestyle interventions among AI families reported different engagement levels based on urban and rural status, where urban participants liked and commented on posts more than rural participants [ 35 ] Phone number changes may also account for lower engagement. The Healthy Children, Strong Families 2 study reported that nearly one-third of AI participants changed their phone number during the intervention [ 35 ].…”