My Quest, a Community-Based mHealth Intervention to Increase Physical Activity and Promote Weight Loss in Predominantly Rural-Dwelling, Low-Income, Alabama Women.

Rural-dwelling, overweight/obese, limited-resource individuals and women have the lowest leisure-time physical activity rates among Americans. This community-based, single-group pre- posttest study sought to increase physical activity, step counts, and promote weight loss in 104 low-income women (84% rural). Analyses included nonparametric and repeated-measures analyses of variance to determine physical activity behaviors, step counts, and weight loss. Results show, from pre- to postintervention, participants improved self-reported step counts, physical activity goal setting and behaviors, and body weight. This study adds support that text message programs can reach a high-risk, limited-resource, predominantly rural population to promote physical activity and weight loss.

My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women.

OBJECTIVE: To evaluate changes in dietary and physical activity behaviors and weight after implementation of a 12-week text messaging initiative (My Quest). DESIGN: The researchers conducted a 1-group, pre- to posttest study design to determine changes after implementation of a text messaging initiative developed using the tenets of the Social Cognitive Theory. SETTING: A total of 55 Alabama counties (84% rural) with high rates of poverty, overweight/obesity, and chronic diseases. PARTICIPANTS: Convenience sample of low-income, primarily overweight/obese women (n = 104). INTERVENTION: Short texts (n = 2-3/d) provided health tips, reminders, and goal-setting prompts. Weekly electronic newsletters provided tips and recipes. Participant self-monitored body weight weekly. MAIN OUTCOME MEASURE: Outcomes included goal setting, self-efficacy, behavioral and environmental factors, self-monitoring, and body weight; data collection occurred through text message response and online surveys. ANALYSIS: Analyses were conducted using McNemar test (dichotomous data), Wilcoxon signed rank test (ordinal data), or paired t test (continuous data). RESULTS: Participants significantly (P < .05) improved dietary and physical activity behaviors and food environment; increased dietary and physical activity goal setting; and reduced body weight. CONCLUSIONS AND IMPLICATIONS: A low-cost, text messaging initiative particularly targeting women residing in rural communities with high rates of poverty and obesity can promote weight loss and improve dietary and physical activity behaviors. Future studies may include a control group and social support component such as group text messaging.