Implementation of a text message intervention to promote behavioural change and weight loss among overweight and obese Brazilian primary care patients

J Telemed Telecare. 2019 Sep;25(8):476-483. doi: 10.1177/1357633X18782092. Epub 2018 Jun 27.

Abstract

Introduction: Mobile-technology-based interventions are promising strategies for promoting behavioural change in obese patients. The aims of this study were to evaluate the feasibility of implementing a text message intervention, and to assess the effects of the intervention on body mass index (BMI) and self-reported behavioural change.

Methods: TELEFIT was a three-phase feasibility study comprising the following stages: (a) the development of text messages; (b) testing; and (c) a quasi-experimental pilot study in which patients who were engaged in obesity/overweight educational groups in public primary care centres in Belo Horizonte, Brazil, were recruited. A bank of text messages was drafted and reviewed by an expert panel, text message delivery software was developed and tested, and a pilot study assessed patients before and after receiving the intervention using validated questionnaires and body measures. The data were analysed using the Wilcoxon test.

Results: A total of 46 patients completed the follow-up; 93.5% were women and the median age was 42 years (interquartile range (IQR) 34-52 years). At four months, participants had a significant reduction in BMI (median 31.3 (IQR 28.2-34.6) vs. 29.9 (IQR 27.2-34.6) kg/m2, p < 0.001), systolic (median 125 (IQR 120-132) vs. 120 (IQR 110-130) mmHg, p = 0.013) and diastolic blood pressure (median 80 (IQR 70-100) vs. 80 (IQR 70-80) mmHg, p = 0.006), when compared to baseline. All patients reported to be satisfied and willing to continue receiving the intervention, and 93.3% felt that the intervention helped them change their behaviours.

Discussion: This study has shown that a text message intervention to promote behavioural change and weight loss was feasible and effective in a short-term period. Participants were satisfied and willing to continue receiving the SMS messages.

Keywords: Overweight; SMS; eHealth; mHealth; mobile phone; obesity; text message.

MeSH terms

  • Adult
  • Body Mass Index
  • Brazil
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Obesity / psychology
  • Obesity / therapy*
  • Pilot Projects
  • Primary Health Care
  • Reminder Systems*
  • Text Messaging / statistics & numerical data*
  • Weight Loss*